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Incontinence and Physical Therapy
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Tips for Bladder Fitness


  1. Voiding should occur every 3-4 hours during the day.
  2. Urine flow should last for at least 8 seconds for women and 12 to 15 seconds for men, from beginning to end. (Count one one thousand, etc.)
  3. It is not normal (but very common) for young to middle aged women and men to have to get up at night to urinate. Utilize “urge suppression techniques” to stop yourself from getting up to void. If you wake up during the night, do not go to the bathroom just because you are awake. Rolling on to your side can help decrease the sense of urgency.
  4. Do not urinate the moment you get home. Use the urge suppression as you drive up the driveway or enter your home. Break the pattern by doing something else between getting home and going to the bathroom. Stop the “key in the door” syndrome where the bladder fully contracts and empties to the stimulus of the key in the door.
  5. No urination in the shower - this sets up an abnormal connection between the brain, the sound of running water and urination. This can lead to the urge to void occurring whenever you hear the sound of running water, as in washing dishes or clothes, or by a running stream.
  6. No “JUST IN CASES”. (A “Just in Case” is - I urinated when I got up this morning but because I am about to leave for work I am going to go again just in case” even though I am not feeling the need to urinate) JICs allowed before bed, prior to long trip, prior or post intercourse.
  7. Don’t do anything but your business on the toilet. Don’t read and do crosswords.
  8. Sit, don’t hover over the toilet. Hovering over the toilet creates overflow activity into the pelvic floor muscles which activates the Voluntary Urinary Inhibition Reflex, inhibiting the bladder. Inability to completely void and difficulty with initiating urine flow can occur.
  9. Do not strain when voiding. This not only puts excessive pressure on the pelvic floor but also creates a large volume being passed through the urethra, which can lead to an overstretched urethra and incontinence issues.
  10. Avoid constipation. Having to bear down to have a bowel movement puts a lot of strain on the pelvic floor muscles.
  11. Avoid bladder irritants, in particular coffee, tea, caffeine, alcohol, carbonation.
  12. Drink water - at least 3/4 of daily fluid intake should be water.
  13. Drink 6-8 8oz glasses of water per day.
  14. Limit your fluid intake after dinner (2 hours before going to bed).
  15. Do not limit your fluid intake in an attempt to decrease frequency of urination. This will decrease your frequency but your urine will be more concentrated which is irritating to the bladder lining. This will also encourage growth of bacteria, which may lead to infections.
  16. It is normal to pass urine when having a bowel movement. Do not prolong the need to have a bowel movement to extend void interval.
  17. The stronger the pelvic floor muscle, the more control you will have over stress, urge and frequency issues.
  18. Abdominal strengthening is an important part of the bladder fitness program.

Other Helpful Links

APTA Guide to Incontinence

Urinary Incontinence: What to Know

Urinary Incontinence: Just the Facts

Prostate Cancer Treatment & Urinary Incontinence


 Our thanks to Christine Greenberg, PTA, BS, CLT  
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