Urge incontinence responds to training better than almost any other bladder problem, and you can start today without any equipment. The key is knowing what to do in the ten seconds after the urge hits, because the wrong reaction makes it worse.
What urge incontinence actually is
Urgency is the sudden need to pass urine, where you cannot hold on for more than about five minutes. When that urge leads to leaking, it is called urge incontinence. Plenty of people get the urgency without ever leaking.
Urge triggers are the specific things that set an episode off. The classic one is the car in the driveway: you have not needed to go all the way home, and then your key goes in the front door and you are running for the toilet. Turning on the tap while you brush your teeth. Walking into the chilled section of the supermarket. Each person has their own set.
Why rushing to the toilet backfires
Your bladder is a muscle, and it behaves like one. Racing for the toilet contracts it, along with everything around it, which makes holding on harder rather than easier. Holding your breath makes it worse again, because your pelvic floor cannot work properly without air.
The whole trick is to stay calm, stay still, and let the wave pass. It does pass. Usually within a minute.
Five techniques that work
Press over your front passage
Place your hand over your urethra and apply firm pressure. You will see small children do this instinctively when they are desperate. A table corner or the edge of a chair does the same job and looks like you are just resting.
Come up onto your toes
Lift your heels off the floor. This works through the nerve pathways between your pelvis and your brain: shifting effort into your calves and lower legs moves the signal away from your bladder.
Distract yourself on purpose
Count backwards from 100 in sevens. It sounds ridiculous and it works, because your brain cannot chase the bladder and do mental arithmetic at the same time. By the time you reach seventy-two the urge has usually dropped.
Breathe slowly and stand still
Slow breathing keeps your muscles relaxed, which is the opposite of what the urgency is trying to get you to do. Think of how you handle a calf cramp. Standing still and breathing beats fighting it every time.
Contract your pelvic floor
A few strong, quick pelvic floor squeezes help settle the bladder and buy you the time you need. This is the long game as well as the emergency brake, because a stronger pelvic floor means fewer episodes in the first place.
When to get it checked
Urge incontinence is very treatable, and pelvic floor physiotherapy has strong evidence behind it. See a doctor or physio if you notice any of these, because they point to something other than plain urge incontinence:
- Blood in your urine
- Burning or stinging when you pass urine, or a fever
- Needing to go constantly through the night as a new change
- Pain in your lower belly or back
- Leaking that started after pelvic surgery or an injury
- Anything that feels different from your usual pattern
A pelvic health physio can check what is driving it and build you a programme, rather than leaving you to map the public toilets wherever you go.
Want the supervised version? Our pelvic pain and pelvic floor physiotherapy team works on this in the Sydney CBD studio, and our Pilates Fundamentals programme builds the deep control these techniques rely on.
