#102 Stop Doing Kegals. They Might Be Making Your Bladder Leaks Worse - With Lindsay Geddes

Think your bladder leaks are caused by a weak pelvic floor? Think again.

In this episode, I’m joined by pelvic floor physiotherapist Lindsay Geddes, and what she shares will surprise a lot of women.

Because in many cases, the real issue is not weakness.

It is tension.
It is pressure.
It is stress.
It is your nervous system.

We dive into why “just do your kegels” is often the wrong advice, why just-in-case peeing can make your bladder worse, and why your breathing, your core, and even your feet could be driving the leaks and urgency you have been struggling with for years.

If you are fed up with:

• leaking when you laugh, cough, or exercise
• needing to pee all the time
• waking up at night to go to the toilet
• being told this is just what happens after kids or with age

You need to hear this conversation.

This episode is a huge reminder that just because something is common, it does not mean you should accept it as normal.

This is one of those episodes that could finally explain what is really going on.

Instagram: @ lindsaygeddespt

Free Community Facebook Group: Women’s Natural Bladder Support: Leaks, Incontinence, OAB, Urge, Frequency

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Transcript

Meet Lindsay And The Big Myth

Max Lowery 0:00

Today I'm joined by Lindsay Geddes. Lindsay is a pelvic floor physiotherapist from Canada who specializes in bladder health and pelvic floor issues. She helps women who struggle with bladder leaks, urgency, frequency, and waking up in the night needing to pee. So this isn't a topic that we usually cover on this podcast. However, I met Lindsay in Mexico through part of a coaching mentorship we are involved with, and I was fascinated by the work that she does. Because the more we talked, the more I realized this problem is incredibly common for women. In fact, up to 50% of women will experience bladder leaks at some point in their lives. And yet almost nobody talks about this. And when women do seek help, they're usually told the same thing. Your pelvic floor is weak, just do your kegels. But what Lindsay shares in this episode completely challenges that idea. Because in many cases the issue isn't weakness at all. It's tension, it's pressure in the body, it's movement patterns, and very often it's the nervous system. In this conversation, we talk about the real root causes behind bladder leaks and urgency, why just in case peeing can actually make the problem worse, and why things like your feet, your breathing, and your core can impact your bladder. And although bladder leaking might be common, it's not something women should just accept as normal. So if this is something you struggle with yourself or you know someone who has, I think you're going to find this conversation really eye-opening. Let's get into it. How do you create a life that allows you to lose weight, eat the foods that you love, and sustain the results? Over the last 10 years, I've helped thousands of people do exactly that. I'm Max Lowry. I'm an author, personal trainer, and weight loss coach. In this podcast, I'm going to share my top tips and tricks from within my one-on-one coaching program. It's my goal to give you the tools and the understanding so that you never diet again. Hello, welcome to another episode of the podcast. Today I'm joined by Lindsay Geddes, who is an expert in pelvic floor and bladder health. So I will let Lindsay do a better introduction than I have. Lindsay, who are you and who do you help?

Speaker 1 1:57

Hi, Max. Thanks for having me. My name, as Max said, is Lindsay Geddes. I am a pelvic floor physical therapist or physiotherapist, as we say here in Canada. I know in places in the UK and Australia also say that. And I work predominantly with women with bladder leaks, urgency, frequency, and night peeing. Before I was a pelvic health physical therapist, I was an orthopedic physical therapist for many, many years. So if you've ever seen a PT or a physio for back pain, knee pain, surgery, car accident, sports performance, that sort of thing, I did that all for many, many years before getting into pelvic health. My background in education, my undergrad degree was in exercise science and human kinetics. And I'm a clinical Pilates certified instructor as well. So I love movement as medicine. I use it all the time. But surprisingly, using muscles and moving your body isn't always the best fix for bladder issues. And I'm sure we're going to dive into that today.

Max Lowery 3:02

Yes, I'm very much looking forward to listening to that. So some context and why we're having this conversation. So Lindsay and myself are part of a coaching mentorship, and we met for the first time in Mexico in November, I think it was. And, you know, we had a chat, obviously working with similar audiences, and I was fascinated to hear about how Lindsay was helping her clients. So ultimately, that's why we're having this conversation today. I want you, the listeners, to benefit from Lindsay's experience because I think she has, and you have a maybe a different way of approaching this, which I was really uh interested to hear more of. But before we go into that, I would love to know a bit more about what specifically drew you to pelvic floor and bladder health work.

