Tips for a peaceful bladder during the holiday travels

The holiday travels can be a source of anxiety for folks who experience bladder control issues. Long travels, flights, airports, being in places where you don’t know the location of the bathrooms, can indeed make things stressful. 

Here are a few tips to go through the holiday travels with a bladder at peace!

#1 – Avoid bladder irritants before and during your travel time

Coffee, tea, alcohol, carbonated drinks, acidic, spicy & sugary food can all be triggers for those who experience bladder urgency & incontinence. Avoiding them the day before and during your travel time may just be what you need to keep yourself out of trouble.

#2 – Keep the bowels moving

I know this can be a challenge when you are away from home and you eat things that you don’t normally eat, drink more alcohol than usual, perhaps eat less fruits and veggies than what you are used to. But remind yourself that constipation is one of the #1 causes of pelvic disorders. When your rectum is full, it can press on your bladder and cause urinary urgency and incontinence. Straining on the toilet can also worsen a prolapse, so you really want to keep things moving while you are away and don’t let it go too long.

One good way to manage it is to carry dried fruits with you so you get your fibre intake, as well as a water bottle to keep those fibres wet & moving along the intestinal track. Fibre supplement caps such as Metamucil can also be a good way to get your fibre intake without carrying too much food on you. However, be aware that increasing your fibre intake without increasing your water intake at the same time can actually make your constipation worse by bulking your stool too much! So make sure that both water & fibre intake go hand in hand! 

If you have not had a bowel movement for more than 2 days, try my intestinal massage to get things started.

#3 Select an aisle seat if possible

There is no point in stressing yourself out while travelling on the plane by having a window seat and not being able to access the bathroom on time if you need to. Sometimes, paying the extra few bucks and buy some peace of mind is the way to go, this way you don’t end up having to wake your neighbours up every time you have to use the washroom. One less thing to worry about!

#4 Exception to “no just in case” rule

I know I have told you in the past that going to the bathroom “just in case” is not a good strategy to work on your bladder capacity. However, when it comes to air travel where you may have to wait in line for security or other things, you can make exception to the rule. This is not the time to work on bladder capacity that day, you can work on it while you are in a more familiar environment. Emptying your bladder before security & boarding could be a good solution to avoid distress associated with bladder urgency while you are waiting in line and cannot use the washroom.

#5 Wear protection in case

There is nothing worse than feeling uncomfortable from urine leakage in your underwear and pants, especially in public when you can’t change right away. Wearing a liner or incontinence pad during your travels can be a good way to keep your mind at peace, knowing that you have protection just in case, and that you can change it if you have an accident. I highly discourage you from using menstrual pads for that purpose, as they do not breath well and may create some irritation around the vulva. Go for pads that are specifically made for incontinence (ex: Poise) and will be much more comfortable for you. Carry a few in your purse in case you need to change them over the course of the day, and maybe a change of underwear as well.

#6 Urgency: stop, breath, distract, kegels

If you are on the plane and have sudden bladder urgency but there is a line up to the bathroom, use the “stop and breath” technique. As you are waiting, try to distract yourself from your bladder by bringing your attention to your breath, and count up to 10 nice breaths in & out, feeling the air coming in through the nose, out through the mouth.

You can also use mental distraction: counting backward from 1000, mentally listing the American states, find the names of all the people you know whose names start with an “A”, or whichever silly task you may find. You can download games on your phone before taking off which you can use for distraction during the bathroom line up. The less you think of your bladder, the more control you will regain over the urgency. Your bladder literally feeds on your thoughts, it WANTS YOU to think of it. Do not let your bladder control your mind!

You can also do a few kegels (pelvic floor contraction / release) to distract yourself from the sensation of your bladder. Squeeze for a few seconds, release, squeeze, release… Do this 5-10 times. Normally, the urgency will decrease as you do this.

#7 Trust yourself

In a new environment, this is so easy to lose your confidence in your bladder control, as you may not know where the bathrooms are. Reminding yourself that there is a huge psychological component to bladder control, and the more thoughts you put into your bladder or are worried about it, the more you are giving material for your bladder to feed on and take control over your mind.

Finding a positive and empowering mantra that you can repeat mentally when you feel about to lose control may be a great way to work around this. Something around the lines of:

“I am calm, in control, and I know I can do this.”

Close your eyes and try to picture yourself in an environment that is familiar to you where you would be in control (ex: in your own house). Or picture yourself on the beach, on the top of a mountain, or any environment that brings calm & quiet into your mind. Take 10 breaths here.

