Physiotherapy and the Bladder

Do you ever have the sudden, overwhelming urge to urinate and yet your bladder is not even full? Or maybe you get that sudden urge and then leak on the way to the toilet?

If you answered yes to any of these then you may just have urinary urgency or urge urinary incontinence. This month’s blog will highlight this common complaint of many women, men and children. Read on to learn some simple bladder calming techniques that physiotherapists recommend in order to calm the bladder and delay the urge so that you can go to the toilet calmly and when it is more appropriate.

A normal bladder is like a balloon. It gradually gets bigger and bigger as it fills with urine. During this time, the bladder wall (a muscle known as the detrusor) remains relaxed as the bladder fills. When the bladder fills to approximately 250mls, that is often our first sensation to urinate. We “could go” but we do not need to. At 350mls we often feel our second sensation to void urine. We “would go” but our bladder continues to fill because our brain can ignore this sensation. When the bladder is at its maximum capacity (i.e. 550 – 600mls), we feel a sensation to urinate and that we “should go”. At this point our detrusor contracts, our pelvic floor muscles relax and we urinate.

However, if you are experiencing urinary urgency then you may have an overactive bladder. The detrusor muscle may be “twitchy” and contract too early when the bladder is not completely full and at a time that it not convenient. You may even leak urine as a result of this urgent sensation.

There are many triggers that may cause your urgency. Here are some of the common ones:

  • Key in the door
  • Running water
  • Cold weather
  • Getting up after lying or sitting down for a prolonged period of time

For example, when someone with urinary urgency arrives home and puts the key in the door, or turns on the tap and hears running water, their bladder has gotten into the habit of wanting to empty every time that cue presents itself.

You may ask “How can physio help my bladder?” A physiotherapist with postgraduate training in this area can help you with bladder issues such as urinary urgency or urge urinary incontinence. There are many bladder calming techniques that you can try when you feel that urgent need to urinate but the bladder is not full. They help to dampen down the urge until you can go to the toilet calmly or it is a more convenient time to go. Below are some interesting bladder calming techniques you can try yourself. Please be aware that this is not a comprehensive list:

Top lip pressure

Apply firm pressure in the area between your nose and top lip.

Sacral rubbing

Rub the sacrum (wedge shaped bone) just above your tailbone.

Perineal pressure

Apply firm pressure to the area in front of your anus. You can achieve this by sitting on the edge of a desk, armrest of a chair or sitting on your heel (if your flexibility allows).

Clitoral pressure

This is for women only! Try the same strategies as above but this time the pressure is on the clitoris. Little girls do this one all the time by crossing their legs and placing their hands firmly on this area.


Take your mind off your bladder. Send a text message, start a busy task, count back in 3’s from 300!

If you can familiarise with this blog, and are experiencing any symptoms of urinary urgency, then you can book a detailed assessment of your bladder with our physiotherapist who has training in this area. Your physio would be happy to help you regain control over your bladder and implement good bladder habits. Please note that urinary urgency may not just be a result of lifestyle and poor bladder habits but may also have other causes such as urinary tract infection, medications, obstetric history, neurological conditions etc. Therefore, if deemed necessary, these causes will also be ruled out or addressed by a medical professional.

Written by Lauren Young


(Continence & Women’s Health)

Pilates Instructor

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