Speaker 1 3:43

Yeah, so I was always pretty interested in it. I think as a woman in the industry, often when I was working with clients as an orthopedic physical therapist, once I got to know my clients, sometimes they would say it their issues to me. So I want to get back to running and my knee hurts, but now that my knee doesn't hurt anymore, I don't know if I want to do this because I'm leaking. And so oftentimes after I got to know them, they would talk to me about pelvic health issues. And so I was always really a little bit interested. And so I started diving deeper and asking people about this from the get-go. And what I found really fascinating is that I could often get rid of their bladder and bowel and pelvic floor issues by not actually doing anything internal, by not actually being a pelvic floor PT, but by optimizing other parts of the body and movement patterns that are going to influence the pelvic floor in the bladder. And so I thought, well, that's pretty cool. I need to learn more about that. It was also around the same time that we were family planning and started to have children of my own. And so I just went full board and just really dove into the training to do pelvic health therapy. Where I really took a big turn in getting really, really focused, particularly on my area of focus right now, is when I was going through my own bladder issues. So my kiddos were not babies anymore. So I couldn't just chalk it up to I was just postpartum anymore. I wasn't perimenopausal at that time. And so I couldn't blame it on being old and things like that. And so I did what every well-meaning doctor, therapist, friend suggests. And what a lot of women out there have heard is I just started to do my daily Kegels. I did all of them. I was a straight A student. I did all the fancy ones, the elevators and the holds and the quick flicks. Anybody that's been prescribed Kegels is knowing exactly what I'm talking about. Back then they didn't have fancy things that you could insert inside and then squeeze around and play like fancy games on your phone with and that sort of thing. So I just did them analog style. And um, my leaking got way worse. Like, way worse. Not only that, I had raging back pain. Like it just was not good for me, not good for me whatsoever. So then I was confused, frustrated, and was like, well, this is not the right answer. So that's when I went even farther into the research, deeper into the clinical expertise of my colleagues to figure out well, if this like general suggestion of Kegels and that the reason why you have bladder issues is that you have weak pelvic floor muscles, and the only way to strengthen them is to do keegals. If that's not the case, then what is? And so I dove even deeper and thus started the journey as to where I am today.

Max Lowery 6:40

Fascinating to hear. Thanks so much for sharing. And what I love about the mentorship that we're in is that people have very similar stories to what you just described, is they went down the they had a problem, they went down the traditional route of fixing something with you know GPs and doctors and things like that. And it was kind of just addressing the symptoms and not really addressing the root causes. Um, and some of them, like yourself included, were actually you know medical professionals themselves, doctors, and were then disenfranchised thinking I can't actually help my my patients effectively, so they kind of became coaches. So it's um yeah, fascinating to hear. And we're gonna get more into the Kegel stuff because that's like the thing I really want to understand more about, and I'm sure our audience do as well. But before we go into that, I would love to know how common are the problems uh that you're seeing with bladder leaking. Like how common a problem is it?

Speaker 1 7:29

Well,

How Common Is Bladder Leaking

Speaker 1 7:30

it is so super common. I'll just ask you, Max, do you know 10 women? Are there 10 women in your life?

Max Lowery 7:38

Um maybe.

Speaker 1 7:41

At least five of them are going to have bladder issues leaking at some point in their life. So up to 50% of all women at some point in their life are going to have bladder leaks. 22 to 33% of them are going to be in the category of urge and urge incontinence, which is what I mostly focus on. That's when it's like I'm minding my own business and all of a sudden I get hit upside the head with a very strong urge. I have to go pee. I need to go pee now. And your bladder doesn't wait until you're on the toilet, you start to get some leaking ahead of time. So there is another type of leaking called stress incontinence. Those, that's the type that's going to come up around jumping, coughing, sneezing, exercising, that sort of thing. That one is a little bit more common. That's the one that will make up that bulk of the 50%.

Max Lowery 8:32

So, yeah, very, very high number then. So, and this is obviously why we're having this conversation, because this is very, very relevant. And to be honest, it's not something, you know, having worked with women for the past 12 years or so, it's not often brought up. So I imagine it's happening behind the scenes and they're not saying it. Um, and maybe just saying it to each other rather than to their coaches. So, Lindsay, what would you say are the most misunderstood things about bladder health and bladder leaking?

Speaker 1 8:58

Yeah, the number one most common misunderstanding is that we get told that if you have bladder issues, whether it's leaking, whether it's prolapse or pain or anything to do with the pelvic floor, it's because you have weak or loose pelvic floor muscles, and that in order to fix it, then you need to strengthen it. And then, of course, the way that you strengthen it is by doing kegel exercises, like isolated squeeze and lift exercises, or maybe doing a little bit of fancier kegels by, you know, doing a cue like slurp up a blueberry and hold that while you bridge or squat or lunge and that sort of thing. And so definitely the biggest misunderstanding is going to be that the weakness of the pelvic floor muscles is the biggest cause.

Max Lowery 9:46

Okay, well, let's elaborate on that on then. Why is that wrong?

Weakness Vs Tension Explained

Speaker 1 9:51

Well, we need to consider the whole pelvic system when it comes to understanding bladder issues. The pelvic system is going to involve the bladder itself, the pelvic floor muscles, but also their connections to the whole rest of the body, including via the nervous system. And when I say nervous system, I mean your brain, your spinal cord, all of the nerves that go to the rest of the body and the messages that they send back and forth. So the bladder and the pelvic floor, they don't live in a closet and operate all by themselves. They are literally attached to the whole rest of your body. When it comes to the pelvic floor muscles, they are not magic. Yes, they may make magic sometimes, but they are not special. If you look at them under a microscope, they are just like muscles like everywhere else in the body. It's just that they get this allure and this mystery because we can't see them and they're part of like a taboo area. And so people will lump them into being a separate thing. But just like, you know, if you've been working with a coach or a trainer or a PT, or if you know a little bit about your own body, you know that your leg muscles can be impacted by what you're doing with your foot. Your headaches can be impacted by what you're doing with your neck muscles or your jaw. Like we will influence other parts of our body because it's all connected, whether it's from fascia or muscles, gravity, biomechanics, even emotions will change how we use different parts of our body. And so when we have problems in one area, we have to look at the whole rest of the body. And there are a few parts of the body that particularly will change very, very strongly how the pelvic floor muscles react. One of them is going to be the foot and ankle. This is not just a Lindsayism. If we all go out there and go to the research and just look at foot and ankle mobility and range of motion and incontinence, you're going to see some connections there. Um, but another big area of the body is going to be things like your abdominal muscles, your core, your rib cage, because those are your biggest pressure management areas that will change how much pressure am I putting down in and around the bladder and the pelvic floor, which will directly impact how those things function. The other thing that gets wildly missed, particularly when it comes to urge incontinence, or when we have stress incontinence, when a big problem is that we have a tight or clenched pelvic floor, that your pelvic floor muscles are too tight, which is actually by far the more common finding when it comes to urge incontinence. So urge, um, urge and urge leaking. Um, what we need to take a look at is the nervous system. So when I say the nervous system, like sure your bladder may be having a hard time filling, holding, and then emptying the bladder where we want it to be emptied, i.e. in the toilet, and sure your pelvic floor muscles may be having a hard time relaxing completely and contracting to keep the tube where the pea comes out closed. But it's the nervous system that directs those things on what to do. It's the nervous system that tells the muscle how firm do we want to be, when do we contract, how do we contract. And it's also the system that will give bladders the give the bladder the signal to squeeze to help bring the urine out. And so if those things are having a mind of their own or a bossy bladder, as I tend to say, this is not to do with how strong your pelvic floor muscles are. This is a nervous system, a brain bladder connection issue.

Max Lowery 13:48

This is absolutely fascinating. And I think what I am hearing more and more from having conversations with uh yourself, Lindsay, and then some other members of our uh community is it's this kind of reductionist approach to fixing problems uh like uh bladder leaking, or even with what I do with weight loss, right? It's like, okay, we're just gonna focus on calories and exercise and not address anything else. And what's becoming clearer and clearer is the body is a system and you have to take everything into consideration. Nothing can be taken into isolation, everything is working together. And I think West, you know, traditional Western medicine is incredible for so many different things, but it's very much a specialized field. You know, you have a problem with your heart, you go see a heart specialist. You have a problem with your, you know, anything else, you're gonna your kidneys, you're gonna go see a kidney specialist, but it's not taking anything else into consideration. Really quick one for me, guys. I don't run ads on this podcast, and I do aim to give you as many high-value tips and tricks as I can for free. All I ask in return is that you help me spread the word. That way I can help as many people as I can to never diet again. The way to do that is to rate, review, and share this podcast. A review will only take 30 seconds, but it would mean the world to me, but more importantly, it could help change the life of someone else. I would love to hear more about the nervous system because this is something that and how what you do to address the issues that are arising from the nervous system uh uh problems, because that's something that we it came up on my conversation with Brooke last uh uh two weeks ago. Uh, and Brooke, just for context, you should go listen to the episode, helps women as well with IBS and gut health issues. And the first thing that she does is she helps that her clients regulate their nervous system. No work can be done before that uh has been done. And that's what I'm beginning to realize more and more. A lot of our clients come to us very dysregulated within their nervous system. We've been addressing it here and there, but not enough. Uh, and we're going heavily into this now because what's becoming clearer and clearer is if your nervous system is dysregulated, your body is not going to behave in the way that you want it to, especially with things like weight loss. So I would love to hear more about um the problems that you see with the nervous system and how you how you help it.