 

Alright – that’s it for my little tips!!! I know you can do this!! 

Happy holidays everyone and see you back in January 🙂 

Sophie

Vaginal scar tissue: 3 techniques to release it

Vaginal tears from childbirth can heal in different ways, and many people are not aware that sometimes they need a little help in the healing process. In fact, vaginal scar tissue can often heal “tight” and not super flexible, and can cause pain with sex.

If this is your case, these techniques can help with releasing the scar tissue and make it softer. I recommend doing them every day or other day until there is no discomfort anymore with any of the techniques and that sex feels comfortable.

Painful sex: how to use vaginal dilators to stretch your vagina

There is this myth going around in our society that it is “good to have a tight vagina” – but good for who exactly?! I’m asking you.

What if I was telling you that most of my clients consulting for painful sex issues present, in fact, a tight vagina, and it sure makes their sex life not pleasurable at all! Is that good? It sure ain’t.

There is a difference between having a healthy muscle tone in your vagina so you can have good sensation during sex, versus having a high tone and tight pelvic floor. Hypertonic pelvic floors are NEVER good and healthy – they can cause pain, incontinence, overactive bladders and so on. We want those tissues to breath, to allow stretch, to be dynamic, to move!

BUT HEY – that was not the point of my post actually. I wanted to tell you that if you feel like your vagina is so tight that penetration feels like sandpaper in your lady bits or like trying to fit a banana in a toothpaste tube, this video is for you.

This is for you, post partum mom who had vaginal tearing or episiotomy, or simply a challenging healing time, and now feels like sex is no longer the same and that there is not enough space down there.

This is for you, menopausal women who had no sex for years and just met a new partner, and discovers the sad reality of “use it or lose it”. Indeed, after a certain age, if we do not have sex very often, the vagina can actually shrink…! But hey, you can get it back!

This is for you, young woman in your 20s who has never been able to insert a tampon without pain, or never been able to have painfree sex ever since you became sexually active. You are actually starting to think that this may be how sex is supposed to be, and may start wondering why people even have sex.

PLEASE DO NOT ACCEPT PAINFUL SEX AS YOUR REALITY!

Return to running after birth: do you make the cut?

When should you return to running after delivery? There is so much controversy about this topic, and I thought I would share the updated 2019 guidelines to enlighten your decision making. Remember that these tests are only one part of the puzzle, and that a Pelvic Health PT assessment should also be part of it to make sure that you core and pelvic floor are ready for it too.

What’s the risk of going back to running without meeting those criterias?

You may put yourself at risk for permanent damage/injuries such as vaginal prolapse (when your bladder is descending into the vagina), or even pelvic/low back pain. Or you may get lucky and nothing will happen. But do you want to take that chance?

I have had clients who regretted not having been informed about holding off on high impact after birth, as they dealt with low back pain or vaginal heaviness for years after the fact… until they finally consulted with a pelvic health PT to address it. Believe me ladies, it is not worth the risk, especially if a few weeks of adequate exercises prescribed by a Pelvic Health PT can prevent those injuries.

Watch my 10-min video below to test where you’re at 🙂 

Also, if after going through these tests you feel like you make the cut, please ensure to go back to running very progressively – starting with some walk/run, flat course, short distances, slower speed, etc.  A pelvic health PT can guide you in the progression. You can find the updated guidelines at p.5 here for more details 🙂

Leaking urine: is your pelvic floor truly weak, or is it tight?

Many people think that if they are leaking urine, they must necessarily have a weak pelvic floor. Starting from this assumption, they start doing Kegel exercises, and sometimes make their problems worse! Why is that?

In this video, I am drawing the distinction between a weak and a tight pelvic floor, and why Kegels can be harmful in some cases!

What to expect after baby?

One of the things I hear the most from my post partum moms is “No one told me this could happen..!”

Indeed, not many women are informed about what to expect in the pelvic area after baby is born. We spend soooo much time preparing for labour, birth and baby’s care. But once these adorable little humans are out of the uterus, it can be comforting to know what is normal and what’s not. No one needs an additional source of anxiety when trying to take care of a newborn, am I right..?

So here’s a list of the most common pelvic symptoms you may face after delivery:

1- Pain and soreness in the perineum

The perineum refers to the area between your vagina and anus. After all it’s been through, normal that it may feel sore and painful for a few days.

Your best friends will be: ice packs, sitz baths with epson salt, witch hazel pads, peri bottle to clean after urination & bowel movement, pain medication if needed. 

2- Painful bowel movement, hemorrhoids, blood in stool, constipation

Again, depending on how your birth went (pushing time, baby’s position, baby’s size, use of forceps or vacuum, tearing, etc…), your rectum area may have taken a hit in the process. Totally normal to have some of these symptoms for the first few weeks.

Your best friends will be: anurex (cooling device for the rectum – available to purchase at my clinic), stool softeners, squatty potty (to have a more optimal position on the toilet), ointment (ask your doctor), donut cushion. For constipation: water, fibre & magnesium supplements. For more detailed info about this topic, read my post about bowel health!

 

3- Difficulty to hold urine, stool or gas

That is to be expected to a certain degree for the first 2 months after baby. You may feel urine coming out with laughing, sneezing or coughing, or even on the way to the bathroom, or at random times. You may feel like you cannot hold gas anymore, and that you have to rush to the bathroom to make it on time when you need to have a bowel movement. These symptoms can be quite embarrassing to deal with, but they should slowly get better over time. Starting on your pelvic floor exercises a few days after birth should speed up your recovery. After 8 weeks, it is not normal to still present these symptoms and you should definitely consult a Pelvic Health PT if that’s the case.

Your best friends will be: pads specifically made for incontinence – they breath better than menstrual pads and will be less irritant for your skin

4- Vaginal heaviness

For the first few weeks after birth, you may feel like your organs are falling out of your vagina if you stay on your feet too long or go for a walk. My suggestion is to try and avoid activities that trigger this heaviness, and avoid lifting more than your baby weight. For example, if a 30-min walk triggers a feeling of bulge in the vaginal area, try and go for a shorter one next time and see if you still experience these symptoms. It is all about listening to your body at this stage, so you avoid long term damage such as prolapse.

Your best friends will be: anti-gravity pose (calves on a stool with pelvis elevated) or horizontal position when symptoms occur, pacing yourself to avoid triggering symptoms, avoid constipation and straining

5- Return to sex 

OK: first, most couples return to intercourse between 3-6 months after baby is born – those are just the statistics. The famous “6-weeks green light” from the doctor can be quite a source of anxiety for many women, actually. Indeed, some moms feel the pressure to get back to sex ASAP, when in fact they still have lots of healing to do, both physically and emotionally especially if they have experienced birth trauma.

Not to mention that moms may feel exhausted, overwhelmed, anxious or depressed. They may have a low libido, sore nipples and vaginal dryness. On top of that, they are figuring out their new role as a mother, their new routine, how to care for their baby, etc. How are they supposed to feel sexy in those circumstances?

Now, supposing that you tried penetrative sex again, I just want to let you know that painful sex after birth is a very common thing, but IT IS NOT NORMAL!  Even though your scar has fully healed and everything was fine at your 6-weeks check up, it does not mean that your scar is moving well, that there is no adhesions, and that it won’t hurt. There are so many things you can do to improve the mobility of your scar with simple massage techniques! Ladies, you don’t need to suffer through this!!

Your best friends will be: lubricant, Book “Reviving your Sex life after Childbirth” from Kathe Wallace – she shows great massage techniques to help with scars, pelvic health PT consult, Sofia Fortin from the Happy Vagina Project & her Sex After Kids masterclass

I hope I did not scare you with this post – but I just wanted to let you know that these issues are super common after birth, so don’t panic if it happens to you. But most of all, I want you to know that Pelvic Health Physiotherapists ARE YOUR BEST FRIENDS for your post partum recovery. They will carefully listen to your birth story, let you cry if you need to cry, let you share your concerns without discrediting them. They will ask you all about your urinary, bowel, pelvic pain & sex symptoms, and they will make a plan with you. They will guide you through your recovery, so you are not alone.

You are not alone, momma, and you deserve the best care.

xx

Sophie

 

 

 

Bladder health 101

As any part of your body, your bladder can become unhealthy if you don’t take good care of it. That’s when people start consulting me for overactive bladder issues (going to the bathroom too frequently), urinary urgency, incontinence and so on.

What can you do to keep your bladder healthy? Here’s a few pro tips!

1- Stop going to the bathroom “just in case”: there is a muscle around your bladder, the detrusor, and if that muscle does not get stretched enough because you are constantly emptying your bladder before it’s full, this muscle can become stiff overtime! Start listening to your bladder signals to maintain a good bladder capacity – it will tell you when you need to go, no need to anticipate it 😉 This is also valid for any parent who may be encouraging their kids to go to the bathroom just in case – I tell ya, these kids will be in my office for overactive bladder issues when they grow older! It’s okay to do it for a “one off” before a long car trip, but in the day to day, try and teach them to listen to their bladder signals 🙂

2- Stay hydrated: to provide your bladder with a healthy, non irritant environment. What does that mean exactly to “drink enough water”? If you look at your urine colour, it should be pale yellow – not dark (exception is made for the first pee of the morning). The darker your urine, the more irritant for your bladder, which can in turn creates symptoms like urinary urgency (that unbearable sudden feeling that you need to go to the bathroom right now and you can’t postpone it!)

3- Be aware of bladder irritants in your diet: coffee, carbonated drinks, sugar, spicy & acidic food,  alcohol can all be triggers for urinary urgency and frequency, as they are considered bladder irritants. If you suffer from these symptoms, try to eliminate one item at a time for a few weeks to observe the effect on your symptoms. If you don’t have symptoms, just make sure to keep a healthy balance in your diet so you do not develop symptoms in the future.

4- Avoid straining while urinating: I know sometimes it is tempting when you are in a rush to try and  push your urine out through holding your breath. But all this extra force on your bladder can be damageable over time and lead to a bladder prolapse (when the bladder starts descending into the vaginal canal). Instead, take a few extra seconds to let your bladder empty on its own as you release your pelvic floor muscles. To do so, visualize the blooming of your vagina and release all the muscles around your vagina and urethra. You can do a gentle contraction of your pelvic floor muscles once the last few drops have gone through, in order to close the urethral sphincter properly – this is super helpful especially if you have symptoms of urine dripping while standing from the toilet. If you have no clue of what I am talking about by contracting and releasing your pelvic floor, consult with a Pelvic Health physio, or watch my video:

5- Do not hold urine for too long: meaning more than 3-4h between voids (depending on your liquid consumption). As much as it is not recommended to go to the bathroom too often, there is also a limit to what your bladder can hold! It is definitely not a good idea to hold your urine for too long – indeed, it can lead to pelvic floor muscle tensions and fatigue (as you will have to contract your pelvic floor in order to hold your bladder for that long…). This can lead to pelvic floor dysfunctions in the long run! So if you are a nurse or any worker on a the road who do not have easy access to a washroom, time yourself or put an alarm or something if you tend to forget to empty your bladder!

Hope this helps!!!

Sophie

 

 

3 key elements to have your pelvis on your side for labour & delivery

Your best friend just signed up for a full marathon in 9 months.
42 km!!! 
You are impressed, especially that she has never run before!

– So how are you preparing for your running event? you ask her.
– I don’t know. I’ll just go with the flow and see what happens I guess!

This story does not make sense, doesn’t it?

Why do we think it makes sense then when it comes to pregnant women approaching delivery then?

…when birthing a baby is the most physically challenging event a woman will ever go through?

In this 20-min webinar, you will learn
3 key elements
to have your pelvis on your side
during labour & delivery

Doing your Kegels right: pro tips!

“I have been doing Kegels but I am not sure if I do it right, so I would like you to check…” – so many women consulting me…!!! 

I don’t blame you ladies. Before taking my first Pelvic Health PT education course, I did not know either… Isn’t it crazy that we are not educated about pelvic health in school as early as teen age? Knowing how to contract and release your pelvic floor is such an important part of maintaining good pelvic health as a woman! It can be a game changer in your sex life, it can avoid embarrassing urine leakage symptoms, it keeps your your bowel & bladder health on the ball, it provides stability to your pelvis & low back… It is extremely connected to so many functions!! But still, we barely know these muscles even exist, let alone how to exercise them…!

If you want to get my pro tips to learn how to contract & release your pelvic floor (aside from the typical “try to stop your flow of urine” exercise that many women were told to do but is so unhealthy for your bladder!!), this video is for you! 

Exercise to stop leaking when you sneeze or cough!

“I want to stop peeing my pants every time I sneeze or cough” is one of the most common reasons of consultation I hear in my clinic. Clients often develop the strategy of crossing their legs to compensate for the poor pelvic floor muscles who just got a little lazy after childbirth or menopause.

Here is a simple exercise you can practice to start re-educating that reflex called “The Knack”. The Knack is a pelvic floor contraction before any increase in intra-abdominal pressure (such as when you sneeze, cough or laugh hard). It normally happens naturally without thinking about it, but when the pelvic floor does not work properly following hormonal changes or pelvic trauma, this reflex can be lost.

But hey!! Don’t worry, there’s something you can do!! Try this out: