Today I want to talk about something that not everyone feels comfortable talking about, but something that is incredibly important and that is your toileting behaviours!
You may be wondering what exactly that means, and simply put when I say your toileting behaviours I am referring to what you do when you need to go to the bathroom and then what you do while you are going to the bathroom.
The reason I want to talk about this today is because believe it or not our behaviours surrounding toileting can oftentimes lead to pelvic floor dysfunctions, including urinary and/or fecal incontinence, pelvic organ prolapse, pelvic pain, not to mention decreased muscular strength, endurance and coordination of the pelvic floor muscles.
Below I outline five behaviours that you likely had no idea could lead to dysfunction (I know I didn't prior to becoming a pelvic health physiotherapist). Take a read through and feel free to comment below with any questions!
1.Delaying It Too Long
We've all been guilty of this, I'm sure. Life gets busy and the next thing you know you haven't been to the bathroom in hours! Once and awhile this is OK, but if you do this frequently (as I often hear from clients who are teachers) what happens is the bladder stretches out in order to hold more urine. This overstretching leads to what is called an atonic bladder -- in other words, a bladder that lacks tone. As you can imagine this effects how well you're able to store and empty your urine, not to mention the state of your pelvic floor.
If you find yourself delaying toileting too long, try to make a conscious effort not to. A normal voiding schedule is every two to four hours. In fact, did you know that movies are designed to be around the two-hour mark so that most people could watch the full movie without having to get up to go to the bathroom?
One of my favourite pelvic floor quotes that I have heard is "They call it a restroom for a reason."
2.Hovering Over The Toilet (I.e Not sitting your butt down on the seat!)
I know a lot of people hate to use public restrooms so they hover over the seat instead of sitting their butt down. It seems logical, but the truth is that hovering or squatting over the toilet is not good for your pelvic floor. When we are on the toilet urinating or defecating, our pelvic floor should be relaxed. By hovering you are not allowing adequate relaxation of these muscles which leads to a number of compensations. Many muscles must engage to hold you up, but without the pelvic floor muscles relaxing, the bladder and bowel don't fully empty which leads to a host of issues other than simply a weakened pelvic floor (including infections, urgency, incontinence and/or prolapse).
If you are someone that just really hates to sit on a public toilet, you can combat this by using seat covers or by making your own seat cover with toilet paper.
3.Bearing Down To Initiate Or Complete The Stream Of Urine Or During Defecation
This one is pretty simple. By bearing down to initiate or complete the stream or urine or during defecation you are essentially pushing down on the pelvic floor. This can cause stretch and strain on the muscles, further weakening them.
One of my favourite pelvic floor quotes that I have heard is "They call it a restroom for a reason." Take your time so you feel less inclined to bear down. And if you are someone who struggles with chronic constipation, then there are effective strategies you implement including dietary management and/or using a better toilet system, such as the Squatty Potty.
4.Not Allowing Time for Full Bladder Emptying
This point is very similar to the previous two in how they affect your pelvic floor. Remember, it is called a restroom for a reason, and if you don't allow time for your full bladder to empty you are faced with potential issues, as mentioned above in the second point, including infections, urgency, incontinence and prolapse. So take your time in the bathroom, and if you find yourself struggling to fully empty your bladder without straining then speak to a pelvic health expert who can help determine why that is the case and how to change it!
5.Voiding "Just in Case," Or Preventative Voiding
This behaviour was probably my biggest "ah ha" moment when I was training to be a pelvic health physiotherapist. Why? Because I, and so many people I know, do this ALL THE TIME! In fact, I had never considered how it might affect our pelvic floor and health in general, but the truth is it really does!
Essentially what "Just in Case" voiding is, is when you go to the bathroom before you need to, for example before you head out on a road trip or a hike, or leave the house just in case you might have to go later. The reason this is a habit that needs to be eliminated is that it encourages your bladder to only hold small volumes and the more you do it the more you will get the urge to urinate when the bladder is only filled with a small amount of urine.
To avoid this, simply wait to use the bathroom until you truly need to!
Cassie Dionne, BPHE, MScPT
Taylored Training Inc.
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