Author| Maureen O’Keefe, DPT specialist in bladder, bowel and pelvic pain physical therapy
Why Can’t I Push My Pee Out?
If you have heard that pushing your pee out is bad for you and are wondering why, we have answers for you. We are Purple Mountain PT, a specialty pelvic health and TM joint disorder clinic located in Grand Rapids, MI. Our focus on pelvic health includes teaching our patients how to control their urine, which also means that some people have to re-learn how to relax when peeing so they don’t push their pee out. To learn more about why you shouldn’t push your pee out, read on. If you know this is a problem for you and you wonder if our physical therapy, which is offered in-person at our clinic or via telehealth, may help you, contact us here.
If you Push your pee out, even slightly, you are straining your pelvic floor!
Under healthy bladder circumstances, the bladder (which is a muscle) should be able to quietly fill up and expand with urine, keeping a low pressure in the bladder. The proper mechanics of urinating are that a signal to the brain occurs letting you know that you need to urinate, you calmly walk to the bathroom, you calmly relax and the bladder should contract strongly, greatly increasing the pressure inside the bladder, thereby releasing urine while the urethra should open and the pelvic floor should relax and lengthen. When someone needs to push their pee out, they are forcing pee out through a closed door and straining everything. If you want to stop pushing your pee out and treat your pelvic floor dysfunction, but have some questions about our physical therapy, contact us here or call 616-516-4334.
What is your brain learning when you push your pee out?
If you consistently push your pee out, you are developing a habit that is teaching your brain that your pelvic floor should activate and tighten when you need to pee. That’s not what we want your body to be doing! This can be challenging to un-learn, but we help people overcome this issue all the time. If you have questions about our costs and availability of pelvic floor physical therapy, call us at (616) 516-4334 or contact us here.
Consistently pushing your pee out can lead to the pelvic floor muscles getting confused when you need to urinate.
Our patients often tell us that they do not strain or push their pee out. Then, after we talk to them and explain what we mean by straining and pushing, they pay more attention and find that they are doing this.
Why would someone push their pee out? If you are like our patients, you tell us you do it for several reasons:
You Push your Pee Out to Finish Peeing.
To “get it all out.” Incomplete bladder emptying is a common problem for a lot of people, so we understand that you are trying to do a good job and empty your bladder fully. However, if you need to push your pee out to empty your bladder, this is a sign of pelvic floor and bladder dysfunction. You are straining your system and causing harm and teaching your brain the wrong method for fully emptying. Our physical therapy for this problem provides holistic care that fully assesses and treats your body to determine how we can recover your normal bladder and urinating function. The patients who find us tell us that this PT has changed their lives for the better. If you have questions about our care, please reach out here.
You Push Your Pee Out to Start Your Pee.
Some patients tell us that they sit on the toilet and nothing happens unless they push. Sometime they are pushing their pee to start the flow of pee because they can’t get the flow to start without a push. If you need to start your pee with a push, we can help you. Reach out to us here.
You Push Your Pee Out to keep your urine flowing, because your stream trickles, stops or stops & starts.
Some of our patients have trouble with their urine flow stopping or coming to a slow trickle when they haven’t fully emptied their bladder. Therefore, to keep the urine flowing they must pee. Our physical therapy helps stop this problem. Contact us here to learn more.
You Push Your Pee Out to Hurry it Up! You are in a rush!
We’ve all been there, when we need to urinate, but we only have seconds to do it. So, we push our pee to hurry it up. We are here to tell you to stop doing this! It is harmful to your bladder, pelvic floor, brain and organ support.
When you urinate, your pelvic floor should lengthen and your urethra should open and dilate, so urine can flow.
If you push your pee, this usually involves tensing your pelvic floor instead of relaxing it! The pushing also generates non-helpful pressure around the urethra and bladder neck, which strains that area and can lead to bladder control problems and possibly pelvic organ prolapse. If you are interested to learn more about our physical therapy, contact us here or call 616-516-4334.
