Overactive Bladder when cycling can be prevented with this training program.
Trust me. I’m well aware that I risk receiving a reaction consistent with yelling “Poopie” on a playground full of preschoolers. However, it is a risk I am willing to take because, like the experience I shared in this previous post on the subject, I know I am not alone. It is an experience I never want to repeat and one I hope to help you to avoid. You too can avoid an overactive bladder when cycling.
For most, the problem will never progress to the severity I endured, and for that, I am grateful, and you should be too. You may not get pain or burning, but the urgency is there. You have to go A LOT, which is worse after long periods spent in the saddle. Such is the curse of the cyclist. Yes, your bladder is an overachiever too.
Technically it is overactive. There are things for that. First, a question. How long does it take you to pee? Why do you ask? The amount of time it takes to empty your bladder is an excellent way to assess its health. Thankfully…
There is Scientific Research for That Overactive Bladder When Cycling
Students at the Georgia Institute of Technology were trying to design a better water tower. The researchers observed how long it took animals to pee to find a more straightforward explanation of fluid dynamics.
According to a recent study, it takes almost every mammal larger than a hamster, regardless of bladder size, 21 seconds to empty their bladder. This ‘Universal Urination Duration’ information gave the researchers precisely what they needed. Other mammals are not influenced by humans’ external factors and are only driven by the biological need to urinate.
In addition to information used to design improved scalable hydrodynamic systems based upon nature, the researchers stumbled upon an unforeseen implication of their study. In what has come to be known by experts in the field of urology as the ‘20 – second bladder rule.’
The time to pee helps diagnose urinary problems in animals and humans. So get out your stopwatch. Thankfully…
There is a Good Reason For That Overactive Bladder When Cycling
The brain-bladder communication computation should be a binary one. Your bladder fills up like a balloon, and when it decides that there is 21 seconds worth of pee inside, it notifies your brain it’s time. For humans, that equates to about eight ounces, or a cup, of fluid.
As every cyclist knows, it rarely, if ever, works this way. You are on a long ride, and the group isn’t going to stop. Or you don’t want to interrupt your solid training interval or long endurance effort. When you finally have the opportunity for a harried duckwalk to the nature break, it takes you much longer than 20 seconds to go number one.
The opposite is also true. When the anxiety and fear of voiding frequency trick you into feeling like you need to pee a dozen times before you walk out the door. A similar ritual occurs at the group’s coffee shop stop, and you can’t stop retreating to the restroom.
Your brain-bladder communication has gone awry in a ‘Goldilocks and the Three Bears’ scenario. Time to pee is the porridge, and the time is never just right. Waiting too long to go has stretched the bladder and weakened the signal. Or going too often has made us more sensitive to cues that may not be there.
Our brain and bladder no longer trust one other. We have developed ‘Cyclist Bladder’- (not a scientific term, I made it up). We know that 20 seconds is the goal, and it is up to us to make things right. Thankfully…
There is Training For That
The first step is a simple one. If it takes you longer than 20 seconds to pee most of the time, then go more often. You are a data-mongering cyclist. I know you can crunch the numbers. This FTP-pee calculation isn’t a complex one.
If the opposite is accurate, and you have the urge to pee more frequently than you should, the solution requires a bit more work. Or worse, unfortunate circumstances have caused you to have difficulty holding it, and you experience leaking, known as stress incontinence.
In both cases, “bladder training” is in order. Training your overactive bladder conditions it to be able to hold onto liquid longer without risk of embarrassment. The goal is to increase the time between urination, thereby expanding the bladder to hold more.
In turn, you will feel less urgency and more comfortable between bathroom breaks. How is it done? Thankfully…
There is a Routine For That
Bladder retraining involves gradually increasing the time interval between urination. You set and follow a fixed schedule, independent of whether or not you feel the urge. If you need to pee before the scheduled time, then suppression techniques are necessary to prolong the time.
Start your retraining schedule by emptying your bladder as soon as you get up in the morning. Set a baseline by recording how long you can wait before having to urinate. It will be your starting point.
Then throughout the day, go to the bathroom at the specific times you determined based upon that reading, increasing the interval by a minute each time. Follow the schedule during waking hours and only go at night if you have to.
The key is to adhere to the schedule as closely as possible. If you don’t have to go, go anyway. If you can’t wait, do your best to resist the urge and stay as long as you can. Then re-establish the schedule.
What do you do if you consistently can’t make it, despite how hard you try? Thankfully…
There are Techniques For That Overactive Bladder When Cycling
Bladder urge suppression techniques include the following:
- Stop all movement, stand still or sit down, and remain calm and confident that you will get through this and the urge will subside.
- Practice relaxed breathing and focus on releasing the tension from your body.
- Concentrate on controlling the feeling by distracting yourself and thinking about something else or engaging in a thought-provoking task.
- Sit on the edge of a hard chair or press your spine against the back of a chair to relax the abdominal muscles for 60 seconds until the urge subsides.
- Mental distraction techniques including visualization of your favorite relaxing vacation, counting slowly, deep breathing, and positive self-talk like “I am in control of my bladder”.
