4 Steps To Manage Urge Incontinence - Episode 6
In this episode I discuss the 4 simple steps you can take to manage urge incontinence.
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Dr. Kari: You. Welcome to the Moron Pelvic Health Podcast. Hi, I'm your host, Dr. Kari Roberts. On this show, we will be discussing a variety of things regarding your pelvic health. These conversations will be a mix of education, personal experiences, and a blend of tips you can apply to have a healthier pelvis. The goal of this show is to normalize conversations around pelvic health and help women stop suffering in violence. Welcome back. Welcome back. Welcome back. Today I want to talk through the four tips or the four steps that you can go through to manage your urge incontinence. Now, just as a reminder, there are different types of incontinence. The episode two episodes ago I discussed the three types of incontinence. Last episode I explained what stress incontinence is and how to manage it. And this week I'm talking all about what urge incontinence is and what you can do to manage it. So put simply, urge incontinence is when you feel the urge to go to the bathroom and you're not able to get to the toilet on time. You might feel a strong urge and it's just like you're doing everything you can to hold it in. But some gives way a little bit, just a couple of drops. You might have a whole little accident. There could be variations in between, but that's basically urgent continents and a lot of what happens with when we empty our bladder. Fun fact, bladder emptying is called Micturician. And that cycle, that process, it's several reflex loops that I don't want to bore you with. But the fact of the matter is, a lot of it is learned behavior. We train our bladder when it's time to empty. And I think about it that sometimes I tell my patients the bladder is like a puppy. I have two dogs, so if you are a dog owner, you might be able to relate. But when you have a puppy, you put the puppy in the crate. And what we do, we crate train our puppies. And when they get out of the crate, they go immediately outside. They go to the bathroom, we give them praise, we give them treats, they play a little bit, then they go back in the crate and so on and so forth. And as they get older and bigger, you can stretch out the amount of time that they're in the crate so that they can hold their urine because they don't want to make a mess where they go to bed. So that's the correlation. However, if you aren't consistent in staying on top of how you're training your puppy, then your puppy will train you. The next thing you know, that puppy is whining and barking like it wants to go outside all the time. It might not even notify you. It might just pop a squat and pee right there on your living room floor. And nobody wants that, right? Nobody wants that. Surprise. You want that puppy, you really want to be the master over the puppy. And so the puppy will learn to go to the bathroom when you want to go to the bathroom. And so the bladder, in my opinion, is very similar. There are things that we can do to train the bladder, but if we don't take mastery over the bladder, then the bladder can be like that puppy and can flip the script and can try to control us. So a lot of times people have like latchkey incontinence where as soon as you get home you're like, oh shoot, I have to go to the bathroom. The funny thing is, home is variable, right? Like you could be on vacation and as soon as you get to the hotel room, your bladder is like, it's time to empty. Or you could be visiting family and when you get to their house, it's time to go to the bathroom. So that's just an example to show you that that bladder learns the behavior when we are home, it's time to empty. Even though you may not want to. Something else is you might have had a Urinary episode that wasn't very good. So now when you feel that urge, you're like, oh man, I don't want to have an ex and I don't want to whip my panties or whatever, so I'm going to go all the time. So then what happens is that bladder gets used to emptying frequently and so it doesn't want to get stretched out. It's like, oh, I'm getting a little bit of stretch, I'm getting a little bit of full. Hey, empty me, I don't like this. So that's what I mean when I say the bladder starts to be like that puppy, right? It starts to take over. So when the bladder starts to take over, then it's telling us when to go to the bathroom, which can be very unnerving, it can be super annoying. So these four tips that I'm going to walk through this four step process is going to help you get mastery over your bladder so that you're not going to the bathroom all the time. Now just to kind of give you some data so that you know what normal is. Normal, healthy adults empty their bladder every two to 4 hours. Yes, every two to 4 hours. So if you're emptying your bladder more than four and you're stretching more than 4 hours, then you might be stressing your bladder out a little bit and then that could be contributing to why you are having the urge because it might just be overflow. It needs to be empty. But what I see mostly in my practice, in my clinic is that women are going to the bathroom much less than every 2 hours, which means that bladder is not getting full. It's just empty me right now. You don't want to have an accident. So you go and listen to the bladder and empty. And what you do is you just reinforce that