If you are like most moms, chances are you have experienced a change in your bladder habits since being pregnant and/or postpartum.
Maybe you started going to the bathroom a few times per hour?
Maybe you can’t leave the house without running to the bathroom before you get the kids in their carseats?
Or even worse…
Maybe you can’t come back to your house without doing the pee-pee dance while fumbling your house keys?
Maybe you have been doing what your friend’s neighbor’s sister said and have been doing a million kegels every day but still can’t laugh without a little leakage?
You’re not alone!
During pregnancy there are quite a few anatomical changes that occur to allow our bodies to carry a baby as well as give birth. As a result of those changes, the muscles of our pelvic floor, hips, and core often forget how to efficiently perform their functions. The muscles of the pelvic floor have several jobs including regulating our bowel and bladder function, sexual function, pelvic organ support, and core stability.
This is why it is SO common among mothers at any stage of pregnancy or even years postpartum to be impacted to some degree by urinary dysfunction (i.e peeing your pants), pain with intercourse, diastasis recti, and low back pain.
However- just because something is common does not mean that it is normal!
So, what can we do about it? If the muscles have forgotten how to properly do their job… we have to remind them how to do it! Just like you are training (or trained) your little ones to develop healthy bathroom habits, you have to retrain your muscles to consistently provide the support and function that you need from them.
Here are our 5 favorite “potty training” tips for moms:
1. STOP “just in case” peeing!
We are all guilty of it. The “just in case” pee rears its head most commonly before a trip in the car or before working out even if we do not have the urge present to go to the bathroom. While this may seem like a proactive way to avoid a leak later, this actually is training the bladder to think it has to empty every time you are about to do the activity you usually urinate before. This incorrect signaling can lead to loss of bladder control even when your bladder isn’t full whenever you perform that activity. A good rule of thumb is to pause and decipher if you actually have to urinate before going to the bathroom to avoid conditioning your bladder’s signaling to the brain that it’s full even when it really isn’t.
2. Minimize Irritants.
If you feel like you are always running to the bathroom, even if only a few minutes have passed, you may be eating or drinking food or beverages that are irritating to the bladder. Some bladder irritants include but are not limited to coffee, tea, seltzer, alcohol, chocolate, and spicy foods. While I would never tell someone they couldn’t have their morning coffee or their late night chocolate truffle, I do encourage them to examine if there is a pattern or link between their diet and their bathroom habits. Knowledge is power! If you find yourself having accidents during your morning workout, maybe you wait to have your coffee until after you’ve finished the workout!
3. Relax!
The muscles of the pelvic floor aren’t just responsible for holding in urine, they are also responsible for relaxing enough to let all your urine out (when you want to let it out)! In order for this to happen, the muscles have to be entirely relaxed. This may be especially important for you if you are someone who runs to the bathroom and then feels like they have to go again in about 15 minutes to finish the rest. Typical reasons for this inability to relax can include hovering above a toilet seat (yes, the pelvic floor is engaged when you stand!) or rushing while trying to pee so you can get to doing the next thing on your to do list. This happens a lot with busy moms who still need to keep a close eye on their little ones or when their kids join her on the ever exciting trip to the bathroom. Take a seat, take a deep breath, and give yourself a 30 second reprieve.
4. Stay Hydrated!
Oftentimes when women are using the bathroom frequently or they know they will be away from a toilet for an extended period of time, they will cut their water intake to avoid a full bladder. While there are a multitude of reasons why this is not an ideal health choice, one less commonly known reason is that when you are less hydrated, your urine becomes more concentrated and subsequently more irritating to the lining of the bladder. This makes the bladder signal to the brain that the bladder needs to be emptied, which inadvertently leads to more frequent bathroom trips- which was just the thing you were trying to avoid in the first place!
5. Weak or tight or both?
One of the greatest misconceptions about the pelvic floor is that when there is dysfunction it’s because the muscles are weak. Just like any muscle, they can be weak, too tight, or weak as a result of tightness. While every person is different, most often we see weakness due to tightness. For this reason, blindly doing kegels to activate the muscles may actually be worsening your symptoms! You may actually need to get the muscles to stretch out first before incorporating kegels into your routine. The best way to avoid the guessing game of whether or not to kegel, it’s so important that you get thoroughly assessed by a pelvic floor physical therapist.
A physical therapist who is specialized in working with pelvic floor will be able to assess for muscle tightness, muscle weakness, muscle tightness AND weakness and also look at your breathing patterns which are also likely to be contributing to your pelvic floor dysfunction. Based on your assessment, they will put together a personalized program for you including trigger point release, mobility work, core and hip strengthening, and more to get you back on track so you can start living your life with confidence!
The longer you wait, the harder this is to resolve, so if you’re experiencing any of these below symptoms, please consider reaching out to a pelvic floor physical therapist for advice:
- You’ve given birth and you don’t feel as strong as you used to.
- You feel like you have to rush to the bathroom or you might leak with coughing, sneezing or running.
- You’re worried you might have a diastasis and how it might affect you getting back to their activity.
- You’ve been diagnosed with prolapse.
- You have pain in the genitals, perineum, pubic, or bladder area, or pain with urination.
- You’re dealing with back pain or hip pain that won’t go away even after you’ve tried other treatments.
Though it may take a bit of work and patience, your body is resilient and CAN be positively influenced to return to its function again, regardless of how long you have been suffering from these symptoms.
If you’d like to talk to a specialist to find out if pelvic floor physical therapy is right for you, call or text us at 973-310-2678.
Dr. Leah Connerty, PT, DPT, PCES
Doctor of Physical Therapy
Postpartum Corrective Exercise Specialist