The Almighty Pelvic Floor // Over Active Bladder
The pelvic floor would have to be one of the most fascinating muscles in the human body! With all its various functions, it really is like a multitasking parent. Today we are going to discuss the pelvic floor’s biggest kid – THE BLADDER.
The Big Kid on the Block - The Bladder
Your pelvic floor and bladder have a very close bond. Your pelvic floor is required to constantly listen to your bladder, and your bladder is required to listen back. Dysfunction occurs when there is a communication breakdown between the two!
When your pelvic floor and bladder are working well, it’s like they are the perfect dance partners. Responding to each other movements instinctively, with or without conscious thought. Swaying together to the rhythm, turning, spinning, lifting in perfect unison. Working together as one.
Normal Bladder Function
During this slow rhymical dance your pelvic floor provides continual support to your bladder, ever so slightly tightening around your bladder neck and urethra to allow your bladder to fill. When the tempo starts to speed up a little, such as when your bladder is getting full, your bladder will start to gently contract, creating a subtle urge that you need to go to the loo. If your brain decides it’s not the right time to go, the pelvic floor will respond to your bladder’s contractions, by creating some of its own.
These pelvic floor contractions tell your bladder “Hey bladder, stop contracting, just relax and keep filling up, it’s not time to go to the loo yet.”. When things work well the bladder listens and ceases it’s contractions. The tempo slows back to a waltz and your urge to go to the loo passes.
When your bladder is really full, it will again start contracting but this time a little more ferociously. An example of this is when you’re absolutely busting for the loo but there are no nearby toilets. Your pelvic floor will respond to these ferocious bladder contractions by strongly lifting and tightening around your bladder, again telling it “no no! we’re not ready to go yet!”.
Think of this interaction similar to that famous dirty dancing moment where Patrick Swayze (the pelvic floor) lifts Baby (the bladder) high up in the air. When your bladder and pelvic floor are the perfect dance partners, this big pelvic floor lift will cause your bladder to respond with “ok, ok, I’ll relax and keep filling, but geez I really do need to go, but ok!”. Again your bladder stops contracting, the urge passes, and you can comfortably go in search for the toilet.
Normal Bladder Emptying
When you are ready to empty your bladder, your pelvic floor should completely relax and lengthen, reducing its hold on your bladder. This is similar to taking your foot off a running hose and the water rushing out.
When your pelvic floor relaxes, your bladder then starts to contract, squeezing out your urine, resulting in a nice strong steady urine flow. Once your bladder is empty, your pelvic floor reflexively tightens a little, your flow will stop, and the bladder filling process a.k.a “the dance” starts all over again.
Abnormal Bladder Function - Overactive Bladder
Overactive bladder (OAB) occurs when your bladder starts to contract when it’s not even full, resulting in a frequent and false urge to go to the loo. Not only are these bladder contractions frequent but they are super dooper STRONG, creating an urge that hits you like a freight train, making you busting for the loo! The pelvic floor will try to discipline your naughty bladder, but the bladder acts like an errant child and just won’t listen.
Often, the pelvic floor is dysfunctional too. Either the pelvic floor acts like an exhausted parent (a.k.a a weak and underactive pelvic floor) or a stressed uptight parent (a.k.a a tight and overactive pelvic floor). As we all know, an exhausted or uptight parent is no longer very effective at disciplining their child. The same goes for a dysfunctional pelvic floor in its attempt to reign in a naughty bladder. It just doesn’t work!
When the pelvic floor becomes dysfunctional, it’s no longer the perfect dance partner, but rather a complete motor-moron that is out of rhythm with your bladder.
It’s important to know that OAB is extremely common. It is experienced by 40% of women and 25% of men! Research shows that pelvic physiotherapy can help turn your pelvic floor from dysfunctional back to functional. At The Pelvic Studio we always work closely with your doctor/s in regards to your bladder problem, as medications (in some cases) may be useful in settling down your bladder symptoms.
Bladder Leakage - Urge Urinary Incontinence
Another common phenomenon associated with OAB is urge urinary incontinence (UUI). UUI is the leakage of urine that occurs with bladder urgency. If the pelvic floor is dysfunctional (weak and/or tight) it won’t be able to hold urine in when the bladder starts ferociously contracting.
Urinary leakage oftens results in embarrassment, social anxiety and a loss of confidence. But the good news is its 100% treatable!
How Can Physiotherapy Help with Bladder Dysfunction?
Your physiotherapist will provide you with a number of bladder retraining strategies that aim in improving bladder control. Having a well functioning pelvic floor will also help reduce urgency, and help you to hold urine until you're ready to empty.