Hi! I’m Tori, and I’m a doctor of physical therapy who specializes in pelvic dysfunction
and I think that pelvic health and pelvic issues should both be more openly discussed
and widely understood because everyone has a pelvis!
So, today we are going to discuss why you shouldn’t hover above the toilet when you
pee. In order to understand why you shouldn’t hover, it’s important to understand the
relationship between your bladder and your pelvic floor during urination. Let’s take
a quick look at the bladder and pelvic floor and review this relationship. Imagine that
this is my bladder and that I’m facing you, and have been cut down the center.
You can appreciate that my bladder is here, sitting on top of my urethra, the tube that
connects my bladder to the rest of the world, and that my pelvic floor, an important group
of pelvic muscles, is here, living underneath my bladder and surrounding part of my urethra.
Some of your pelvic floor muscles actually act as a urethral sphincter, and are in charge
of opening and closing the urethra pending on what you’re up to.
Now, your bladder is comprised of smooth muscle, which means you have no voluntary control
over it, much like you don’t have control over the smooth muscle in your intestines;
however, your pelvic floor is comprised of skeletal muscle, which means you do have voluntary
control over it, much like you have voluntary control over the skeletal muscle in your biceps.
So, as counterintuitive as it may be, when you urinate, the smooth muscle in your bladder
is actually contracting, in order to push the urine inside of it out of the urethra
while, simultaneously, your pelvic floor is relaxing, so that that urethral sphincter
is open and the urine can easily and effortlessly exit the bladder through the urethra and out
into the world.
So, when it comes to toilet positioning during urination, the ideal position would encourage
the pelvic floor to relax and let the bladder and only the bladder be in control of emptying
itself.
Hovering doesn’t allow for either of those things. Here’s why. The pelvic floor is
one of your deep core stabilizers, which means it is activated and supporting you when you
are standing, and hovering demands even more stabilization than standing. It is also synergists
with your abdomen and inner thigh muscles, which means when they’re turned on, so is
your pelvic floor. So, when you hover, your pelvic floor is activated not only because
it’s stabilizing you, but also because your abdomen and inner thighs are activated in
this position.
Furthermore, because your pelvic floor cannot fully relax when you hover, your urethral
sphincter is probably not fully open, which means you likely need to strain in order to
empty your bladder. Straining essentially uses pressure in your abdomen to force the
bladder to contract and push urine through a urethral sphincter that isn’t entirely
open. It’s a poor habit that can reinforce pelvic- and bladder-related issues, because
it forces the bladder to empty against the wishes of your pelvic floor regardless of
how full your bladder actually is.
So please don’t hover, especially if you have bladder or pelvic floor dysfunction,
and if you’re in a public restroom and feeling gross about the toilet seat, either put some
toilet paper down or bring those disposable toilet seat covers with you so that you can
sit instead of hovering.
If you want to learn how to sit on the toilet properly to pee, you can check out this video,
and that’s why you shouldn’t hover when you pee! Thank you so much for watching and
be sure to join me on the 10th and 20th of every month for future pelvic PSAs, with surprise
PSAs on the 30th when I can make them, where I attempt to cover an interesting pelvic health
or pelvic issue topic in 5 minutes or less! See you next time!