Feel like you’ve exhausted all of your options? Worried this will never change? I have good news: you’re not alone. And there’s hope. Here is what’s going on: Most often kiddos with bedwetting past a year of daytime dryness are dealing with constipation .  When most people hear that word, they think of it in its simplest terms: infrequent bowel movements. In fact, constipation can have a lot of related symptoms most people don’t know about. Constipation can look like many things: Extra large bowel movements Firm or hard stool Leaking/losing stool Bedwetting and urinary incontinence Recurrent UTIs Extremely frequent &/or urgent urges to void Decrease frequency of bowel movements Bowel movements >2x/day Abdominal discomfort/distention Skid marks or itchy anus Very loose stool Persistent difficulty with toilet training or refusal to make BM on toilet Irritability Difficulty with sleep Changes in mood/behavior Loss of appetite Often, parents aren’t getting enough answers from pediatricians, even the most well-meaning ones. Many parents I’ve worked with are exasperated that the techniques they’ve been trying aren’t having an effect. They’re not finding success with cutting out fluids at night or asking their child to go one more time before bedtime. The vast majority have no idea that constipation is likely the driving force behind the wetting. Fortunately, once they’re armed with that information, they can begin to address the root causes—and finally see results. Here’s what I recommend parents try: Put a stool—like a squatty potty—in front of the toilet. Your child’s feet should be supported and knees higher than hips. Encourage your child to drink more water. Consider adding a fiber supplement to their daily diet (I like HyFiber liquid fiber). Abdominal massage daily. This can be a nice way to wake up or an added part of the bedtime routine. Big, clockwise circles on the tummy help to stimulate a bowel movement. And here’s a bonus: these techniques apply to adults dealing with constipation, too. Try it! New Normal is here to support and guide parents looking for solutions to their kids’ bedwetting. Together, we can help you and your child get a good night’s sleep. Katherine Shephard, PT, DPT  is driven by a passion to help people rebuild their confidence, resume their lives, and reclaim their normal by improving pelvic floor health.  Along with treating patients and running New Normal PT, she also mentors other pelvic health physical therapists and lectures at St. Catherine University in their doctor of physical therapy and physical therapist assistant programs. Dr. Shephard treats adults and children of any gender with pelvic floor-related symptoms . With three littles at home, she can relate to parents and translate her care to work with their busy lives. New Normal PT offers both in-person and virtual care options for maximum convenience and flexibility.

Have to pee before leaving the house? If you’re of a certain age—well, just about any age old enough to be reading this—you were likely taught to go to the bathroom before leaving the house. “Just try,” your parents said, so you did. Time after time, year after year.  And now… Do you get an urge to pee when you are about to leave  the house? The restaurant? The store? The gas station? Is it causing issues and discomfort in your daily life? If you thought, “yes” and you want to learn more about it - we can help! There’s a simple reason why you feel the urge to pee in these situations, and a couple of straightforward, painless techniques you can try to get rid of that unwanted urge. Here’s what’s going on: Urges to pee come from your brain (not just your bladder). All day long, your bladder is sending information to your brain with the message, “I’m this  stretched.”  Your brain puts this information into context. Without consciously thinking about it, your brain is referencing your current environment, your past experiences, and your options:   What am I going to do next?  What have I done in the past?  Am I cold/hungry/tired/happy/distracted?  Etc. etc. etc.  Then your brain sends down an urge to pee—or not. Remember Pavlov’s dogs? He rang a bell at feeding time. Over time, his dogs started to salivate with just the ringing of the bell — even if there wasn’t food.  Sometimes our urge to go to the bathroom is just the same.   A conditioned response. A pattern.  Fortunately, we can use those same tools of mental conditioning to break the cycle. With the right information, you can rewire your brain so that the urge to pee no longer disrupts your day to day.  How to make it stop: Change the pattern.  Switch up your usual routine for leaving the house. For example, if you always [something], try [another thing] instead. Don’t go to the bathroom. You know your own body. If there’s no reason to believe that your bladder is full (other than habit), resist the impulse to go “just in case.” Just leave. As with a lot of things in life, sometimes the key is, “don’t overthink it.” Pick up your keys, march out the door, and don’t stop to second-guess yourself.  By breaking the mental connection between “leaving the house” and “needing to pee,” you’ll retrain your brain so that it stops sending you incorrect info about your bladder’s fullness.   Try it! It’s easier to change than you think — and you’ll be giving yourself newfound freedom. You might be surprised by how great it feels to just leave places when you want to! Of course, not every change is easy, even if the steps seem simple. We’re always happy to work with our clients to help give them support and in-depth information about what’s going on with their bodies. If you’re dealing with an unwanted urge to pee, this is something we can work on together. Katherine Shephard, PT, DPT  is driven by a passion to help people rebuild their confidence, resume their lives, and reclaim their normal by improving pelvic floor health.  Along with treating patients and running New Normal PT, she also mentors other pelvic health physical therapists and lectures at St. Catherine University in their doctor of physical therapy and physical therapist assistant programs. Dr. Shephard treats adults and children of any gender with pelvic floor-related symptoms . With three littles at home, she can relate to parents and translate her care to work with their busy lives. New Normal PT offers both in-person and virtual care options for maximum convenience and flexibility.   Bladder control women

Wearing a pad every time you run? Wearing only black shorts/leggings? Noticing the wetness seems to be not just sweat? If you’re thinking, “that’s me!” and you’re feeling over it, this is for you! There’s hope! When you experience leaking with running, here’s what’s going on: The pelvic floor is a very dynamic set of muscles.Those muscles have to be especially dynamic when you’re running, which engages so many parts of your body. There are lots of things that could be going on with your pelvic floor that are probably contributing to leakage. Here are some of the most likely culprits: Your pelvic floor muscles are being engaged more than they need to be.  Your body overall is holding more tension than is required. Constipation. Weak pelvic floor muscles. Notice that weakness is last on the list? That’s because it’s not as common as people think. Many people have pelvic floor muscles that are strong enough—but just aren’t doing their job well.  So before you assume that Kegels will solve the problem, here are a few things to try first: Running with a slight forward lean. Running like you’re running uphill or into the wind can position your body such that your pelvic floor is better set up for success. Running with a slightly faster cadence (how often your feet hit the ground). This changes where your foot hits the ground and how the force of hitting the ground is transferred through your pelvis and pelvic floor. Get those bowel movements moving. Your rectum (where poop is stored) is right next to your vagina (if you have one) and bladder. When there is constipation, poop is taking up space and pressing on the bladder. This can lead to an unhappy bladder and leakage. Overall, what these techniques can help with is creating an environment where your pelvic floor can do it’s job. Once you’ve recruited your pelvic floor to work more effectively, you should be able to experience less leakage while you enjoy your run. Try it! Katherine Shephard, PT, DPT  is driven by a passion to help people rebuild their confidence, resume their lives, and reclaim their normal by improving pelvic floor health.  Along with treating patients and running New Normal PT, she also mentors other pelvic health physical therapists and lectures at St. Catherine University in their doctor of physical therapy and physical therapist assistant programs. Dr. Shephard treats adults and children of any gender with pelvic floor-related symptoms . With three littles at home, she can relate to parents and translate her care to work with their busy lives. New Normal PT offers both in-person and virtual care options for maximum convenience and flexibility.