Ever wonder if shutting off your urine stream is the key to strengthening your pelvic floor muscles? Let me explain why it’s likely to do more harm than good…
Let’s face it, there may be a time when it’s a good idea to strengthen your pelvic floor muscles. Whether you just had a baby, are entering perimenopause, or are menopausal. Sometimes more control ‘down there’ is important so you can delay urination or stop the leaks.
As a pelvic health physical therapist (physio) I work with ladies on strengthening these muscles when bladder leaking, urgency, and frequency become a problem. It’s common that I hear the question;
Shouldn’t I be working on stopping my urine stream to strengthen my pelvic floor muscles?
The answer is NO, and here’s why.
When you are emptying your bladder the muscles of the pelvic floor are relaxed. They need to be relaxed in order for the bladder to be able to do its job. Your bladder is a muscle and when it’s emptying it’s actually contracting or squeezing this ensures that all the pee leaves and only a small amount is left behind.
If your pelvic floor muscles are not fully relaxed or if you are voluntarily contracting them, as in the case of shutting off your urine stream, this makes your bladders job a whole lot harder.
Shutting off your urine stream or doing the ‘urine stop test’ increases the likelihood that you will not empty your bladder completely. The amount left in the bladder is called ‘post-void residual’, a medical term that means your bladder is not fully emptying.
Why is it important to empty your bladder well?
If your bladder is not fully emptying, you are more likely to have a return trip to the bathroom sooner, which is annoying but the real downside is the increased likelihood of developing a bladder infection.
Not emptying your bladder well means the extra urine in your bladder may become a breeding ground for bacteria.
Curious about more information on strategies to avoid bladder infections? Check out my blog on the subject here.
Further, a recent study looking at the validity of the ‘urine stop test’ found that performing pelvic floor muscle exercise (Kegel exercises) while peeing did increase post-void residual amounts in the bladder. Researchers also specified that urine stream interruption exercises should NOT be used in the practice of pelvic floor muscle training.
So what IS a good way of strengthening your pelvic floor muscles?
If you look at the anatomy of the pelvic floor muscles, there are two primary layers of muscles. The first layer is the most superficial or the closest to the skin.
This superficial layer consists of a triangle that forms between the sit bones of the pelvis and circular muscles that surround the urinary and anal sphincters. These circular muscles are like the muscles of your mouth, when they contract it closes.
The second layer is the Levator Ani muscles that form a bowl at the bottom of the body. These muscles are supportive for our pelvic organs and when they activate they lift upward, toward the center of our body.
To do a pelvic floor muscle contraction properly you need to activate both layers of muscle, by closing and lifting, in that order.
The difficulty with performing pelvic floor exercises is that unlike other areas of the body, we can’t see this area easily. Therefore it makes it hard to visualize what good muscle activation actually feels like.
To give yourself an advantage, I often suggest remaining on the toilet for a few minutes after peeing and working on your pelvic floor exercises. The positioning on the toilet means you can feel the lift more than sitting on an ordinary chair.
In order to get the muscle activation correct, I often suggest visualizing a ‘zipper’.
A zipper on a pair of pants starts at the bottom and zips to the waistline.
This is the movement sequence for the ‘close and lift’ technique as well. The bottom of the zipper is the closure and the lift is the movement of the zipper upward to the level of the belly button.
The ‘close and lift’ technique (or zipper) is a better way of getting the strength and coordination of your pelvic floor muscles, without running the risk of developing a bladder infection. Yay!
Feeling like you could use some personal coaching when it comes to pelvic floor muscle exercises and bladder control?
I would love to chat with you to see if personalized health coaching is right for you, follow this link to contact me!
Happy Bladder wishes! 
~ Tami
Tami Lines is a licensed Physical Therapist with certifications in Pelvic Rehabilitation and Women’s Health Coaching. She is the founder of Pelvic-Health-Matters. Tami has over 15 years of experience with expertise in bladder Health, and pelvic floor muscle dysfunction for adolescent and adult women. She is also a mom of two wonderful young adults working their way through college.
References:
Chesnel, C., Charlanes, A., Tan, E., Turmel, N., Breton, F.L., Ismael, S.S., Hentzen, C. and Amarenco, G. (2019), Influence of the urine stream interruption exercise on micturition. Int. J. Urol., 26: 1059-1063. https://doi.org/10.1111/iju.14092
Kowalik CG, Daily A, Delpe S, et al. Toileting Behaviors of Women-What is Healthy?. J Urol. 2019;201(1):129-134. doi:10.1016/j.juro.2018.07.044