Then there is always crossing your legs and hoping for the best. If all else fails, thankfully…
There are Exercises For That
Pelvic floor strength plays a role. The pelvic floor muscles are within the pelvis, between the tailbone (coccyx) and the pubic bone. The muscles support the bowel, bladder, and other internal organs.
When the pelvic floor muscles contract, the internal organs are lifted and tighten the muscles that hold the bladder and bowel closed. Relaxing the pelvic floor allows for easy passage of urine.
If your pelvic floor muscles are weak, the internal organs will lack full support, and you cannot effectively control urine flow.
Pelvic floor exercises, known as Kegel Exercises, are designed to improve the muscle tone of the pelvic floor.
Follow these tips to get started strengthening your pelvic floor:
1. Identify your pelvic floor muscles
To isolate your pelvic floor muscles, stop urination in midstream and hold it momentarily. You have contracted the proper muscles, your pelvic floor muscles, to do so.
2. Find the right position for you
Once you’ve identified your pelvic floor muscles you can do the exercises in any position, although you might find it easiest to do them lying down at first.
3. Use proper technique
Sit on a towel and tighten your pelvic muscles as if you’re lifting the towel from the chair. Hold for a count of three to start, then relax for a count of three.
4. Maintain your concentration
Focus only on tightening your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs, or buttocks. Breathe freely during the exercises and avoid holding your breath.
5. Progress your routine
Repeat three times a day and aim for at least three sets of 10 to 15 repetitions a day while increasing the length of the contraction.
Here are some Kegel Exercise tips and mistakes to avoid.
- Don't make a habit of using Kegel exercises to start and stop your urine stream. Incomplete emptying of the bladder increases the risk of a urinary tract infection.
- Try to avoid bearing down as if having a bowel movement. It can increase abdominal pressure and cause damage to your pelvic floor muscles and potentially put excess strain on your heart and other organs.
- Make Kegel exercises part of your daily routine. You can do Kegel exercises discreetly just about any time, whether you're sitting at your desk or relaxing on the couch.
- Your pelvic floor muscles are made up of fast and slow-twitch fibers and require a combination of rapid quick contractions and slow long holds to strengthen effectively.
- It is important to learn how to relax your pelvic muscles also. Remember to take the time to ease the contraction and remember how that feels.
- Consistency is the key with Kegel exercises. It may take some time to notice the results. Don’t give up!
Conclusion—Eliminate That Overactive Bladder When Cycling
Cycling is a beautiful sport, but it is not without its things. Thankfully, there are things for that.
Your thoughts?
What things do you love about cycling and what things would you love to avoid? Comment below! Your fellow virtual cyclists want to know.
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Semi-retired after more than 20 years as the owner and director of a private Orthopedic Physical Therapy practice, Chris now enjoys the freedom to dedicate himself to his passions—virtual cycling and writing.
Driven to give back to the sport that has enriched his life with countless experiences and relationships, he founded a non-profit organization, TheDIRTDadFund. In the summer of 2022, he rode 3,900 miles from San Francisco to his “Gain Cave” on Long Island, New York, raising support for his charity.
His passion for cycling shines through in his writing, which has been featured in prominent publications like Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. In 2024, he was on-site in Abu Dhabi, covering the first live, in-person UCI Cycling Esports World Championship.
His contributions to cycling esports have not gone unnoticed, with his work cited in multiple research papers exploring this evolving discipline. He sits alongside esteemed esports scientists as a member of the Virtual Sports Research Network and contributes to groundbreaking research exploring the new frontier of virtual physical sport. Chris co-hosts The Virtual Velo Podcast, too.
This is a great article. I am also a healthcare progressional and have also experienced overactive bladder /urge incontinence that has developed when I have been on long, multi week cycle tours. I think in my case, my brain started associating stopping with peeing – fine when in the countryside, and therefore reinforced by peeing each time I stop. I then began to notice it when it became a problem when I would stop in a village or urban area, and a massive problem when spending a rest day in an urban area. The consequences of leaks of pee are also quite problematic when you’re touring and have only a few clothes and little chance to wash them.
There are a few points I would add though:
1) You mention ‘stress incontinence’, but actually the symptoms you describe are better described as urge incontinence. Stress incontinence is a mechanical failure of the urethral sphincter. It typically occurs in older women, often as a a consequence of pregnancy, although can also affect men particularly after prostate surgery
2) Those experiencing urinary symptoms should consider possible differential diagnoses. For middle aged men, this would include prostate problems. (Both benign prostate hypertrophy and prostate cancer). Other prostatic symptoms include difficulty voiding, poor flow, dribbling at the end of the stream. Women should consider urinray tract infections, which cycling can be a risk factor for.
3) In addition to the bladder training you describe, which is definitely the first line intervention, there is medications available, such as solifenasin. I used this for a period of time and stopped once my symptoms were under control.
(Obviously none of the above should be taken as medical advice!)
Amazing insight, Richard! Thank you for sharing your insights. The struggle is real as I’m constantly reminded. Ride safely!