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Got the urge to go to the bathroom but can't hold it in? Here's how physical therapy can help.

Physical therapy for urge urinary incontinence and overactive bladder syndrome.

Ever get that urge to pee at the most inconvenient time? For instance, in the middle of your workday, when you’ve finally found a spare moment to sit down for lunch, and all of a sudden you get this intense urge to urinate causing you to run to the toilet before, well, you might pee your pants. Or maybe you can relate to that feeling of anxiously scanning highway signs for the nearest bathroom because you’re afraid you might not be able to ‘hold-it-in’ long enough without leaking?

Well, you're definitely not alone. In the US about 17% of women have overactive bladder syndrome (OAB) and an estimate of almost 12.2 million adults have urge urinary incontinence (1). Urinary incontinence is twice as common in women than men due to pregnancy, childbirth, and menopause contributing to a higher incidence of symptoms.

So.... (big exhale out) if you’re reading this and feel a little confused about the difference between OAB and urge urinary incontinence this might help…

  • OAB is the urge to urinate frequently. This means you’re getting the urge every hour, 30 minutes, or even every 15 minutes. In a healthy adult, it’s considered typical to urinate every 2 hours. When you get the feeling like it’s “time to go” less than every 2 hours, that’s when adverse habits start to form and OAB syndrome develops.

  • Urge urinary incontinence begins with a sudden and intense desire to urinate, but instead of running to the bathroom in time or having enough strength in your pelvic floor to hold it in, you end up wetting your underwear. Not fun.

Some women suffer from both OAB and urge incontinence or just one of the two. Both can feel stressful and overwhelming at times no matter your age or situation.

Pelvic health physical therapy is a wonderful treatment option for you or anyone you know who lives with OAB or urge incontinence. In PT (or physio as they call it everywhere else that’s not the US :) ) you will learn a myriad of techniques to retrain the bladder-brain connection, strengthen the pelvic floor, reduce tension in the pelvic floor, and/or engage in behavioral therapy treatments to help reduce symptoms.

What you should expect:

  • On the first visit you should expect your physical therapist to ask you a series of questions like: “how often do you feel like you need to urinate?” “If you get the urge to urinate can you hold it in long enough to make it to the bathroom without leaking?” “How often do you leak during the day?” etc.

  • After your physical therapist asks all the many questions that we love to ask, she may perform a vaginal pelvic floor examination following your consent. This could take place either on the first visit, or second visit, or not at all depending on what you and your therapist decide together. If you do have a pelvic floor examination, your PT will be able to understand the strength of the pelvic floor muscles, endurance (the period of time your muscles can stay contracted), and the coordination of the muscles (meaning, do you move through the full range of motion at the correct time?).

  • Lastly, your pelvic PT may hand you a bladder diary to complete over 2-3 days minimum at home. In this diary you will write down what you drink each day, the volume of urine you urinate each day, if you had urgency or incontinence, etc. From this information you and your PT will develop a plan on how you can change your habits so that you experience less urgency and feel confident enough to wait before running back to the toilet.

My favorite habit retraining tip:

Create a plan or calendar with your PT that lists out the amount of time you need to wait each day and week before making your way to the toilet. The time should begin with you waiting 5 minutes before going to the bathroom and increase by 5 minutes every week until you’re able to wait for around 2 hours. On the calendar you can write down your exercises for the day, a tip or reminder to breathe deeply and contract that pelvic floor as you wait, or a note with questions you have for your next PT appointment.

Before this post ends and you move on with the rest of your day, I want to remind you that if you’re reading this and you do live with OAB and/or urge urinary incontinence, you are not alone and there is someone out there who can help. You can always reach out to me with any questions via the contact button on the top or search your local area for your nearest pelvic PT.

Hope you all stay healthy. Love to your bladder, pelvic floor, and most of all to yourself! You got this.

To read more blog articles by me you can click on the blog tab under “Physiotherapy” on the top of your screen.

With light,


***This blog post is only for general information and knowledge. If you are experiencing any type of incontinence emergency please contact your nearest physician or physical therapist.***



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