The Do's & Don'ts of Retraining Your Bladder
The Do's & Don'ts of Retraining Your Bladder
Are you looking for ways to limit bladder leaks and get your bladder back on track? While bladder leaks happen for a variety of reasons, doctors often recommend bladder retraining for people leaking urine. The pelvic floor muscles are just like any other muscle in the body and can be trained and retrained over time. This pelvic floor muscle training works with reflexes in your body to delay and better control urinary urges and can help manage increases in intraabdominal pressure that can lead to bladder leaks.
To start, record important details about your food and drink intake, plus your trips to the bathroom, in a journal. Make sure to record how many seconds you pee each time (hint: it should be a minimum of 8 seconds every time) as well as record your bowel movements. This “bladder diary” will help you determine if your bladder retraining exercises are working, along with identifying any triggers causing bladder leaks, so you can better understand your body.
How to keep a bladder diary:
Start with a baseline.
Record what time you urinate, if you were able to fully empty your bladder, and when you leak throughout the day. It’s best to record daily diary entries starting from the moment you wake up in the morning until you go to bed at night. Make a note if you wake at night to pee as well (a condition known as Nocturia). It’s also important to record if you leaked with a specific activity or if it was associated with a strong urge to urinate but you didn’t make it to the toilet in time.
Determine how many minutes or hours you typically wait in between urination during the day.
Increase the amount of time you wait to urinate by at least 5 minutes, working up to 15 minutes or longer. For example, if you typically urinate every hour, then you would wait one hour and 5-15 minutes before urinating again. If you are already able to delay more than 2 hours consistently between trips to the bathroom, this section doesn’t apply to you.
Stick to your schedule.
Start your morning by emptying your bladder and then start your interval routine for the remainder of the day. Even if you have the urge to urinate, try to stick with your interval schedule. If the urge to urinate is too strong, empty your bladder and start your interval again. Remaining as consistent as possible will help you stay on track for positive results.
As your body becomes accustomed to the interval schedule you have set for yourself over time, continue to increase your interval length over a period of weeks and months to decrease urination frequency and urgency. Urinating 6-7 times a day is a great goal to strive for because that is the average number of times people urinate a day. Urinating anywhere from 4-10 times a day can also be normal, it just depends on your body.
Record patterns or key observations.
As you try out new intervals and work on urination frequency, record anything that might be important for you to look back on later.
Similar to exercising your body through cardio or strength training, you can incorporate different exercises or techniques designed to strengthen your pelvic floor muscles, gain more control over your bladder and reduce bladder leaks.
Top tips for how to retrain your bladder include:
Visit a licensed pelvic floor physical therapist.
An expert can help you build a personalized bladder retraining plan. A pelvic floor therapist will take the time to create a routine that works for you, as well as offer support and advice throughout your bladder training journey. Pelvic health physical therapists assess how well the pelvic floor muscle functions and can treat patients through pelvic floor biofeedback, muscle coordination training, breathing techniques, behavioral retraining and progressive loading exercises.
Schedule bathroom visits.
Taking the time to schedule bathroom visits, such as using the interval system outlined above, helps the bladder to better sense how much urine is present and whether or not you truly need to urinate. This leads to a decrease in urination urgency and frequency. Remaining on a schedule will help you see results and be a good indicator of your progress over a period of time.
At-home pelvic floor exercises.
Kegel exercises paired with other effective pelvic floor exercises take just a few minutes per day and can help strengthen the pelvic floor to better manage urination urges.
What NOT to do when retraining your bladder:
Don’t give up!
It can be hard to retrain your bladder and adjust to a new schedule. Go easy on yourself and keep trying if things get tough.
Don’t pee whenever you have the urge.
Try your hardest to stick to your urination schedule. It can be hard resisting the urge but overtime it will get easier and you’ll have to urinate less frequently.
It can take between 6-12 weeks before you can accomplish your bladder retraining goal. Setbacks are normal, so don’t be discouraged! I recommend using Poise® Ultra Thin Pad with Wings for days where you are concerned that leaks might get in the way. Wearing a pad specifically designed for urine will keep you ten times drier than the leading period pad and helps manage leaks as your body adjusts to new urination intervals.
Retraining a muscle gives you back control of your urination frequency and decreases sudden uncomfortable urges. Different retraining methods work for different people, so whether you prefer keeping a bladder diary or working with a pelvic health physical therapist, or both, finding the right method for you will get you back on track and feeling confident again when it comes to your bladder.
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Author Summary: Dr. Heather Jeffcoat,DPT, Pelvic Health Physical Therapist is the founder of Fusion Wellness & Femina Physical Therapy(FeminaPT.com).Her work focuses on pelvic and sexual health education for all, and she lectures internationally on Female Sexual Dysfunction and chronic pelvic pain. She is also the author of Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve.