Written By: Dr. Malerie James, PT

If you’ve been out in the woods or up a granite slab for a few days, you know your regular bowel and bladder habits might be a bit out of whack.

dehydration + tissue irritation + overworked muscles
                               =
Bladder spasms, pain, urge, or even UTI!

Normally, we pee around 6-8 times per day, about every 2-5 hours. When we’re super dehydrated from temps, altitude, exercise, or some other combination of adventure, it can lead to more concentration of the urine in the bladder. Increased concentration leads to bladder irritation or even inflammation, like cases of interstitial cystitis. The tissue becomes sensitive to the urine, and becomes more spasmodic. This contributes to the micturition reflex activation that gives us the sense of urgency or fullness that rushes you to the bathroom, only to trickle a little and still not feel relief from the urge sensation. More on that later! 

Rehydrating tissues with food and water intake , electrolytes as needed, Epsom salt baths, Sitz baths, and breathing can reduce these symptoms.

If you’ve been squatting to pee with a 40lb pack or hanging from a harness and voiding, you may notice it is hard to relax enough to fully empty your bladder. Breathing deeply into the belly and rib cage (aka  “umbrella breathing”) will allow the pelvic floor muscles to stretch and relax. Calming your nervous system by flooding it with oxygen can help reduce heart rate, cortisol levels, and muscle tone. One trick I like to share with my clients is to gently blow bubbles. This allows for good control of the breath without losing the relaxed sense of the pelvic floor with a deep breath in. Avoid pushing your pee out! Sometimes our push or strain actually makes the pelvic floor muscles contract, which halts or slows the micturition reflex arc to stop the bladder from spasming. 

To practice the urge control method, follow these 4 steps:

*URGE* 😳

1. 🛑  Stop! (If you’re walking, stand still. If you’re standing, sit down or lean against the wall.)

2. 🧘 Breathe. (4 big belly breaths)

3. ⬆️❌⬆️❌Pelvic floor squeezes (kegels, 4 quick flicks with full relaxation between each)

4. 🤪 Distract. (Make a list in your head of your favorite ice creams, do that two-minute task you’ve been putting off, or just return to walking or working.)

    

If the urge comes back and you aren’t near a bathroom or it hasn’t been more than at least 1 hour since you’ve last voided, repeat steps 1-4 to make it!