Speaker 1 16:12

Mm-hmm. It's a great question. And it's a mandatory question. And I know Brooke as well, and I love what she's doing, and I love that she's incorporating the nervous system piece. And what a lot of people don't realize is that so gut health, IBS is something that she really works with. There is a strong

The Nervous System’s Role

Speaker 1 16:30

correlation for people who have IBS will also have a higher risk of having overactive bladder or urge incontinence. And that nervous system piece is a key connector between those two things. So it is absolutely important. And so let's just paint a picture here. A lot of people understand Pavlov's dog. So this was Pavlov was um a scientist. I'm sorry, I don't remember what his um uh technical title was, but he did the research where he would ring a bell and feed the dog, ring a bell and feed the dog, ring a bell, feed the dog until there was an association there. And so eventually he would ring the bell and the dog would salivate. And so at that point, he couldn't get into the dog's brain and figure out what the br the dog was thinking. But regardless, it wasn't just thoughts that this bell would create in this dog, there was physical reactions. There were physical reactions to something that the nervous system picked up. And so when we have urge and urge incontinence and a lot of bladder issues, what's happening is that your nervous system is taking in information 24-7, regardless of whether you're awake, regardless of whether you're asleep, regardless of whether you're thinking about it, your nervous system is there to assess the environment inside your body and or sorry, inside your body and outside your body, and to tell you whether or not it's safe. And if your nervous system picks up, like, oh, this is a time that I should alert this person, I should get this person's attention because I feel unsafe. There's kind of two universal languages that are very common that the body will use. One is I need to pee, and the other is I hurt. And so pain, chronic pain, bladder issues, gut issues are all really, really common in a population who have this dysregulated nervous system. The other way that I explain this as well is that if you've heard anything about the nervous system, you've probably heard about the sympathetic nervous system versus the parasympathetic nervous system. The sympathetic nervous system is that fight, flight, freeze, and fawn response. There's something really scary here. I either need to fight it, I need to run away from it, I'm gonna freeze. Hopefully, it doesn't see me, or I'm gonna fawn and faint. On the other hand, we've got the parasympathetic nervous system. This is our rest, digest, love, and sex. I'm content, I'm grounded, I'm very aware of my surroundings, I'm very connected with those who are around me. And those two parts of the autonomic nervous system help regulate lots of different things in our bodies. Autonomic, we use that word because it's all the automatic things, how I'm digesting, how I'm filtering my urine, what my muscles are doing at rest, um, breathing rate, heart rate, all of this. When we live more so in a sympathetic state, in a dregulated nervous system, this could be from stress, anxiety, trauma, environmental toxins, poor diet, overexercising, um, sedentary lifestyle, all of these different things. We're living in a heightened sympathetic state. And there are some very, very predictable things that will happen in the pelvic system in response to this sympathetic res uh this heightened sympathetic state. One of them is that our pelvic floor muscles tend to get over tight. So we get in a clenched and hyperactive or hypertonic state in the pelvic floor muscles. The pelvic floor muscles will help control the bladder in two big ways. For one, it supports the bladder. But the bladder, especially if it's sensitive, irritated, a bossy bladder, is kind of like the princess in the pea, if anybody remembers that story. That princess wants a perfect mattress to sit on. It doesn't want it to be too tight, it doesn't want it to be too loose, it wants some nice give to it, and we don't want it to be lopsided. So if the pelvic floor muscles get rigid because of the sympathetic state, then the bladder's not going to like it. The other way that the pelvic floor muscles really help bladder control is that they wrap around the tube where the peak comes out, the urethra, and help close it. And if those set of muscles are too tight, they can't respond very well. They'll act like they're weak. So they're not fast enough, they're not coordinated, they can't fully relax. And so they won't be able to keep that tube closed. And so, how do we address this? So we in the moment of urgency and leaking, we have certain processes that we go through to stop the unwanted reflex that's happening in the moment. And this is often glossed over by some of the folks who are in the pelvic health world. So they'll do things like, oh, just distract yourself or count backwards from 10, these sorts of things. Which I don't hate that they're saying that. I don't hate that because that is a very small portion of it. But that's cleaning up the mess once it's already spilled. That's cleaning up the mess once it's already there. Yes, we need a robust strategy to try and stop that Pavlov's dog reaction in the Moment. It needs to be a little bit more robust than just distracting yourself. There's more that we need to add to it. But we need to zoom out and address the nervous system, that brain bladder connection before the mess happens, before we're in cleanup mode. So we do a lot of things about gradual exposure to different thoughts and experiences that may trigger urge or urging continence or bladder issues. We do general nervous system balancing activities, whether it's through breathing, through mental and emotional grounding and regulation strategies. And we do a lot of physical work because as a physical therapist, as somebody who knows a lot about anatomy and physiology, we know the tracks of where those nerves pass through in the body. And we can actually influence them and improve them by doing certain physical things to the encasings around those nerves to calm the nervous system through body work as well as through things like mindfulness and things like that as well.

