Anatomy/Physiology Archives - Revitalize Physical Therapy

When you think of bathroom training, you probably think of your little one learning to use the potty for the first time, but it’s for adults too – especially those with urinary incontinence.

It may sound silly, but at some point, if you have urinary incontinence, your body needs to be retrained on proper voiding habits and mechanics. And just what do we mean when we talk about urinary incontinence? You may be familiar with the feeling of a little urine leaking after a cough (known as stress incontinence), as one in three women can relate, but there are other kinds of urinary incontinence as well. There is regular leaking throughout the day (overflow incontinence) due to your bladder not releasing urine when it should, and accidentally urinating before you’re able to get to the restroom in time because the urge is too strong, often described as “key in door” because people tend to leak on their way to the bathroom (urge incontinence). You can even have mixed incontinence, which is a combination of stress and urge incontinence.

Ultimately, the goals of bladder retraining include urinating less frequently, urinating larger and healthier volumes of urine, and increased volitional control over voiding.

Part of bladder retraining is starting a bladder retraining diary that captures what life is like for you on a day-to-day basis with urinary incontinence. It may feel weird to do, but it is a legitimate way to help. You may use your bladder retraining diary to keep track of urges and leaks. You can record what times you go to the bathroom, how much you urinate (no need to measure fluid ounces, as using “Mississippi seconds” to time length of void suffices to gauge how empty or full your bladder is), and the type of fluids you’re drinking. Bladder irritants cause your bladder to contract even if it isn’t yet full, and this leads to incontinent episodes. The top three biggest offenders are caffeine, alcohol, and carbonated beverages. You may even choose to abstain from said food or drink. You may feel disheartened when you are first keeping track of what’s going on, but the idea isn’t to feel bad when accidents or setbacks are recorded in your diary, rather to use the diary in your detective work to help create patterns which will help you solve the problem.

As for how you’ll actually retrain your bladder, you’ll start by extending the time you wait to urinate by 15 minute intervals. (People who don’t have urinary incontinence generally go to the bathroom six to eight times per day and zero to one time at night.)

Kegels, or performing a pelvic floor muscle contraction, are a great bladder suppression technique. In other words, when you turn the pelvic floor muscles on while performing a Kegel, a message is sent to the bladder to turn off, which allows it to fill up for longer before needing to void.

Speaking of Kegels, your pelvic floor physical therapist can demonstrate exactly how to perform Kegels properly. Don’t be embarrassed to ask us for a demonstration! They can be difficult to master, and helping you resolve urinary incontinence is what we are here for! The other reason why it’s best to check with a pelvic floor PT prior to initiating a Kegel strengthening program is because KEGELS AREN’T FOR EVERYONE. If a person has a history of overactivity, or tightness of the pelvic floor, Kegels exercises are contraindicated as they can exacerbate the problem. Some signs that may indicate overactivity or tightness of the pelvic floor muscles include pelvic pain, urinary frequency, and constipation, to name a few.

Urinary incontinence can feel embarrassing, but you shouldn’t let that embarrassment keep you from speaking to your doctor or physical therapist about your symptoms. If you are determined to retrain your bladder, recognize, though, that it is a commitment. It may take as long as 12 weeks to see improvement. You may want to carefully choose a calm time in your life to embark on this journey, versus a time when you know it may be tougher to remain compliant. Still, it’s worth it because urinary incontinence can hold you back from enjoying all the things you love to do: seeing movies at the theater, taking long car trips, and traveling. It’s time to show your bladder who’s boss! I encourage you to talk to your doctor and physical therapist (or contact me for a free consultation) so you can get back to living life leak-free!

When you have pelvic floor dysfunction, your initial goal is to just feel better. But once you hit a certain point in your recovery – and it can happen sooner than you think – you are left wondering how much of your old life you’re ready to return to, like work.

I am here to tell you that you can definitely work with pelvic floor dysfunction, as long as you and your medical team agree that you are ready! You can still be the amazing, passionate worker you were before – the only difference now is you may have to get a little creative in how you approach work. Here are my tips for working with pelvic floor dysfunction:

Get your game plan ready. Consider what accommodations you need for your pelvic floor dysfunction in a new job. You may want to pick a job that involves less stress than before, or one that lets you rely less on caffeine. Think about how you care for your pelvic floor dysfunction on a typical day and your symptoms. Do you need to take out time for yoga, a relaxing bath and exercise? Get your pelvic floor physical therapist’s opinion on what would make for a pelvic floor dysfunction-friendly work environment. I particularly like incorporating stretch breaks. Everyone can benefit from standing up and getting away from the computer for a few moments, because as the phrase goes, “Sitting is the new smoking.” Use the break to do a quad stretch: As you stand, you’ll bend your knee back behind you and grab your ankle or foot. Then, you will pull that same knee into a more bent position until you feel the stretch in the front of your thigh. Hold the stretch for thirty seconds, and repeat three times on each leg. Do this just once a day. (As always, get your doctor’s permission before you do any kind of exercise.)

Once you know what you are looking for in a job, read ads closely and make a list of important things to note or eventually ask about. Does it sound like you will be expected to rarely leave your desk? Will you be discouraged from calling in sick or taking PTO? Is overtime expected? In the interview, ask about pacing. And don’t forget to research companies with whom you interview. Check out Glassdoor. Type in a company’s name in the search bar, click on that company’s name, and then “Reviews.” What are former and current employees saying? While these should be taken with a grain of salt, as they are not fact-checked, if you see a lot of bad reviews, especially from employees that complain about a lack of work-life balance, you might want to reconsider. It’s important to set yourself up for success right from the start!

Consider remote work. COVID changed so much about the way the world works, and one of the biggest changes was to the way we work. If you are interested in remote work, check out sites such as remote.co and remotive.com. You can also filter on LinkedIn and Indeed for remote jobs. You don’t automatically have to work remotely if you have pelvic floor dysfunction, but you may want to: At home, you can frequently stretch, visit the bathroom as much as you need to, and dilate or take a warm bath on a break.

Start your own business. A great way to make sure your needs are being met on the job is to be your own boss! This can be challenging to do, as getting customers can be hard, but if you have a partner who will financially support you while you start it up or a decent amount of savings, it might be worth pursuing.

Look into part-time work. Forty-hour workweeks can be hard, even if you don’t have pelvic floor dysfunction. While you may find you are fine with keeping the same hours, you may need to think about part-time work, then reevaluate that decision later on, as you progress in your healing from pelvic floor dysfunction.

If you have an employment gap because you needed to take time off for treatment and self-care, present it from the start. Pretty much every job search requires you to redo your resume, and that can be challenging with a career gap. Don’t try to tackle this alone. Get help from the experts: Your library may be able to assist – for example, the Brooklyn Public Library offers free resume and career help. Indeed offers some good advice as well.

Going back to work can be a vital part of your pelvic floor dysfunction healing journey. It is a marker that you have made progress, and that is something to celebrate! The right job can be great for mental health. You may find it to be a good distraction from the challenges of dealing with pelvic floor dysfunction, and a great boost to your self-esteem.

And remember, changes like needing to switch to remote, hybrid or part-time work aren’t necessarily permanent. They represent what you need to be successful in this moment, and you will likely reevaluate them as time goes on. Being flexible and checking in with yourself are key. I am wishing you the best of luck in getting a job that supports you (and especially your pelvic floor) in 2025!

Category: Anatomy/Physiology

Mind Over Bladder

Can I Work With Pelvic Floor Dysfunction?