RecoverRx Performance and Recovery Blog
This blog is dedicated to all things from recovery to performance. Our industry expert Physical Therapists provide evidence based information and opinions educating our readers on how to optimize their health in order to be able to overcome injuries and live the life they were meant to live!
By Dr. Ariel Sernek, PT, DPT
Have you ever found yourself in a store or driving home and you get hit with an all encompassing need to pee? You can’t think of anything else and you use all of your power to control it to get to the bathroom drip free. You get right to the door of the bathroom and all your efforts fail … you peed your pants. You think, well this is great and there’s nothing I can do about it.
We start with anatomy and physiology. Don’t worry I’ll make it easy to understand. Let's start with the bladder. It’s a smooth muscle called the detrusor muscle and we don’t have voluntary control over it like we do our arm and leg muscles. The bladder is controlled by our autonomic nervous system, which means it functions automatically without us having to think about it. The parasympathetic nervous system allows the bladder to contract to start pushing out the urine through the urethra. Think Parasympathic = Pee. The sympathetic nervous system helps relax the bladder muscle to store urine and fill up the bladder. Think Sympathetic = Store.
The bladder works in the opposite fashion of the pelvic floor muscles. While one is contracting the other is relaxing. So in order for us to urinate, the bladder contracts and the pelvic floor relaxes. Any other time we are relaxing the bladder muscle to store urine and the pelvic floor is contracted to stop leaking.
Now that we got all the scienc-y stuff out of the way, we can talk about how to fix this problem.
First we NEED to know how often you’re going to the bathroom. Most people don’t realize that we should be going 6-8 times in a whole 24 hour period. If you are going 3 times a day, we may need to increase how often you go so you are not over stretching your bladder muscle. We may need to cue you to go less if you’re going 10-15 times per day. We also assess what your input and your output is, so how much you drink and how long it takes you to pee. To know how your bladder is functioning, we use a bladder diary or tracker.
Next, we have to identify and become aware of our triggers. These could be running water, warm showers, pulling into the driveway, touching a door knob/handle, or a simple thought about using the bathroom. Sometimes the triggers may not be environmental, but diet related. Carbonated, caffeinated, sugary, alcoholic, and acidic beverages can also trigger our bladder to want to contract and get that irritating fluid out as quickly as possible. These factors may be different from person to person which is why we have you fill out a diary, because no person is the same.
The next treatment step is to use our pelvic floor, prefrontal cortex, and autonomic nervous system to control the urgency and bladder contractions. First, you want to STOP moving and stay still whether you are sitting or standing. Next, you want to contract your pelvic floor muscles 5 quick times in a row. This will communicate to your bladder to relax and stop to fill. The third thing you will do is take 2-3 deep breaths making sure to exhale slowly. This will stimulate your autonomic nervous system to decrease stimulation to the bladder and decrease the bladder contractions causing urgency. The last thing you will do is to distract yourself with a to-do list, for example - counting backwards from 100 by 3s; something that takes your prefrontal cortex away from the thought of your bladder and onto another task. This is why urinary urgency and bladder control is better at work than at home. You are more distracted by work tasks and things to do that it’s easier for your brain to put off going to the bathroom. Again, we still want to maintain a 6-8x frequency throughout the day and night.
If you are still having issues or complaints with this, please reach out and I can create a customized program for You! You can reach me directly at firstname.lastname@example.org or check out our Pelvic Health page https://www.recoverrxpt.com/pelvichealth.html to learn more or set up a visit.
What is Inflammation?
Inflammation has a bit of a bad reputation, but it is actually a necessary and healthy part of your immune system. Your inflammatory response kicks into gear when your body comes into contact with something it perceives as harmful, such as a pathogen, irritant, or chemical. While inflammation can occur from a physical injury, like when your toe swells up after you stub it, it can also result from your body helping you get better when you catch a cold. Both of these are examples of acute, or short-term inflammation, which, again, is a necessary and important part of life. On the other hand, chronic, or long-term, inflammation can cause problems for your health. If your body is regularly exposed to inflammatory components through food, environmental toxins or other sources, your inflammatory system has a hard time turning off.
Your Diet’s Impact on Inflammation
Chronic inflammation is linked to a number of conditions including asthma, allergies, autoimmune diseases, depression, cardiovascular disease, insulin resistance, cognitive decline, osteoporosis, arthritis, and obesity. Some painful joint conditions, including osteoarthritis and gout, are potentially triggered or exacerbated by inflammation in the body. This may also be true for localized pain from injury and even chronic, generalized pain that is not improving with other treatments.
"A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation," explains Dr. Fred Tabung of Harvard’s School of Public Health. "But your diet is also one of the best ways to reduce it."
It probably won’t come as a surprise that many of the foods you deem “unhealthy” are also the ones that cause inflammation. Inflammatory foods include: refined carbohydrates (such as white bread, pasta, pastries), candy, fried foods, sugar-sweetened beverages like soda, alcohol, and processed meats like hot dogs and sausage.
Foods that fall into the “inflammatory” category can promote the production of reactive oxygen species (ROS), TNF-alpha, and interleukin 6, which are all indicators that the immune system has been ignited. Consuming these foods can also disrupt the balance between inflammatory and anti-inflammatory cytokines that are produced by the immune system.
It’s important to note that inflammatory foods can be a part of a healthy diet, and enjoying them along with foods high in fiber and antioxidants is a great strategy for keeping inflammation at bay. Mainly choosing foods that fight inflammation and keeping inflammatory treats in moderation is key to keeping your health vibrant and preventing disease, so let’s explore which foods help do just that.
Foods that Fight Inflammation
According to Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health, "Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects.”
This research is important because it shows that prevention is vital to health, and being proactive in preventing disease can start in the kitchen. Other studies have supported the idea that dietary polyphenols in a variety of foods can help lower inflammation in your body and improve the function of cells that line your blood vessels.
While most fruits contain a variety of vitamins and minerals that support your body, a few fruit families are especially known for their antioxidants and polyphenols, which are protective compounds found in plants. These include berries, which have been linked to lower risk of heart disease, Alzheimer’s disease, and diabetes; and stone fruits, such as cherries, plums, apricots, and peaches, which contain fiber, vitamin c, potassium, and a variety of phytochemicals. In addition to many fruits, brightly-colored vegetables like kale and spinach can improve the function of cells that line the blood vessels, helping your body combat damaging inflammation.
Nuts and seeds, along with olive oil, fatty fish like salmon and sardines, and spices like turmeric, ginger, garlic, and rosemary, are other options that have been associated with reduced markers of inflammation and a lower risk of cardiovascular disease and diabetes among people who consume them regularly. Some beverages are also known to be rich in antioxidants and are thought to have anti-inflammatory benefits, including coffee, green tea, and drinks containing cocoa. Even supplements containing curcumin (found in turmeric) may reduce inflammation that causes pain like arthritis.
So if you have pain or inflammation that seems to come and go and is not always related to your activity level, consider adjusting your diet to include more anti-inflammatory foods and less of the other. Also, give us a call and we can help you find other long-term solutions to your pain and discomfort!
Dr. Luke Greenwell, Dr. David Bokermann, Dr. Sarah Greenwell, & Dr. Ariel Sernek are Performance Based Physical Therapists with extensive backgrounds in treating the injured athlete. At RecoverRx, they are passionate about returning people to the sports & activities they love. Check out more about them by visiting our About Us page.