What are 'urgency triggers'?
It is well known that the terms women's health and pelvic floor go hand in hand together. A huge emphasis is place on this group of muscles in reducing the symptoms of incontinence among both women and men with either large improvements or complete cessation of symptoms. There have been countless studies conducted on the association between the two which is why we- your physiotherapists- sound like a broken record sometimes when we say "lift your pelvic floor".
But what about the times when you feel a sudden urge to urinate and you feel that your pelvic floor muscle control alone just won't be enough?
Urgency refers to the sudden desire to void or pass urine with the inability to defer or wait for longer than 5 minutes.
Urge 'triggers' refer to certain activities, places, or times that may bring on an urgency episode. For example, driving home from work every day you have absolutely no desire to pass urine and then as soon as you put your keys in the front door, you feel you have to run to the toilet. Or when you turn the tap on when brushing your teeth, or when you are in the cold section in the supermarket. These are just a few of the many triggers that may bring about an urgency episode. Urgency can happen without leaking.
The great news is that urgency can be cured, and if not, greatly improved. We already know how to contract the pelvic floor muscles so I am not going to talk about that in detail but that does play a large part in fixing these triggers.
There are a few other things that you need to do to manage an urgency episode.
The most effective technique is perineum pressure. This is placing your hands over your front passage and applying pressure. You will often see children doing this when they need to wee. I understand that this might not be seen as the most appropriate thing to do while searching for cheese in the supermarket! With that in mind, the corner of a table or the edge of chair can be great at applying the pressure while it looks to others that you are just resting your legs or have a little rest.
Technique two is raising your heels off the floor and coming up on to your toes. Again you will often see children doing this. The reason this movement may help is linked to the neural pathways from your pelvis to the brain. Keeping it simple, by lifting your heels, the message to your brain shifts from your bladder to the muscles contracting in your calf and lower leg.
The next technique is distraction. I will often suggest to my female patients to count backwards from 100 by 7's. This shifts your brain to thinking about something other than your bladder and while you're busy subtracting 7 from 72 your urgency has passed or reduced.
Breathing and walking slowly is the last important technique. Breathing and walking slowly will keep your muscles relaxed (remember your bladder is a muscle, after all). If you think about when you get a cramp in your leg, you would normally find staying still and breathing is more effective in stopping the cramp. Racing to the bathroom will contract the muscles more, including the bladder muscle, making it harder for you to control. Holding your breath will make it harder for you pelvic floor muscles to contract to help stop leaking and to help you pass the urge.
Contracting the pelvic floor is the final step in reducing and controlling an urgency episode.
When you feel a sudden urge to pass urine, try any or all of the above steps. I am absolutely certain that your urgency will improve with the above techniques. It might work better on some occasions compared to others and that is very normal. You just need to give it a go. Good Luck.