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What to do if you are experiencing bladder weakness?

The pelvic floor is a very important muscle albeit a well-hidden.  Improving the strength can not only improve bladder control, it can also increase your general confidence, improve your sex life and improve seemingly unrelated problems such as back and neck pain!

Pelvic Floor Muscle Training is an effective intervention for treating (or curing) urinary incontinence – one study has found 60% reported cure or almost cure with supervised exercises compared to 16% in a home exercise group.

Here are some facts about your bladder and pelvic floor which you may not be aware of:

  • Our bladders are designed to hold 400-600mls fluid (approx. 1 pint) and the Detrusor muscle within the wall of the bladder sends a message to our brains when the bladder is full. 
  • We should aim to be drinking 1.5-2 litres of fluid in a 24-hour period.  The detrusor muscle can become ‘weak’, deciding the bladder is full enough when it really isn’t, leading to increased trips to the toilet. 
  • Sometimes we can end up visiting the loo more often to prevent any leaks or urgent trips to the bathroom.  Either way we, or rather our bladders can get into bad habits.
  • Our pelvic floor muscles are like the trap door – if working effectively the door is closed and nothing can get out.  If when we know our bladders are not full up, at the first urge to wee we can engage our pelvic floor strongly (known as ‘The Knack’), we can encourage the detrusor muscle to relax again and instead of squeezing the bladder it can allow it to go on filling. 

How to strengthen your bladder?

  • If the pelvic floor muscles are weak this can be tricky.  Sometimes crossing the legs or sitting down (or both) can help us engage the pelvic floor. 
  • To strengthen up pelvic floor exercises are a must.  To strengthen up the endurance (fast twitch) muscles that we need to reduce frequency and urgency we need to zip up around the back passage – imagine trying to stop yourself passing wind and then lifting around the front, imagine stopping the flow of wee.  Try and hold for up to 10 seconds then relax.  Aim to build up to be able to do 10 repetitions each with a 10 second hold.  Start in sitting or lying if easier but progress to doing them in standing as soon as you can.  Try not to hold your breath and continue to breath in a relaxed way.
  • It’s important to work the quick (fast twitch) muscles too.  These are the ones we need to quickly activate if we cough, sneeze, laugh or jump.  To do these quickly zip up the pelvic floor then relax completely.  Try and repeat 10 times. 
  • To make a difference we recommend you do both the long and short holds 3 times a day.  It can take up to 6 weeks to start noticing a difference.  It depends on the reason for the pelvic floor muscle weakness and other factors but it may take up to 3 months to really see a big improvement. 
  • If you feel your muscles are strong and you’re having no problems, to maintain strength aim to do pelvic floor exercises once a day.  This can prevent issues in later life when changes in hormones can cause trouble. 

Please seek help if you are at all unsure about these exercises or your own individual problems.  Sometimes the pelvic floor can become too tight or there can be an imbalance which would need addressing.  Women’s Health Physio’s are very used to assessing and treating a range of pelvic floor issues. 

Posted by: AislingBirch
Date: Wed, April 08, 2020

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