World Continence Awareness Week 15th - 22nd June 2020 - OAB

As it's World Continence Awareness Week, I thought I'd post an email out each day to help you understand more about continence...

We're kicking off with a common condition known as Overactive Bladder. This is a problem where the bladder becomes irritated and struggles to expand and hold larger volumes of urine. A small, stiff and irritated bladder will lead to:

> Increased frequency
> Multiple night time wees
> Sudden and strong urges to urinate
> Multiple small volume wees
> Difficulty making it to the loo in time
> Restricting fluid intake, especially when going out
> Regular 'just in case' wees, to avoid leakage
> Wearing a continence pad for confidence

All of these gradual changes to your day to day life can soon take over and limit you socially, in terms of exercise and in terms of self-confidence.

Specialist physiotherapy is a great way to kickstart your recovery and bladder rehabilitation. Here are a few tips to get you going:
 

Try to drink about 2L of water per day - a tracker bottle from HydrateM8 or somewhere similar can help you keep note of your fluid intake.

If this feels like a mountain to climb right now, just try to increase your intake gradually over the next few weeks. Initially, you will wee more, but this will settle over time as your body gets used to the new levels of hydration.

Find your bladder irritant. Look at what you eat and drink each day and see if your bladder urgency increases after certain drinks.

Caffeine is a common trigger, as well as, citrus drinks, tomatoes and some types of alcohol.

If your bladder becomes irritated after eating or drinking certain things, try cutting them out or reducing them over the next 6 weeks or so. If your symptoms improve, you know what you need to do!

Let's think about bladder rehabilitation. Like with any muscle of the body, the bladder needs to be flexible, strong and able to squeeze and relax at appropriate times.

Your bladder is a storage device and we want to aim for wees every 2-3 hours during the day and not really more than once at night.

Deferment
You can listen to your desire to empty your bladder and attempt holding on for a few minutes before actually going to the toilet. This can be a challenge initially but try sitting on a firm surface, avoid the sound of running water, avoid the sight of the toilet and try squeezing your pelvic floor for up to 20 seconds to see if this helps to calm your bladder. You can also try to stand up and lift up onto your toes and back down repetitively, this triggers the same nerve that relaxes the bladder a little and might help you to hold on for longer.

Timed Voids
Another bladder training option is to aim for a certain amount of time between wees. For example, if you get up in the morning at 7am and have a good wee, you may wish to avoid going again until 9am. If you feel the desire to empty before 9am, try to hold on. And then from 9am, you may wish to try to hold until 11am, and so on through the day.

Initially, the bladder will shout, kick and scream at you, like a toddler that's not allowed that packet of sweets in the supermarket. But over time, the bladder will become under your control rather than the other way around.

Try these techniques out and let me know how you get on.

Quite often, I will see clients with an overactive bladder problem, and they notoriously struggle with the slow holds of the pelvic floor training programme.

While you're sat reading this email, try to squeeze your pelvic floor muscles and hold the squeeze for as long as you can. Avoid gripping your buttocks or holding your breath!

How long can you hold?

Ideally, a good 20 second hold would be enough to calm the bladder urgency. If you're not quite there yet, work on gradually increasing the hold time by 1-2 seconds every week.

Don't forget the fast squeezes too, as they are an important part of any pelvic floor training programme.