Max Lowery 23:15

Love that. It's fascinating to hear because I think the more I kind of read into it and research, the more I'm realizing that the nervous system comes first. I'm reading a lot into polyvagal theory at the moment, and I think uh Deb Dana, I think her name is, she says, state precedes story. So, in the context of how I help my clients, we're very much trying to help them shift their mindsets and reframe their thinking, um, change their behavior, change their habits. And that's only possible if the nervous system is regulated. You cannot make the changes, you cannot reframe, you cannot be kind to yourself. It's very hard if you are stuck in that fight or flight response or freeze response. Um, so yeah, things like breath work, uh for me personally, this is something I have to deal with as well, is slowing down. Um, I rush and hurry everywhere. Um, doing less, spending more time in nature, all these things can have a massive impact uh on your on regulating a nervous system. So it seems that nervous system is a big root cause uh for your clients. Are there you've listed a few other things in the environment? What would you say are the other kind of key root causes to this problem?

Speaker 1 24:25

Yeah, so nervous system, absolutely. And uh another root cause, it's kind of like an umbrella, because there's a few different things underneath of this umbrella, but issues in other parts of the body. So have looking beyond the pelvic floor in how especially your feet and your ankles are functioning, your hip. A lot of people don't know this, men or women, because we're not taught this about our body, but your pelvic floor has a left and a right side. That's because I've got my good old model here. We've got the pelvis, all these red things on the bottom of this bowl shape here, those are the pelvic floor muscles. They have a left and a right side. And that's because some of the pelvic floor muscles they reach out of the pelvis and they'll attach onto the leg bone. This is the socket for the hip. You can't see the leg bone here because there's not one on this model, but this is where it would attach into. So some of the pelvic floor muscles are also hip muscles, and some of the hip muscles are also pelvic floor muscles.

Root Causes Beyond The Pelvis

Speaker 1 25:30

And because you can be doing something completely different with one leg versus the other, you can be doing something completely different with one side of the pelvic floor versus the other. Remember that princess in the pea, and remember that trying to close the urethra, the tube where the pea comes out, those pelvic floor muscles aren't going to be able to do that very well. And how we influence how you move through one leg versus the other has nothing to do with doing Kegels. We need to optimize how is the foot receiving load, how is it moving, the ankle, the knee, the hip. So that's one area that we work a lot in. The other area is that a lot of people are surprised to hear that the pelvic floor muscles are a key part of your core. So if you were to Google core or if you ask somebody off the street what your core muscles are, a lot of people will just say, Oh, your abdominal muscles, your ab muscles, right? But we need to think about your core as like a canister or a can. So if you had like a soda can, it has walls on the top, on the bottom, and around the sides. So in the human body, the sides of the core, the top is going to be your breathing diaphragm up here in your rib cage. The bottom is your pelvic floor, around the front and sides are your abdominal muscles, and in the back are your deep back muscles. We need those to be all balanced. Balanced is the key. Because what happens is that when one of them are not pulling their weight, one of the other ones is going to have to step up their game to be able to take over. The pelvic floor muscles and the deep back muscles tend to be some that are classic for taking over. And then we got back pain, and then we have pelvic floor issues. Another root cause that we're often working on is what is this part of your body doing? Your core is really, really important for managing pressure when it goes through this area. So when people talk about core stability, pressure is a big part of that. So how much pressure you have in this part of your area will dictate how firm is this to be able to push and pull and step and bounce and project my voice and all of these different things. And how we create pressure and stability is by contracting different muscles and changing the shape and size of the canister. So if I had that soda can and we just squished it, the pressure inside would increase quite a lot, wouldn't it? And so if you had that soda can and you just squished it, that pressure inside of the soda can would increase quite a lot. And so a key part of what our core does is it manages pressure in and around this area. And if that is imbalanced, maybe your diaphragm is really rigid because you're a chronic cougher or you're a chest breather, or maybe you've had rib injuries or frozen shoulder or shoulder issues, which are going to create stiffness in and around your rib cage, if your abdominal muscles or your back muscles are not functioning well because of pain or injuries or a sedentary lifestyle or something like that, maybe rectus diastasis from pregnancy. And then if your pelvic floor muscles are not functioning well because of that sympathetic nervous system, maybe some perineal tears or different equipment being used from childbirth, these sorts of things, then your core is not going to be able to manage that pressure very well. And when that pressure is not managed very well, it puts a lot of undue stress in and around the bladder and downwards on the pelvic floor, meaning that they won't be able to function very well and bladder control becomes really, really problematic. So there are some other root causes, but I would say those are two of the big ones, Max.

