Ever heard of the phrase “small bladder”?  Has this ever been applied to you or someone you know?  The person that is constantly on the lookout for the nearest bathroom and seems to have to go ALL THE. TIME?

This can have a major domino effect on our quality of life…

• Not being able to sit through a movie

• Sitting in traffic being incredibly stressful for fear of losing your bladder control

• Forgoing a hike that you love for fear of no bathroom access

• Errands and trips being dictated by your bladder sensations

First of all, a “small bladder” is more than likely NOT the case.  But what is going on IS an inconvenience and is NOT normal. AND it can be helped!

Emptying our bladder MORE than every 2-3 hours is considered too frequent.  And waking more than once at night is also not normal. And the impact on our overall health from not being able to sleep more than a couple hours at a time can be devastating in the long run.

Then WHAT is going on to cause someone to have to run to the bathroom for what seems like every 10 minutes?

For MOST cases, I would say it is most likely a combination of TWO or THREE things, with some people just having more of an issue with one.

1.   A Shortened Bladder Muscle: the muscle that surrounds the bladder called the detrusor could have become shortened, and is thinking it is “full” sooner than it should.

2.   An Irritated Bladder: the lining of the bladder could be irritated (which causes us to feel a strong urge to empty) by over concentrated urine, or food or drink that is irritating to the bladder.

3.   Painful or Spasmed Pelvic Floor Muscles: the pelvic floor muscles could be in a state of spasm which can irritate the bladder, due to how close they are to one another and shared nerve supply.

For the above three causes, a pill won’t be able to “fix” them.  Have you heard of a pill you can take to suddenly make your hamstrings flexible?  Or a pill that made it so that you could eat all the irritating foods you wanted without issue?  Or a pill to cure muscle imbalances and over tension? And no, a “muscle relaxer” doesn’t actually “relax” muscles… it just depresses your nervous system and you would sleep well.

So if a pill won’t work, then it’s up to simple things like habit adjustments and working with our muscle system.  EASY for a pelvic PT!

So let’s get to WHAT TO DO.

1.   Start to be aware of a pattern with any food or drinks you have consumed before the onset of the “gotta go” feeling.  This can vary widely from person to person, but some things that may irritate the bladder can include alcohol, coffee, carbonated beverages, spicy or tomato-based foods, and chocolate. Now, this is NOT a list of things you should NEVER have.  It is merely a list that you should study and consider reducing something that you consume frequently for a week, to see if you notice a difference in your bladder habits.

2.   When you feel the urge to go, and it has NOT been very long, first ask yourself if you REALLY need to go?  Can you delay the bathroom trip by 5, 10, or 20 minutes? If you don’t feel that you can delay, then try to do 3 pelvic floor contractions and take a couple of slow deep breaths. This SHOULD reduce the urge sensation somewhat. This is known as the “urge control technique”.  Starting to stretch out the time between bathroom stops can help the bladder muscle get acclimated to being a bit more lengthened than it was used to which will result in not feeling like you have to go as often.

3.   Check in with your abdominal muscles.  Are they tense? Could you take a big belly breath inhale?  Do you have tension in the muscles connected to your pelvis, especially the inner thighs?  Tension in the abdomen or thigh muscles could suggest tension in the pelvic floor muscles. Working on taking deep, slow breaths with your belly expanding with inhale as well as gently stretching your leg muscles could be of great help to you.

4.   If you have tried the above things and you don’t notice much of an improvement, you can see your pelvic physical therapist who can work with you to play detective.  They can take a thorough history, assess your muscles from head to toe, and assess how your core and pelvic floor muscle team is functioning. They can also help you with creating a 24-hour bladder diary and get a better idea of how eating, drinking, and toileting habits may be impacting you.

A pelvic PT can also help guide you towards seeing a urologist if it seems that your issues require more medical testing.  This is why a good pelvic PT can be the best first stop for this issue!

So if you DO need to see a pelvic physical therapist, you will get actionable and holistic treatment after a thorough assessment that you will likely need and benefit from regardless of any further testing or diagnosis.  Your pelvic PT will teach you the essentials of a healthy bladder, good bladder habits, and help with addressing YOUR specific issues.

So the next time you are bothered by your “small bladder” or your friend’s small bladder, work through these simple steps and see if you can say GOODBYE to what is one of the most inconvenient things we can experience with our bodies!