Gotta Go! // Part II

Anisha Drake PT, DPT, MCS

This is a two part blog, if you have not read PART I of this blog, visit our previous post by clicking here. By now, you should have identified at least one trigger for urination. While it’s great to know your triggers, it is more important to know what to do when you experience a trigger to urinate.

Do you remember the scenario last week where you had to run to the bathroom as soon as you walked through your door? Your Bladder does. It knows that you when you walk through your door it needs to send emergency signals to your brain.. Rushing to the toilet will cause your brain/ bladder to think there is an emergency. In emergency mode, the fight or flight system takes over (sympathetic nervous system). This may make you more likely to leak on the way to the bathroom. Once you leak on the way to the bathroom, you then feel you need to run faster next time making the cycle stronger.

Step one to respond to a trigger bladder:

Don’t panic! Walk slowly to the bathroom and breathe deeply. You might notice the first couple of times you do this there might be some leakage, so try this experiment where you feel comfortable.

Step two: Distract

The goal of distraction is to push back the urination by 5-15 minute intervals. It is important to note, if you are doing the distractions correctly the urge should decrease. The goal is not to fight the urge to go the bathroom but to decrease the urge itself. It may take some practice before the distractions work. The important thing is not to panic and put yourself in emergency mode.

Here is how to perform distractions:

  1. Stop- stay still and breathe. Anxiety just makes it worse.
  2. Breathe – inhale expanding the ribs, exhale minimally contracting the pelvic floor. At the next inhalation relax the pelvic floor. Repeat this 5–10x.
  3. Think – about anything but your bladder. I like to name all the state capitals, or perhaps the last 10 Super Bowl winners. Something that makes your mind actively not thinking about not going to the bathroom.  


Step three: Desensitize

Once you feel more confident with your distractions try to eliminate the trigger all together. Once you walk through your door and your bladder starts talking to you. Turn around and walk back outside. Once the urge decreases with your distractions try to go through your door again.  


The bottom line is we go to the bathroom when our bladder is full , not when it is convenient. If the bladder is not full when you get home, start a movie, or between classes then don’t go. If you habitually cannot decrease the trigger, contact a pelvic health physical therapist. A physical therapist trained to treat urinary frequency may be able to provide more instruction, or refer you to a urologist or other medical professional if necessary.

Dr. Anisha Drake is a Board Certified Women’s Health Specialist  at One on One Physical Therapy. She  treats pelvic pain, post-prostectomies, urinary/fecal incontinence, constipation/ IBS, pelvic congestion, Interstitial Cysitis, diastasis rectus abdominis  and endometriosis as well as overactive bladder. Anisha received her Doctor of Physical Therapy from University of Saint Augustine in 2009.