Pelvic floor muscle training can help treat overactive bladder syndrome


Pelvic floor muscle training can help treat overactive bladder syndrome

Statistics show that 1 in 3 women in Australia suffer from urinary incontinence, Overactive Bladder (OAB) syndrome being one of the most common forms. Overactive bladder is also known as urge incontinence and can be triggered by something as small as hearing running water or seeing the toilet. Overactive bladder disorder is characterised by urinary urgency, increased frequency and nocturia (getting up in the middle of the night to urinate), with or without urgency urinary incontinence (UUI).[1]

There is good evidence that shows that pelvic floor physiotherapy can help with overactive bladder syndrome.[2]

What are the Pelvic Floor Muscles?

The main muscles of the floor of the pelvis stretch like a hammock from the tailbone at the back to the pubic bone in front and are responsible for holding urine in when you don’t want to urinate. As a result of weakened pelvic floor muscles some people may leak urine or have difficulty controlling the flow of their urine. When the pelvic floor muscles lose their normal control it is known as pelvic floor dysfunction.

Common pelvic floor dysfunctions include:

  • stress incontinence
  • urge incontinence
  • urgency (overactive bladder)
  • antenatal care
  • postnatal care
  • vaginal prolapse
  • pelvic pain
  • faecal incontinence
  • bowel conditions (eg constipation).

Pelvic floor muscles can become weakened as a result of:

  • not keeping them active or over working them
  • being pregnant and going through birth
  • chronic back pain
  • chronic constipation and straining when going to the toilet
  • being overweight, obese or having a body mass index (BMI) over 25
  • excessive or incorrect heavy lifting
  • previous injury to the pelvic region
  • growing older

How can pelvic floor physiotherapy reduce overactive bladder symptoms?

Women’s health physiotherapists who specialise in helping women rehabilitate their pelvic floor muscles are commonly called ‘pelvic floor physiotherapists’. Pelvic floor exercises are aimed at strengthening the pelvic floor muscles and exercises are an excellent, nonsurgical way to work to relieve overactive bladder and incontinence symptoms.

Recent research has shown that contracting the pelvic floor muscles can lead to reducing the pressure produced by overactivity of the detrusor muscle: the muscle in the bladder wall that contracts to help push urine out of the bladder.[3] According to the same study, pelvic floor muscle contractions also activate the frontal cortex of the brain, which is responsible for the “voluntary urinary inhibition reflex” leading to improved conscious control of bladder function.

The pelvic floor muscles go around the urethral opening, vagina, and rectum in women. Like all exercises, they require frequent practice to strengthen the muscles and keep them strong. Many people have difficulty identifying their pelvic floor muscles as they are not visible externally. This is where a session with a pelvic floor physiotherapist can help you develop the correct pelvic floor contraction technique.

Can both men and women have overactive bladder syndrome?

Both men and women can experience overactive bladder and urinary incontinence and benefit from personalised exercises. It is common for men to suffer from overactive bladder more frequently than any other form of incontinence. Some men also experience increased urinary frequency, urgency and nocturia—the urge to go in the middle of the night.  When your bladder is contracting frequently due to dysfunctional pelvic floor muscles, you feel like you have to go before your bladder is actually full. Men with incontinence usually find pelvic floor muscle training can help in getting over this problem.

Our women’s health specialist is able to provide appropriate and ongoing treatment in order to minimise your level of discomfort with a personalised plan. Your personalised plan will include specific pelvic strength and stability exercises, postural awareness, movement strategies and back care in an effort to reduce the load on your lower back and pelvis. Monique is also specifically trained in providing bladder and bowel education and advice on the management of abdominal separation.

A referral is not required for women’s health physiotherapy consults, however it may be beneficial for the physiotherapist to liaise with your GP and/or gynaecologist after your first consult.



[1] Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010; 21(1): 5-26.

[2] Fitz, F., Sartori, M., Girão, M. J., & Castro, R. (2017). Pelvic floor muscle training for overactive bladder symptoms – A prospective study. Revista Da Associação Médica Brasileira, 63(12), 1032–1038

[3] Adélia Correia Lúcio, Christiane Boaventura Lourenço, Benito Pereira Damasceno, Maria Helena Baena de Moraes Lopes, Carlos Arturo Levi D’ancona. The effect of pelvic floor muscle contraction on detrusor overactivity pressure in neurogenic and non-neurogenic women during urodynamic study. American Journal of Physical Medicine & Rehabilitation, 2018