Max Lowery 29:31

Yeah, fascinating to hear. And I imagine the average uh doctor that you go to to, you know, if a woman goes to a doctor and asks about help with this is not, you know, not going to address any of these things.

Speaker 1 29:41

Absolutely not. And at first I would get frustrated by this because it is just right there in the anatomy books and the biomechanics books. And so it would frustrate me. But then I had to step back and say, we are not actually training those practitioners to do this. So a family physician, a general practitioner, they really don't learn anything about the pelvic floor. They may have learned the anatomy way back in medical school, but they are not trained in in-depth biomechanics. That's just not their specialty. They need to know a little bit about a lot of different things. And most of their training is going to be on the medications. For urologists, urogynecologists, gynecologists, they are trained surgeons. So they have a ton of training in anatomy, but for the purpose of surgery and procedures, injections, and a lot of medications, they are not trained in bladder retraining and the biomechanics and other ways that the body can influence the bladder and the pelvic floor. So you're absolutely right. And I hear this all the time. A lot of women will come to me frustrated and pretty angry that their doctor, they had been maybe working with them for years or shuttled around to many different practitioners and they were never told these things. And I get it, I understand the frustrations, but I also can understand that that that's just not the way that they're trained.

Max Lowery 31:07

And what I love about living in this day and age is that we're fortunate enough to have the internet and you know, coaching and and and receiving help online has become normalized. Because I imagine specializing in this uh, you know, 20, 30 years ago before and doing it kind of against the grain, not in the traditional kind of uh medical environment, would have been much, much harder. But now with the internet, with things being normalized, you know, you're able to impact women all over the world. What would you say are some of the early warning signs that women should not ignore?

Speaker 1 31:40

Well, essentially, I think you mentioned this earlier that not a lot of women are talking about this. But I find that there's kind of two ends of that spectrum. Some women would never say anything to anybody because it's just taboo, it's embarrassing, we're told not to say anything about it. But then there's this kind of subgroup of women, particularly

Early Warning Signs To Note

Speaker 1 32:00

the women in their later years or as soon as they are postpartum. They just chalk leaking up to being like normal, like, oh, I pee my pants and you pee your pants and we all pee our pants, and isn't that funny? And I get it that if you're doing that so that you don't feel alone, I get it. And I want you to know that having any leaking is not normal. It's not expected, it's not normal. There is a big difference between normal and common. Is it common? Absolutely. We already talked about that. But is it normal? Should you have to live with leaking just because you had a baby or you're going through perimenopause or you're postmenopausal? Absolutely not. So an early warning sign would be I have leaking, any type of leaking. Another early warning sign may be that you're having a lot of frequency. So we should be able to hold our urine for at least two to four hours comfortably. If you find like, wow, I can't get through a whole movie or a meeting at work, or that would really be stressful if I was in a car journey, if I knew it was going to be longer than an hour, those are some signs that your bladder is not tolerating filling for a very long period of time. And if you get these sudden urges, so what is normal, what is ideal is that when we need to pee, the sensation should creep up slowly. It starts as a whisper. The longer you go, it gets stronger and stronger. In the early times of that, we should be able to ignore it, especially if we're busy or distracted. But with urgency, urgency is different. It comes very suddenly, it goes zero to a hundred. It's quite intense. And for a lot of people, it can be actually really stressful, uncomfortable, and painful at times. So if you're getting urgency, that's another early warning sign. Night peeing. So unless you are over 65 or pregnant, getting up to pee at night is actually not considered normal. So if you have diabetes, you are probably um developing, um, that's not the word I'm looking for. Uh if you have diabetes, you are probably um creating more urine overnight. So you could potentially be getting up that once per night. But otherwise, we shouldn't be getting up in the night. Now, if your partner snores or you hear something outside, or if you're a light sleeper and you roll over and you're like, well, I better get up and go pee anyway, then we're saying, okay, well, is that your bladder waking you up or is that just a habit to get up? But either way, if you're getting up, sometimes I work with people, Max, that are getting up like every hour at nighttime, like multiple times a night to go pee and not making it to the toilet, having leaking along the way. So if you're getting up more than once a night, that is gonna be an early warning sign that your bladder and your pelvic floor are not um are are not happy.

