Happy Bladder Health Month! No, November is not only about cooking turkey and putting on a football game, it’s also the month we try to spread more awareness about Bladder Health and Urinary dysfunction. 

Do you struggle with urinating? 

Do you find yourself sitting on the toilet and starting and stopping in the middle of a stream? 

Do you find yourself on the other end of the spectrum and you find yourself running to the bathroom every 30 minutes?

If you find yourself nodding your head YES to that last question then check out this article by Dr. Anisha Drake discussing trigger bladder (  Gotta Go!  ). 

IF you think you have issues with initiation, retention or hesitancy (these are all voiding dysfunctions)… then you’re in the right place! 

Voiding dysfunction is more common than you think and can be a significant disruption to your everyday life. Voiding dysfunction includes difficulty initiating voiding, inability to fully empty your bladder, and even hesitancy with voiding including starting/stopping in the middle of a stream. There are a number of causes that could be contributing to these problems including:

Overactivity of your pelvic floor muscles: 

  • Your pelvic floor muscles form the floor of your core and they need to be able to lengthen and contract effectively depending on the task at hand. 
  • What does this have to do with urination? When your pelvic floor muscles contract they send a signal to your brain to tell your bladder muscle to relax and vice versa. If your pelvic floor muscles are not contracting or relaxing as they should then it interferes with the signals sent to your brain. 
  • If your pelvic floor muscles are in a constant state of contraction and they are unable to relax, there may be too much pressure on urethra.


  • Stress is a huge part of our everyday life we may not recognize when it is impacting our ability to void. 
  • Stress can also be a reason you may have difficulty relaxing your pelvic floor and thus have difficulty initiating a stream or notice yourself starting/stopping while you are urinating. 
  • Relaxation techniques including diaphragmatic breathing, mindfulness, and meditation are some good options. 

Learned voiding dysfunction…what is that?? 

  • Over time we’ve all been accustomed to certain patterns or habits that we have picked up over the years. Maybe you’ve been taught that it’s okay to squat and pee when in a public restroom. Or you’ve been starting and stopping your stream of urine every time you’ve gone to pee in a public restroom because someone walked in. And we’ve all done the “just in case” peeing at some point in our lives. 
  • All those behaviors and habits can lead to dysfunction in the relationship between our pelvic floor/brain/bladder and result in difficulty with urination. 

Pelvic Adhesions: 

  • Adhesions are scar tissue that can form after surgeries, infections, conditions such as endometriosis or injury to tissue/organs in your pelvic region. When scar tissue forms it can impact your organs and can lead to a number of symptoms including pain, bowel obstruction and urinary bladder dysfunction.

If any of these situations sound familiar to you then you may be in need of a Pelvic Health PT. Treatment can include bladder retraining, pelvic floor relaxation exercises, manual therapy, internal self-massage or the use of a dilator. A pelvic health PT can help discuss these options with you to get you back to living your best life!

 Click here to book your appointment with Aretha Narayan, a pelvic health PT at One on One Physical Therapy.


About The Author

Aretha Narayan

Aretha Narayan received her Doctorate in Physical Therapy from Oakland University. Aretha underwent her pelvic floor training working with pelvic health physical therapists on clinical rotations and advanced training through the Herman and Wallace Pelvic Health Rehabilitation Institute.

Aretha took an interest in pelvic health after witnessing many patients, friends, and family quietly dealing with symptoms associated with pelvic health conditions and seeing how it affected their physical, emotional, and mental well-being. Her goal is to help all patients live a symptom-free life through physical therapy.