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Overactive Bladder Syndrome (OAB)

Ashley Dougvillo 
February 7, 2022

I have been seeing a bit more of this in the clinic which to me means…it is time for a blog!!

OAB is described as a frequent and sudden urge to urinate.  In some cases, this may be difficult to control and may result in incontinence (uncontrolled loss of urine).  Other symptoms include a sudden need to urinate upon standing, multiple times of urination throughout the night, or more than 8 times of urination in a 24 hour period.

So what exactly is occurring here?  The bladder and the brain are connected via a circuit of nerves and communicate closely with one another.   When this circuitry is functioning well, the kidneys allow the bladder to fill with urine, as the bladder fills nerves will eventually signal to the brain the need to void, urine then passes through the urethra (these same nerve signals allow the pelvic floor muscles and muscles along the urethra to relax).  The bladder helps with this process by tightening and contracting.   When somebody gets diagnosed with OAB, usually what has occurred is that the muscles of the bladder start to contract even when the volume of urine in the bladder is low which creates an ongoing urgency to urinate.

Prevention is a piece of this as well so maintaining a healthy weight, regular exercise, managing comorbidities such as diabetes, limiting alcohol and caffeine intake, and quitting smoking all can help!   There are other pathologies that mimic OAB and therefore it is always important to get checked out with your ob/gyne as well as with a pelvic floor physical therapist.  From a physical therapy standpoint, if this is something you are struggling with, an internal assessment of your pelvic floor muscles would be beneficial to assess for tightness or weakness that could be affecting function.  Additionally, education on breathing and pressure management strategies, proper coordination of pelvic floor muscle activation, bowel and bladder irritants, and a bladder schedule may assist with symptom improvement and/or resolution.  A lot of time when I am treating patients I start them with a bowel and bladder diary to look at trends in their voiding patterns over a 24 hour period.

Ultimately there is a solution for you if you are struggling with bladder dysfunction!  The first step is to reach out to a medical professional and have confidence that an answer will be found for your individual needs!

Meet the Author
Ashley Dougvillo joined Smith Physical Therapy and Running Academy in 2019. She graduated from Marquette University in Milwaukee, WI in 2008, receiving her Bachelor of Science degree with a concentration in Biomedical Sciences. She then went on to attend Northwestern University in Chicago, IL to complete her Doctorate of Physical Therapy in 2010. She is a Certified Manual Therapist and has additionally obtained specialty certifications in the Pose Method of running, kinesiotaping, FMS/SFMA, ASTYM, and Women's Health.