Physiotherapy for Overactive Bladder
Physiotherapists use a variety of techniques to help people who have overactive bladder (OAB), teaching patients how to strengthen their pelvic floor muscles and retrain their bladders. The goals of treatment are to reduce feelings of urgency, improve continence and boost general wellness levels. Physiotherapy for overactive bladder may be successful when used alone or in conjunction with other OAB treatments.
1. Understanding the Anatomy of the Pelvic Floor
Pelvic floor muscles support the bladder, uterus, vagina and rectum. They may weaken as you grow older. However, pelvic floor weakness is not a normal part of the aging process. Weight gain, childbirth and an array of health conditions may result in the weakening of your pelvic floor muscles.
One of the pelvic floor muscles is called the urinary sphincter. It is circular in shape and surrounds your urethra. Your urethra is essentially a small tube that urine flows through as it leaves your bladder when you urinate. If your urinary sphincter weakens, you may experience urinary incontinence, especially when you laugh, cough, sneeze, or lift heavy objects.
Physio can strengthen your urinary sphincter and help you to control it better. There are many other muscles in the pelvic floor that help support your bladder and other organs. A skilled therapist will help you to restore those muscles to optimal health too.
2. Strengthening the Pelvic Floor Muscles
Many people are not aware of their pelvic floor muscles, or they misidentify them. Exercising the correct pelvic floor muscles is essential if you want to reduce symptoms of OAB. A physiotherapist can help you to identify and exercise the correct muscles that are involved in your problem so that your treatment will be successful. With exercise, your pelvic floor muscles will gain strength, coordination and flexibility.
You may already be familiar with the pelvic floor exercises known as Kegels. However, they are not the only pelvic floor exercises that may be helpful for you. In fact, for some people who have OAB, Kegels may be contraindicated.
If you have OAB, your pelvic floor muscles may be too tight. You are likely unaware of whether your muscles are tight or not, but a physiotherapist can determine the tone and strength of your pelvic floor muscles.
If your pelvic floor muscles are tight, a therapist can teach you how to become aware of the tightness and show you how to relax your pelvic floor muscles. This will enhance your level of comfort and reduce symptoms of OAB.
Exercising the different muscles of your pelvic floor can target specific OAB symptoms, and a physiotherapist can help you with this. For example, if you suffer primarily from urgency, a therapist may recommend different exercises than if your main issue is dribbling.
Your therapist may recommend that you use vaginal weights or other tools to perform your exercises. Another tool a physiotherapist use to help relieve your symptoms is biofeedback training. Biofeedback may be provided by using an array of painless electronic and mechanical means. Biofeedback is useful if you have a hard time identifying your pelvic floor muscles, as it can help you to be confident that you are performing your exercises optimally.
3. Learning Mind-Body Techniques
Many people become discouraged if they perform pelvic floor strengthening exercises and still suffer from OAB. While a strong pelvic floor is important to success, there are other exercises and techniques you must perform in conjunction with the pelvic floor exercises. A skilled physiotherapist can guide you as you learn these techniques.
Your mind interacts with sensations from your bladder, which are transmitted via your nervous system. A skilled therapist can help you to be aware of the mind-body connection of this automatic reflex. With increased awareness, you will be able to stop reacting automatically to the sensation of urgency and gain better control over your OAB symptoms.
A physiotherapist can teach you an array of mind-body techniques that will help you to retrain your mind and bladder when you feel the urge to void. The therapist may teach you techniques for using your mind to distract yourself from overwhelming feelings of needing to urinate or help you perform meditative and breathing techniques that help you cope with the urgency you experience.
You will learn how to retrain your bladder so that you will only need to urinate every few hours, instead of every few minutes.
4. Keeping a Urinary Journal
A physiotherapist may encourage you to keep a urinary journal. While this may initially feel cumbersome, it is an important part of treatment for many people. Keeping a journal can help you to identify when your symptoms are better and worse. By identifying patterns, you may be able to recognize foods, situations or activities that impact your symptoms.
For example, if you have an increase in symptoms when you visit a certain person, you may need to evaluate if you tend to drink alcohol when you visit that person or feel anxious when in their presence. You can then take steps to remedy the underlying trigger for your symptoms.
5. Toning Your Abdominal and Back Muscles
Your pelvic muscles are not the only muscles that need to be kept healthy for you to gain better control over OAB symptoms. Having healthy back and abdominal muscles is beneficial too.
This doesn't mean you have to be an athlete. Even small improvements in muscle tone, strength and flexibility go a long way towards reducing symptoms of OAB. Your physiotherapist will recommend specific exercises appropriate for your needs and level of wellness.
6. Monitoring Your Diet and Lifestyle Habits
Eating a healthy diet and maintaining an active lifestyle is important for bladder health and general wellness. Your physiotherapist can teach you ways to optimize your health. For example, the therapist may provide you with dietary tips or smoking cessation tips.
Your therapist can even design a whole-body wellness exercise program for you. The therapist will provide you with emotional support if you have been reluctant to exercise due to fears of incontinence. Skilled therapists can help you to discover exercises that you enjoy and are perfect for your current level of fitness. If you need to lose weight, the therapist is an excellent resource.
7. Choosing the Right Physiotherapist
While most physical therapists can provide assistance for individuals who suffer from OAB, I recommend that you consult with a physiotherapist who specializes in urinary tract problems, if possible. Check with your urologist to learn about services that are available in your area.
If your urologist has not already referred you to a physiotherapist, ask for a referral. By using physical therapy techniques, you will achieve more comfort and success treating your OAB. A skilled physiotherapist is an excellent addition to your health care team.