With many years of pushing your pee out, you may notice that it gets more difficult to start the flow of your urine. Then, once your flow is actually happening, it may stop. A frustrating pattern may develop, such as the following:
- My pee won’t start, so I push my urine to get it to start
- My urine flow trickles, so I have to continue to push
- Even when I push, my urine flow stops, so I have to push my pee even harder
- I don’t feel like I emptied fully, so after I leave the bathroom I feel like I have to go again
- Sometimes when I stand up after urinating, then some pee will trickle out onto my underwear.
Over time, this urine not starting, flowing, then stopping flowing can be a sign of the pelvic floor muscles and bladder getting confused.
Unfortunately, pushing your pee out teaches your muscles, urethra and bladder the wrong things to do to facilitate normal, relaxed urinating. What can happen is that the pelvic floor muscles learn to be tense when peeing, instead of relaxed. Repeated tensing of these muscles can lead to adaptive shortening or stiffness of the muscles. Stiffness and tension in the pelvic floor muscles is also called “high tone pelvic floor” or sometimes it may be called “hypertonic pelvic floor dysfunction”. Our PTs provide you an assessment that identifies if this is happening for you and treatment that addresses your whole body and is needed to resolve pelvic floor problems. If you are interested to learn more about our physical therapy, contact us here or call 616-516-4334.
Pushing your pee out leads to problems in the pelvic floor muscles. All of these things listed below are various ways of saying you have pelvic floor dysfunction:
High tone pelvic floor, pelvic floor dysfunction, stiff pelvic floor, hypertonic pelvic floor, short pelvic floor, trigger points in your pelvic floor, weakness of the pelvic floor, tightness of the pelvic floor.
If you want to stop pushing your pee out, go back to the basics of retraining your normal peeing mechanics. This means:
Step One: When you feel the need to urinate, honor this need by calmly walking to the bathroom
This is an important part of healthy bladder mechanics. Too often, our patients have lifelong history of never using a public restroom. This is unhealthy and leading you to have bladder issues down the line. If you would like to take care of your bladder issues and pushing your pee out problem, contact us here or call 616-516-4334.
Step two: Sit on the toilet (or stand if you choose to stand) and relax, first by breathing.
Breathe using your diaphragm and creating 360 degree breaths. 360 degree breaths mean that your entire ribcage opens like an umbrella when you inhale and descends like a closing umbrella when you exhale. This breathing should be gentle, slow and relaxing breathing.
Step three: Soften and lengthen your pelvic floor. If you’ve been pushing your pee for a long time, this will be tricky. But, practice makes perfect. Repetition is your friend!
Sit on the toilet, breathe and let go of your pelvic floor. Try to keep your abdomen fairly relaxed. Allow for your urethra to soften. Imagine your bladder, urethra and pelvic floor melting and everything dumping easily into the toilet. Be relaxed throughout this. If you push your pee out, truly try not to do it this time and in future attempts. If you are interested to learn more about our physical therapy, contact us here or call 616-516-4334.
Step four: Wait patiently for all of the urine to get out. Do not rush your urination or cut it off before you are finished.
Incomplete emptying is not good for you. It can lead to build up of bacteria and/or a constant urge to urinate. As best you are able, we would like you to patiently sit on the toilet and fully empty your bladder. If you have pelvic organ prolapse, you may have some “kinks” in your anatomy that render emptying your bladder fully difficult. If this is the case, then gentle rocking or positional changes can be helpful to further tip your pelvis and get some more pee to come out, without pushing your pee out.
Step 5: Consider double voids! Double voids are when you have finished peeing, but you suspect there may be more pee that needs to come out, so you try to pee again.
There are a couple of ways to double void. One is simply to sit on the toilet longer and to repeat the breathing, relaxing, letting go efforts of peeing. The second is to finish your first pee, wipe yourself, stand up, shift your pelvis a bit, then sit down and try to pee a second time. This second time you will again breathe with your diaphragm, relax and let go of your pelvic floor. Some patients have success getting more pee to empty doing double voids. If you are interested to learn more about how to improve your need to push your pee out, contact us here or call 616-516-4334.