Max Lowery 34:56

Thanks for sharing. I would love to know a bit more about the frequency thing, because this is one thing we spoke about uh in Mexico, because I I'm not gonna name their names. I have two male friends who we go, we we go on regular hikes. One of them is my climbing partners, and in the space that I've had gone to the taken a pee once, they've probably gone five or six times. What it what exactly is going on there? Why is that happening and should they be concerned?

Speaker 1 35:21

Um, I don't think that they need to, you know, go out and make sure their will and last testament is all right and finalized. Um, but I think they should pay attention to that. That is not a normal response. So that tells me it gives some clues to some things. It gives some clues that their sympathetic nervous system, their brain bladder connection, is on overdrive. It's sending a lot of false alarms. So I'm going to assume that once they get to the toilet or the urinal, that if they started the flow of urine and started counting 1100, 2100, 3100, and so on, if it's less than seven seconds, that bladder

Frequency, “Nervous Pees,” And Men

Speaker 1 36:00

didn't actually need to give any signals that it needed to pee. If it is fully over that, then your friend may be hydrating a lot, and that could be a normal response. But if it's a very small pee and it's happening, you know, I have to pee every 30 to 45 minutes, that's called frequency. So a few different things can, you know, be contributing to that. So, yes, it can be uh that the uh nervous system, the sympathetic nervous system is on high alert. So, what are their stress levels like? What is their anxiety like?

Max Lowery 36:33

But also we're usually on the side of a mountain. So Exactly.

Speaker 1 36:37

I was gonna say a lot of people will get the nervous peas, right? Do they also get that in their regular life? Would be a question that I have. Or do they only get that when they're climbing or when they're public speaking or in a really important meeting? If it's really only during like high stress or high stimulation times, I probably would just monitor it to say that just could be the way that this nervous system shares their excitement. But if it's if it's spreading to other parts of their life, that's there's a sign that their nervous system is on too high alert. The other time that it will, or the other thing that it will clue into is the status of their pelvic floor muscles. They could be overactive or clenched or hypertonic, as all these are all kind of terms for the same thing. And again, as I was saying before, when our sympathetic nervous system is is activated and we're nervous or fearful, those pelvic floor muscles will come on even more, and that can create some more frequency.

Max Lowery 37:41

Good to know. I'll be sharing this podcast with them because it is uh it's definitely a talking point whenever it happens. What would you say are some things that women should stop doing immediately, which might be making their problems worse?

Speaker 1 37:55

Yeah. So I would say we get this blanket statement of, oh, every woman should be doing their daily Kegels. This is not true. If you don't have any bladder issues and a trained expert has not told you and given you a really good reason, we do not need to be doing Kegels every day. So that's one thing we need to stop. Especially, we shouldn't be doing them. Um, there was this kind of phase of time where it's like, let's practice them when you're on the toilet. That is not a great time to do it. If you want to test the effectiveness of a Kegel every once in a while by seeing if you can stop the stream of pee when you're on the toilet, that is an allowable cheat. But we want to keep the association of I sit on the toilet, I relax my pelvic floor muscles. We want that association to be strong because that really helps both urine issues and also bowel issues. Um, so that's definitely one. Another one is just in case peeing. So a lot of people will do this, especially if they have urgency and frequency and leaking, is that okay, I'm gonna go to the gym. So I'll go pee before I leave. I go pee as soon as I get there, I do my workout, I go pee before I leave. And it's just a lot of these just in case peas when I don't actually really need to go. Because what happens is that there's sensors that are in the walls of the bladder. Those sensors sense how much urine there is in the bladder. And they have a certain threshold, i.e., there's a certain amount of urine in the bladder. Once it gets to that threshold, I send a signal through the nervous system up to the brain, and then the brain and the bladder communicate to tell us that I need to go pee. What happens is that if we're constantly emptying our bladder at a very low volume, an inappropriately low volume, under that seven seconds of flow, as we talked about, those sensors get retrained to alert you at a very low amount of urine. So then you're actually going to make your frequency and your urgency and probably your leaking worse. So we want to try and get rid of that just in case peeing. So those are just a few of the bad habits that we try and overhaul. There are so many of them, Max, that a lot of people don't realize that they're doing because they may have had good reasons to do it. Well, I don't want to, I don't want to leak on the way to the gym, or I don't want to leak on the way home. So I'm going to go pee. So I understand why people are doing this, but if they knew the long-term consequence of it, they would change it. So the first step in my program is that we just overhaul all of the bad habits that we have around our bladder, our pelvic floor, our bowel, so that everything can just function a lot more efficiently.

