Bladder & Urinary Problems

Urinary symptoms can be frustrating, embarrassing, and disruptive to everyday life. Whether you are experiencing leakage, urgency, frequent urination, difficulty emptying your bladder, or changes following pregnancy or surgery, you don't have to simply live with these symptoms.

At Core Pelvic Health & Wellness, I provide individualized pelvic health physical therapy to help identify the factors contributing to your bladder and urinary symptoms and develop a treatment plan based on your goals.

What are bladder and urinary problems?

Bladder and urinary problems can affect people of all ages and may occur for many different reasons. Symptoms can involve how often you urinate, how urgently you need to go, your ability to control your bladder, or your ability to fully empty your bladder.

Pelvic floor muscles play an important role in bladder control and coordination. However, urinary symptoms are not always caused by the pelvic floor alone. Breathing patterns, abdominal pressure, posture, mobility, habits, nervous system regulation, pregnancy, childbirth, surgery, and other health conditions may all contribute.

What symptoms can pelvic floor physical therapy help with?

You may benefit from pelvic health physical therapy if you experience:

  • Urinary leakage

  • Leakage with coughing, sneezing, laughing, or exercise

  • Leakage with running or jumping

  • A sudden urge to urinate

  • Difficulty making it to the bathroom in time

  • Frequent urination

  • Getting up frequently during the night to urinate

  • Difficulty starting your urine stream

  • Difficulty fully emptying your bladder

  • Urinary hesitancy

  • Straining to urinate

  • A feeling of incomplete bladder emptying

  • Urinary symptoms following pregnancy or childbirth

  • Urinary symptoms following pelvic or abdominal surgery

  • Bladder symptoms associated with pelvic pain

  • Difficulty controlling urine during exercise or physical activity

Conditions associated with bladder and urinary symptoms

Pelvic health physical therapy may be helpful for people experiencing:

  • Stress urinary incontinence

  • Urgency urinary incontinence

  • Mixed urinary incontinence

  • Urinary frequency

  • Urinary urgency

  • Nocturia (frequent urination at night)

  • Difficulty emptying the bladder

  • Pelvic floor muscle dysfunction

  • Urinary symptoms during pregnancy

  • Postpartum urinary symptoms

  • Urinary symptoms following prostate surgery

  • Pelvic pain with urinary symptoms

  • Bladder pain conditions

  • Interstitial cystitis/bladder pain syndrome

Understanding your bladder

Your bladder and pelvic floor work together.

Your bladder stores urine while the pelvic floor muscles help support the bladder and control the release of urine. Healthy bladder function requires these muscles to contract and relax at the appropriate times.

Sometimes pelvic floor muscles become weak and have difficulty providing adequate support. In other situations, the muscles may be overly tense and have difficulty relaxing when you need to urinate.

More pelvic floor strengthening is not always the answer. An evaluation can help determine whether your pelvic floor muscles need strengthening, relaxation, improved coordination, or a combination of approaches.

Bladder symptoms can be influenced by:

  • Pelvic floor muscle strength and coordination

  • Pelvic floor muscle tension

  • Pregnancy and childbirth

  • Menopause and hormonal changes

  • Prostate surgery or other pelvic surgery

  • Abdominal or pelvic surgery

  • Constipation

  • Pelvic pain

  • Hip or low-back dysfunction

  • Breathing patterns

  • Core and abdominal pressure

  • Posture and movement patterns

  • Exercise and activity levels

  • Bladder habits

  • Nervous system sensitivity

How can pelvic floor physical therapy help?

Your treatment may include:

  • Education about bladder and pelvic floor function

  • Pelvic floor muscle strengthening when appropriate

  • Pelvic floor relaxation and down-training

  • Coordination of the pelvic floor with breathing

  • Bladder retraining strategies

  • Urge suppression techniques

  • Toileting and bladder habits

  • Constipation management strategies

  • Core and hip strengthening

  • Postural and movement assessment

  • Manual therapy when appropriate

  • Scar tissue treatment

  • Exercise modification

  • Education regarding pressure management

  • Individualized home exercises

What happens during your evaluation?

1. We talk

I will ask about your bladder symptoms, medical history, pregnancy and childbirth history when relevant, bowel habits, activity level, and how your symptoms are affecting your daily life.

2. We assess

Depending on your symptoms, your evaluation may include assessment of your breathing, posture, abdomen, hips, spine, strength, mobility, and pelvic floor muscle function.

3. We develop a plan

I will explain what I find and work with you to develop an individualized treatment plan based on your symptoms and goals.

And again:

An internal pelvic floor examination is not required for every patient. If an internal examination may provide useful information, I will explain why and discuss it with you beforehand. You are always in control of your care.

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