Dr. Mandi Murtaugh Physical Therapy + Yoga

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Urgency Part 2: Your Bladder is a Big Fat Liar

In Urgency Part 1 we talked about what Urgency is, and what might contribute to it. Again, an urge is a sudden strong sensation to empty your bladder that is hard to postpone.

What’s so abnormal about this sensation, you might ask? Let me break it down.

Our bladder’s job is to fill, hold, then empty. That’s it. All day long, it moves through that cycle. The walls of the bladder are a muscle. That muscle relaxes to fill and hold, then contracts to empty. It’s a smooth muscle though, meaning you can’t control it—it’s like the muscle of your heart (thank goodness we don’t have to think about contracting that one, right?!).

A normal “full bladder” sensation is a STRETCH, meaning the walls of the bladder stretched or lengthened enough to tell you it’s about full. You can easily ignore this, though, and move on with your day. You’ve had this feeling, right? Right. 

An urge, however, is a CONTRACTION, or shortening, of the bladder walls. Which means it is literally trying to empty, right then and there. No wonder it sends you running to the toilet! What’s the worst thing you can do if your bladder is literally trying to empty? Step your legs apart, right? Walk. Run. Yep, that’s definitely not going to do the job.

This is basically an incorrect signal, and often a false alarm. The strength of an urge is NOT correlated with how full your bladder is. Your bladder is a big fat liar. And the more you follow its command (ie. head to the loo), the more it thinks it’s normal. The bladder is, for better or worse, highly trainable. It squeezes, you run, and it gets reinforced that this is ok. Super annoying.

If it’s trainable, can you train it back, you ask? Absolutely.

How?

The short answer is: stop obeying it! Try to ride out the urge with legs crossed and by squeezing your pelvic floor. If you can wait till the urge subsides, then head to the toilet: you’ve won. Keep doing that and it should start to get easier to control, and sometimes go away completely. 

The long answer: Head to Urgency Part 3 for the full scoop on Bladder Training.