It is something most women do multiple times a day without a second thought. But according to one Australian pelvic health expert, a simple habit in the bathroom could be quietly causing bigger problems.
Heidi Barlow, a women's physiotherapist with a following of more than 945,000 on Instagram, has revealed the surprisingly common mistake she sees in her clinic again and again. And it all comes down to how you sit on the toilet.
In a video, she shared what she calls a 'free bladder tip', urging women to rethink their position the next time they go to the bathroom.
'Here's a free bladder tip... Next time you sit on the toilet to wee... make sure your feet are actually flat on the floor because so many of my patients don't realise that they're doing it but sit on the toilet and are up on their tippy toes,' Heidi said. 'It means that you can't relax your pelvic floor, so you can't empty your bladder properly.'
It might sound minor, but the reasoning behind it is far more significant than many realise. When you sit down to urinate, your bladder contracts to push urine out while your pelvic floor muscles are meant to relax. This coordination is key to fully emptying the bladder. However, if you're perched up on your toes, your body is doing the exact opposite. Being on tiptoes activates the muscles in your hips, glutes, hamstrings and calves, and that tension can extend to the pelvic floor, making it harder for those muscles to release.
Over time, that can lead to a cascade of frustrating symptoms. According to Heidi, one of the most common is bladder frequency, which is a constant feeling of needing to go, even when you've just been. There's also an increased risk of urinary tract infections, as leftover urine in the bladder creates the perfect environment for bacteria to grow.
And it's not just tiptoes causing issues. The expert says she regularly sees women making other everyday bathroom mistakes without realising it, including hovering over public toilets instead of sitting down, pushing or straining to empty the bladder or bowels, and perhaps most commonly, rushing.
Hovering, in particular, is a habit many women adopt to avoid contact with public toilet seats, but it can have a similar effect to being on tiptoes. When you're holding yourself in a squat position, your pelvic floor can't fully relax, which again interferes with proper bladder emptying. 'It's definitely a habit I encourage my patients to break,' she explained.
Instead, she recommended creating the right conditions for your body to do what it's designed to do. For some women, that might include using a footstool, especially when it comes to bowel movements. By elevating the feet, leaning forward with elbows on the knees, relaxing the tummy and focusing on breathing, you can help the pelvic floor release more effectively.
When one follower asked whether they should switch between positions, writing: 'I intentionally raise my feet up (squatting potty) due to ahem haemorrhoids. Should I actually be switching between these two toilet poses?' Heidi responded: 'Since you empty your bladder more often and won't always have a stool, I'd just use the squatty potty for bowel movements!'
Her comments section quickly filled with women realising they'd been getting it wrong for years. 'Ahhh thank you! I thought I was meant to be on tiptoes! Just got to undo about 25 years' worth of doing it wrong then, I'm sure I'll be fine,' one person wrote. 'Wait I always scrunch my toes underneath my feet… is that bad too?' another admitted. To which Heidi replied simply: 'Yes! Relax.' 'I'm too short to do this. So I got a buddy stool for my feet,' one joked.
Beyond positioning, Heidi also stressed that pelvic floor health isn't a one-size-fits-all approach, but rather something many women misunderstand. While pelvic floor exercises are often recommended, she said not everyone actually needs strengthening. In fact, many women she sees in clinic have an overactive pelvic floor that is too tense, meaning the focus should instead be on learning to relax those muscles. Assessment with a women's health physio is key, as the right approach will vary from person to person.