Step 6: If you cannot fully empty your bladder you may consider using other tricks, such stimulating your sacrum to see if it helps your system to eliminate.
This is a technique that comes from our spinal cord injury patients, who have trouble with voiding. Sacral stimulation is simply very gently touching, almost tickling, the area of your sacrum, which is located just below your low back. The nerves that control this area and give you sensation here also can influence your bladder and pelvic floor. Some people find that gently touching or stroking this region can help you to pee without pushing your pee out.
Step 7: Running water is an option to facilitate urinating, but use it on a limited basis
Running water: most of us are familiar with the idea that if you hear running water, it may give you an urge to pee. If you truly cannot get your urine to come out when you relax, you can try running the water and seeing if this helps. We don’t love this tip, because it can condition your bladder to react to running water, which isn’t the greatest issue to have. But, using this sparingly is an option. If you have questions about the symptoms you are experiencing and wonder if we may be able to help you, contact us here or call 616-516-4334.
Step 8: If you’ve urinated and you can tell you just can’t get all of your urine out, reach out to us at Purple Mountain PT. We are here to help you
If you finish urinating and you still feel like you need to go, we can help you. Or, if you are struggling with recurrent urinary tract infections, we can help you. Or, if you simply cannot pee without pushing your pee out, we can help you. Our PTs are specialists in bladder disorders, pelvic floor dysfunction and retraining your body how to pee. Our whole body treatment taps into the power of your spine, nerves, organs, breathing, pelvic floor and more to facilitate your ability to urinate with ease. If you are interested to learn more about receiving physical therapy with us, contact us here or call 616-516-4334.
Step 9: Final tip if you continue to have bladder problems and always need to push your urine out: keep in mind that you have pelvic floor dysfunction and may also have constipation. Our PTs treat constipation and resolving bowel issues can improve your bladder function.
We hope this gives you some insights and tips into why you should not push your pee out. Usually our patients come to us and have several issues going on with their body. For example, some people push their pee out + know they have a diastasis recti abdominis + experience stress incontinence on occasion. Other people have endometriosis + painful intimacy + push their pee out. Some patients have urinary frequency + push their pee out. Commonly, the women we help have pelvic organ prolapse + push their pee out. Most of our patients have low back pain + pelvic floor dysfunction. Our licensed physical therapists are here to help you feel like yourself again. Not only do we specialize in helping people who need to push their pee out, we also specialize in pelvic pain and pregnancy and postpartum care. If you have questions about whether our PT may be able to help you, either in person here at Purple Mountain PT in Grand Rapids, Michigan or via telehealth, call us at 616-516-4334 to speak with us to ask your question or contact us here.
Purple Mountain Physical Therapy, located in Grand Rapids, Michigan, is a specialty pelvic health and TM joint disorder clinic. We treat adults and children who experience any problems with peeing, pooping or pain. If you are pushing your pee out, rest assured that you are not alone and that we can provide you care to improve this. Getting your pushing problem resolved is important so you don’t give yourself a pelvic organ prolapse, anal fissures, nerve strain, pelvic pain and other associated pelvic floor dysfunction problems. Because we help people with all ranges of pelvic, hip, back, spine and TM joint conditions, we are uniquely qualified to provide you care for your issues. Our patients most appreciate the compassionate and private treatment we provide that is one-on-one with your physical therapists. We consider this work to be an honor and our patients tell us our treatment is more comprehensive, healing and beneficial than they’ve experienced elsewhere. Not local? No problem, we provide telehealth visits and consultations, also. We pledge to give you our best! Call 616-516-4334 to get your questions answered or reach out to us here.
Peace,
Dr. Maureen O’Keefe, DPT specializing in pelvic health, neck, TM joint, back and hip problems since the 1990s! Our team at Purple Mountain PT is here for you, when you are ready! We look forward to meeting you!