cycle to have that urge where you can't control it, which leads to incontinence, which is why we're having this conversation, right? So here are the four things that you can do when you feel the urge so that you can gain control. Back of your bladder so that you don't have that urge. Incontinence. The first thing is going to be breathe. Just breathe. Just breathe. Take some deep breaths. Tell yourself, I emptied my bladder less than 2 hours ago. You are not full. You want to be emptied, but you're not full. And I've got things to do. You might be at the bank, you might be at the store, you might be at work, you might be out in public and you don't want to use the bathroom out in public. Whatever the case, just breathe through it. Breathe. Deep breaths. Fill that belly, expand that belly and exhale in through your nose, out through your mouth just to kind of calm your system down, calm that bladder down. That's the first step. The second step, if that deep breathing is not enough, you might need to put a little bit of pressure on the front side of your pelvis. So we've got the pubic bone which sits right at the front of our bodies. And what we can do is sit down and just kind of rock forward. So you're putting a little bit more pressure on the front of the pelvis. So now we've got pressure on the front of our pelvis and now we're doing some slow, controlled, deep breaths. The next thing to do is to squeeze. This is one of the only times when I will say it is okay to squeeze or to do a kegel. You're going to try to do quick contractions to close that bladder, right? Close the muscle around the bladder so that that urine doesn't slip out. And what I would recommend is like five to ten in a row. Boom, boom, boom, boom, boom, boom. Like that. Squeeze, squeeze, squeeze, squeeze, squeeze. Because the bladder can't squeeze to empty when the muscles are squeezing to keep the bladder closed. So what happens is as you squeeze and turn on those pelvic floor muscles around the urethra so that your bladder doesn't empty, a lot of times that contraction in the bladder, that's saying empty me, empty me, it will relax. Okay? That's the third thing. And then the fourth thing is weight. And as someone that used to go to the bathroom over 15 times a day, I'm going to tell you it does not seem like it will be this easy. And I am a conspiracy theorist and I really didn't think it was going to work. So I'm like, I'm going to do all this and I'm going to come back and I'm going to tell them it didn't work for me, give me something else. But I was mistaken. This works. And number four in my opinion is the most, I don't know, satisfying, gratifying way about it. So when you wait, you're just going to wait. That bladder is not going to squeeze forever. That urge is not going to go forever. Remember, we're sitting, we're putting pressure on the front of our bladder so you can wait it out. Just wait it out. And then once it's done, you can stand up and you can gracefully walk to the bathroom, not look like a crazy woman. If you feel like you got a sprint to get to the bathroom, it's time to sit down again and it's time to go back through those steps. Once you wait, and you should wait anywhere from 30 seconds to five minutes. Everybody's body is different. Every situation is different. There have been times I sat down and waited 15 seconds and been good to go. There's been times when I really had to wait the whole five minutes. But that squeezing of the bladder saying, empty me, empty me, empty me, will eventually relax. And once it relax, you've got your composure. You are short of yourself. You are in control, right? You're the master over your bladder. You are the boss. The bladder is not your boss. Then you can walk to the bathroom, gracefully pull down your panties and empty your bladder. Those are the four things that you can do to manage your urge incontinence. So just as a review, you're going to breathe, you're going to put pressure, you're going to sit down and put pressure on the front of your pelvis. Then the next thing you're going to do is do some quick squeezes, some quick contractions, kegeling to kind of make that squeezing from the bladder calm down. And then the fourth thing, while you're sitting, while you're doing the deep breath, while you're putting pressure on the front, is we're going to wait it out. So I hope that is helpful. Let me know if that works. Let me know how you feel about it. If you're watching this on YouTube, leave me a comment. If you're listening, send me a DM, email me. I would love to hear from you if you're like. I've tried all this and I need more. This is general information for the general public. If you want a personalized plan, then please go ahead and reach out to me. I offer virtual visits and in person visits in the Atlanta area. I would love to be your Pelvic floor physical therapist and get you on a specific personalized plan for you. But until then, thank you so much for listening to the podcast. If you're on YouTube, thank you for watching. I will be coming next week with another helpful episode. Thank you for listening to the Pelvic Health podcast. If you want to take the quiz to see if you would benefit from speaking to a Pelvic Health physical therapist, simply go to the link in the description or go to www.moronepelvichealth.com quiz again, thank you so much for listening to the podcast. And don't forget to tune in next week for another amazing episode.