Max Lowery 40:37

Yeah, it's one of those things which sounds like it makes sense. It's like, oh yeah, well, obviously I'll just go before, but actually you're reinforcing bad habits ultimately, which makes the problem worse. And that's just one of the things that you're not necessarily going to find on Google, is it? Like that that's that's uh a difficult thing to come to terms with. I really want the women listening to this to know that they're not alone um in their struggles, right? What

Habits To Stop Right Now

Max Lowery 41:00

would you say are like what state are your clients coming to you in? Like, how is this impacting their lives on a day-to-day basis?

Speaker 1 41:07

This is a really, really big question, Max. It breaks my heart when women come to me and their bladder issues have stolen their sense of freedom. They have ruined their sense of self-confidence at home with their partners, having intimacy, at work. I've had women say that they've turned down promotions because they know that they can't sit through the board meeting long enough and that they don't want to get up and leave. They don't want their colleagues smelling the urine in their pad. I've had women who have had to quit their job completely because they can't leave their house because they have to pee every 20 minutes. Um, I've had people who are like, I have a job that I'm on my feet all day and I have nowhere that I can change my pad consistently. And it breaks my heart when women have had this challenge for years, sometimes decades, and I'm the first one that they've told about it. They haven't told their partners, they have no friends because it is just so self-esteem shattering that they couldn't bear talking to anybody about it. And so a key part of what I do my best to provide is a safe space to say you are not alone. Look at up to 50% of women will have bladder issues at some point. You are not alone. And you don't have to live with this. There are so many things that we can do to change this. You don't have to live with this. You don't need to have the secret anymore. You don't need to go running out and telling all the people in your life. But I have a community that you can talk about this with so that you don't feel alone anymore.

Max Lowery 42:51

I love that. And it's exactly the same for me and and my clients. Yes, obviously, dieting uh is a bit more out in the open, but the internal struggle is not out in the open. And the the women I work with, they're they're often in loving relationships and they have supportive families, but their families just have no idea why it's so difficult. The typical thing is the husband saying, you know, why can't you just stop snacking? Why can't you just go on a run? Just do what I do, it's not hard. Um, but obviously the female body and the the psychology, the physiology, the societal pressure is completely and utterly different. And one of the most empowering things for our clients is yeah, they suddenly join a community of women who are supporting, motivating, inspiring, inspiring each other and understand and get it. Uh, and I think that's it's our community, I'm sure with yours, has been one of the most valuable uh additions and assets to what we do.

Speaker 1 43:42

Absolutely well said.

Max Lowery 43:44

So, final kind of two questions. If there's one takeaway you want the listeners to to leave with today, what would it be?

Speaker 1 43:53

My one takeaway would be that what you have probably been told about your black. Or problems being the cause of it is not the full picture. It is not just about weak or loose pelvic floor muscles. Your bladder is not broken, that just needs a risky medication or a surgery. We must look beyond those things and look at the full root causes. And unfortunately, some of the practitioners that we are told to go to, they are not trained to look at all those things. But when you do, when you get to the root causes of things, the nervous system, the connection to the rest of the body, plus the pelvic floor and all its beautiful nuances and the bladder itself, real lasting change can happen. We just need to look broader than the bladder in the pelvic floor.

Max Lowery 44:46

Thanks so much for that, Lindsay. And I think, firstly, if anyone is struggling, contact Lindsay. We'll talk about how that can happen in a second. But I think even if you don't contact Lindsay, listen to everything in this podcast. And if you go to visit a professional and they're not taking these things into consideration, then potentially think twice and get a second opinion. Awareness and knowledge is key. And now that you've listened to this podcast, you have more awareness about what the root causes might be. If people did want to get in touch with you, Lindsay, what's the best way to do that? Like, are you on Instagram? Yeah, how how should they do it?

Speaker 1 45:22

Yeah, so I have a few different channels that you can find me at. So I'm on Instagram at LindsayGedis PT. I also have a free community Facebook group called Women's Natural Bladder Support, Leaks, Incontinence, OAB, Urge, and Frequency. I wanted every word in there so that people could find it easily. And uh uh Max, maybe you could share those links. I also offer a free masterclass. So I do run live masterclasses every month. I just ran one this week on some of the exercises that are going to address all the different parts of the body that we talked about. And I do a new one every month, but I also have one, if you don't want to wait for the next one, that you can watch anytime, any day, that you can um go through and we talk about what are the things that you need to change, what are the steps that you need to do, and gives you some insight into how I work with women as well. So I'm happy to share that link as well.

Max Lowery 46:22

Amazing. Yeah, I will link everything below this episode. Well, thank you so much, Lindsay. It's been fascinating to hear your knowledge and your experience. And I'm really glad that we've managed to bring this to the podcast because I was really excited having that conversation in Mexico. Um, so thank you very much, and we will have you again back soon.

Speaker 1 46:39

You're so welcome. Thanks for having me, Max.