Train your bladder like you train your puppy
I’m a cat person, so I’ve never had this experience first hand, but I’ve certainly seen my friends potty train their puppies. And what’s the number one rule they all follow? Creating a routine and schedule. They take their puppy out first thing in the morning so the puppy knows that’s when they’ll get to go. Then they get to go again and again at predictable increments throughout the day, all the way through the evening. If their puppy starts whining at the door, they may get an extra potty break. Training your own bladder? Not all that different.
Faulty bladder habits contribute to symptoms like:
Stress incontinence (leaking pee with activities like coughing, sneezing, jumping)
Urge incontinence (leaking pee with strong, sudden or unexpected urges to urinate)
Urinary frequency (feeling like you have to pee all the time)
Urinary urgency (having strong, sudden urges to pee)
It’s amazing how much better bladder habits and schedules can impact urinary incontinence, urgency and frequency. In short: you can train your bladder just like you trained your puppy.
A healthy adult bladder can hold up to 16 oz of fluid. It’s typical to get the initial urge to urinate when the bladder is about half way full, with the expectation that the person can delay that urge for some time before truly needing to pee. A normal urinary stream empties a little less than an ounce per second, making a normal urinary stream last up to 20 seconds or so with the average adult needing to urinate every 2-4 hours, assuming reasonable hydration.
Furthermore, short of a history of bladder surgery, it’s unlikely that you have a “small” or “big” bladder. You can, however, change the functional capacity of your bladder without changing the actual size. How, you ask? Stick with me.
Our bladder has needs and a schedule of its own, just like a puppy. If your bladder gets used to peeing when it’s only half way full, that half will eventually become your new, whole capacity. That means that rather than getting that initial urge when your bladder has maybe 8 ounces of liquid sitting in it, you might start getting that signal at 4 ounces. Therein lies the problem with taking yourself to pee “just because” all day long. On the contrary, if you ignore the urge to pee when your brain is screaming that you need to go, with time your bladder and brain will work together to say “screw it” and will stop sending that signal altogether. You can stretch your bladder by chronically holding, increasing the capacity of your bladder and reducing your body’s ability to give you a reliable signal that you need to pee as your bladder approaches full.
By peeing when we don’t need to, or by ignoring the urge to pee when we do need to, we mess with our bladder and brains ability to reliably signal to us that we need to go. This can lead to all sorts of bladder misbehavior, like peeing with a sneeze or a jump, spontaneously emptying when we don’t want it to, or making us feeling like we need to pee 20 times a day or 2 times a day instead of the expect 6 or so.
So what can we do to address bladder misbehavior? Consider these 4 steps:
Stay hydrated! Dehydration can irritate our bladder, leading to all sorts of bad behaviors. Click here to learn more about how much water is enough water.
Limit bladder irritants! Caffeine, alcohol, carbonated drinks and artificial sweeteners can all irritate the bladder, increasing the likelihood of urinary incontinence, urgency and frequency. More water and less of the other stuff can help.
Put your bladder on a schedule! If you’re someone who prides themselves on being like a camel and peeing just a couple times a day, make sure you’re peeing every 2-4 hours. If you don’t need to, refer to rule #1 and keep trying.
Pee when you need to, and don’t pee when you don’t need to (unless you’re used to peeing 2-3 times a day in which case refer to rule 3).
So there you have it - get that bladder on a schedule, stay consistent, and hopefully you’ll be peeing better in no time! But please keep in mind, there are a number of reasons someone may experience urinary urgency, urinary frequency and urinary incontinence. If you’re struggling with bladder control or discomfort, contact your provider and consider scheduling an appointment with a pelvic floor physical therapist who can help you determine what’s going on with your bladder and what you can do about it.
Want to come see us in Austin or schedule a virtual consult? Click here!
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.