Incontinence

Rolling, Rolling, Rolling Like A River: Tips For Good Urinary Stream

We’re all a bunch of smarty-pants over here. But to become one, you must learn from one. This week, we’re excited to learn a few things from one of the smartest women we know. Evelyn Hecht is a pelvic physical therapist from the Big Apple on a mission to help us deal with the not-so-fun things that happen when our pelvic muscles need some love. At Lily Bird we talk a lot about incontinence, but what about the other side of that coin? Read on to hear what this expert level smarty-pants has to say. It might change how you handle your next trip to the loo. 

How To Tell If There’s A Problem

A healthy urinary stream is continuous, effortless and feels relieving. If you’re not experiencing all of these, your pelvic floor muscles may be the issue. When the pelvic floor isn’t able to relax to allow urine to flow out easily, you might notice the need to strain during voiding, a start/stop experience when urinating and a feeling of incompletely voiding.

The pelvic floor is a hammock-like group of muscles at the base of the pelvis. This diamond-shaped musculature runs from the front of the pubic bone to the back of the tailbone and has side attachments to a deep hip muscle.  It surrounds the urethra, a hose-like structure and has a sphincteric function, so it opens and closes to allow the exit of urine or keep continence. When the pelvic floor is closed around the urethra it squeezes the hose shut. Without the ability to relax your pelvic floor muscles, there is no hope of having urine pass through the tightly shut door. 

What You Can Do About It

To have a steady urinary stream your muscles of the pelvic floor need to be able to soften, lower it’s tension. If you find yourself struggling with initiating a steady stream, try these tips for success:

  • Don’t hover
    • Sit on the toilet, do not squat over the toilet and hover! Doing the “hover-and-hold” like most women do, especially when using a public restroom, actually keeps the pelvic floor contracted. Use the toilet seat paper that most establishments offer in their restrooms and fully sit to fully release your pelvic floor.
  • Listen to water
    • Turn on the faucet. Hearing the sound of running water will stimulate the urge to go. If you don’t want to waste water, listen to some free YouTube recordings of waterfalls, or rain. 
  • Breathe deeply
    • Do a few diaphragmatic breaths prior to peeing to activate the parasympathetic “rest and digest” nervous system to enhance your urine flow. Put one hand on your stomach and the other on your chest, with each slow inhale gently expand your stomach without moving the hand on your chest. Exhale allowing the stomach to deflate. Diaphragmatic breathing causes the pelvic floor to move gently as well as relaxing your entire body.  
  • Make a sound
    • When voiding make a low “shhhhhh” or “grrrrrrr” sound to activate the core which supports the bladder while lengthening the pelvic floor muscles and opening the urethral door.
  • Apply pressure
    • Apply gentle manual pressure to the bladder region. Place your hands over your lower abdomen. As you exhale, gently press in and down towards your pubic bone.
  • Lean forward
    • Lean forward at the end of voiding, especially if you have prolapse, to make sure all urine has emptied out.

If That Doesn’t Work

If you are still having trouble initiating a steady urinary stream, you may need a more comprehensive treatment approach with a pelvic physical therapist such as EMH Physical Therapy in NYC. We can evaluate the ability of your pelvic floor to relax and contract, assess the mobility of your bladder and urethra; test the strength of your pelvic floor and the surrounding musculature. Your physical therapist will be able to perform hands-on interventions, prescribe personalized exercises and stretches, and utilize biofeedback to help you learn how to return to good pelvic floor and bladder function.

With a little bit of practice and support, you will have your stream flowing steady and strong!   

Is an unruly bladder one of the things that’s stopping you from living your best life? Lily Bird can help. Lily Bird has you covered with pads and underwear delivered right to your door. Start your trial today.

By Evelyn Hecht, PT, ATC at EMH Physical Therapy in NYC