To P or not to P

I had heard about the connection with the heel and the bladder, but didn't understand how it worked, so have gone down a bit of a rabbit hole trying to find out more…

Pee-pee, wee-wee, tinkle whatever name you have for urination, we all do it, we always have done it and sometimes we do it when we don’t want to do it.

A few facts about urine

Some women in ancient Rome drank turpentine (which can be poisonous) because it made their urine smell like roses.
Each year in Canada, about 225 men fall overboard and drown as a consequence of standing up in a boat to urinate overboard.
Ancient Roman spies used urine as invisible ink to write secrets between the lines of their official documents, hence the saying: “read between the lines.” The messages appeared only when heated.
Hippos are retromingent, which means they are able to urinate backwards
Male lobster’s bladders are in their heads, and when they fight, they squirt each other in the face with urine.
One kidney could handle the task of filtering the blood and making urine perfectly well. If one kidney is removed, the remaining kidney can increase in size by 50% within two months to take over the whole job.
Leonardo da Vinci proposed that houses be built with spiral staircases so people couldn’t urinate in the corners.

Urinary Incontinence

Urinary incontinence affects 300 million people world-wide. That’s 1 in 4 women and 1 in 9 men. Studies are showing that 50% of people deal with incontinence at some point in their life. (Aren’t you happy you’re reading this?)

Urinary incontinence is not normal, it’s not meant to be part of growing old or having kids. It’s common, but not normal.

3 most common categories of urinary incontinence

Urge incontinence: when you feel the need to go to the bathroom immediately. Often there are triggers, such as putting your key in the front door or parking the car in your driveway. Something suddenly tells the brain “I gotta go and its gotta be NOW” (This is the most common type)
Stress incontinence: not stress as in the nervous system, but leaking during a laugh, orgasm sneeze, cough, jump or jog. It is the increase in intra-abdominal pressure and you leak, but you don’t necessarily have an urge to go.
Mixed incontinence: is a mixture of both stress and urge incontinence

Your inner trampoline

The most obvious thing we consider of when thinking about urinary incontinence is strengthening our pelvic floor muscles. Tightening everything to hold it in. This may be part of an answer. But it is worth saying that you can have over tensed muscles just like you can have lazy ones. Pelvic floor exercises such as Kegles might not always be the solution. Often the problem arises when the pelvic floor holds too much tension and what is needed is relaxation, which feels counter intuitive.

Think of the pelvic floor as a trampoline that provides support for the bladder. What makes a trampoline effective? If it’s too tight, there is not going to be enough movement for the trampoline to work and if it’s too slack, there is too much movement for it to work.

The same is with the pelvic floor, we need the muscles to activate when needed but also to release and relax at the appropriate time.

A mini study

2012 researchers did a pilot randomised trial on effects of yoga on urinary incontinence. Half women did a 6-week yoga program and saw a 66% reduction in the frequency of urinary leakage. The other half who didn’t do the yoga only saw a 13% improvement. The study was very small, 19 women, so make of that what you will.

One question I have is why was there a 13% improvement when they did nothing? But when you read the study, that is not quite true. Everyone was given a pamphlet with instructions about standard behavioural self-management strategies for improving bladder control, which included pelvic floor exercises and other techniques which is generally the first thing your doctor would provide. As always having some knowledge on a subject is going to help – provided you take action on it of course.

Try this for urge incontinence

Maybe even just reading this is triggering something in the brain and making you want to go. One suggestion is to try to breath more slowly. Find your calm space. Reassure yourself it’s ok. Do some heel pumps. From a standing position lift one heel and press that heel down to the earth then swap, lift the other heel and press it down to the earth. There is a connection with the nerve that connects with the calf muscle all the way to the bladder. The pumping action of the calf muscle stimulates the contraction of the pelvic floor muscles.

Some useful effects of yoga

To claim that Yoga is the antidote to everything would be stretching the truth, but it certainly helps with many things. Here are some ways it might help in this case:

Yoga strengthens the whole of the core and the body, which all help the pelvic floor muscles.
It balances the nervous system.
It gives us that ability to calm down and come to the moment, building awareness which can also help with urge incontinence.
It can encourage us to keep us working as a whole. (E.g. If you think about breathing, on the inhale the pelvic floor AND the diaphragm soften and move down and on exhale they move up a little. They work together naturally. We can do breathing exercises to increase our awareness of this.)

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