by Ashley Newton, PT, DPT
If your family was anything like mine, before a car trip, my mom would always ask if everyone made sure they had gone to the bathroom. And even if you didn’t have to go at that moment you would make a trip to the bathroom to try to avoid any stops on your car trip. Fast forward to today when lots of adults urinate ‘just in case’ before they go out to the store, feel like they are constantly going to the bathroom, and wait in ridiculous lines to use the toilet. What is going on? Why do people feel the almost constant urge to urinate? The answer is multi-layered, but I will discuss causes that fall into the following categories: neuromuscular, musculoskeletal, and dietary.
The first thing that you need to know is that as the bladder fills, we get our first experience of urinary urgency at 50% full. The amount of time it takes a bladder to fill is 2-4 hours! However, the connection between the bladder and the brain is very smart and if someone starts to urinate more frequently, the body starts to experience urinary urgency earlier and earlier. As a result, people feel like they have to go to the bathroom more frequently even though their bladder is not full. The behavior ultimately trains the brain and bladder!
The bladder is surrounded by a muscle called the detrusor. When the detrusor contracts, it pushes urine out of the bladder. If the detrusor is contracting too much, it gives the sensation of urinary urgency. We also know that fascia suspends the bladder and that the pelvic floor muscles support it. If there are issues with pelvic floor coordination and/or strength, the muscles are not doing their job of supporting the bladder. Dysfunction in the muscles of the pelvic floor can cause urinary urgency as well.
Lastly, there are known foods and drinks that cause bladder irritation. Bubbles from seltzer, citrus, coffee, and chocolate, just to name a few. These foods irritate the bladder lining and can cause the sensation of urgency. Now it is important to note that since the urine inside the bladder plays a role in urgency, restricting water in an attempt to not go to the bathroom actually worsens irritation! This actually makes the urine more concentrated and thus more irritating to the bladder wall.
If you feel like you are going to the bathroom ‘all the time’, it may be helpful to consult your local pelvic health physical therapist to retrain the brain and body so that life is not so interrupted by trips to the bathroom.
I am excited to share tips and education with you in LYT newsletters to come! Follow me on Instagram @ashleynewton_dpt and @activcoreprinceton_pelvic for weekly content on pelvic floor, the nervous system, yoga, and wellness!