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There are several different types of bladder-related problems that result in you losing control over the process of urination. One of these many conditions is called neurogenic bladder, a condition in which the brain or the nerves cannot communicate effectively with the muscles in the bladder.

If you or a loved one is dealing with this condition, know that you're not alone, and that there is help available. Today, we’re here to shed light on what is a neurogenic bladder and how physiotherapy treatment plays a pivotal role in managing it. Keep reading!

What is a Neurogenic Bladder?

To understand how physical therapy can help, it’s important to grasp what a neurogenic bladder is.

Several nerves and muscles work together for your bladder to hold urine until you are ready to empty it. When your bladder gets full, the nerve signals from your brain lets you know that you need to empty the bladder and then you feel the need to urinate. When you’ve found a bathroom, your brain sends nerve signals to the muscles that control urination to squeeze or relax, and then you answer nature’s call.

When the nerves between the brain and the muscles that control urination are damaged by injury or illness, the muscles may not tighten or relax at the right time. As a result, the bladder may not fill or empty properly, leading to the development of one of two types of neurogenic bladder: an overactive or underactive bladder.

With overactive bladder, the muscles that control urination may become overly sensitive and squeeze more often than normal before the bladder is even full.  As a result, you may feel frequent, sudden, and strong urges to urinate. Sometimes, the muscles that contain the urine within the bladder may also weaken, leading to urine leakage before you can reach the bathroom.

With underactive bladder, even if the bladder is full, you may not feel the urge to urinate. And when you do urinate, your bladder may not empty fully or at all.

Some people may experience both overactive and underactive bladder.

Symptoms of a neurogenic bladder

With a neurogenic bladder, you may experience a combination of the signs and symptoms mentioned below:

  • Frequent, sudden, and strong urge to urinate
  • Loss of feeling that the bladder is full
  • Dribbling of urine without noticing it
  • Releasing only a small amount of urine during urination
  • Painful urination
  • Pain or pressure in the abdominal area

Role of Physical Therapy and Common Techniques

Physical therapy, while valuable for treating and rehabilitating the muscles that control urination, is not a standalone holistic treatment for neurogenic bladder.

Effectively managing neurogenic bladder often requires a comprehensive approach, involving lifestyle adjustments, medications, and, in some cases, catheterization to optimize bladder function and overall well-being.

Physical therapy aims to restore and maximize bladder function by strengthening the pelvic floor muscles and bladder muscles, increasing bladder capacity, and improving coordination between the nerves and muscles that control urination.

Here are some common techniques used in physiotherapy for bladder:

1. Pelvic floor exercises (Kegels):

These exercises focus on strengthening the pelvic floor muscles that support the bladder and control urination. Your physical therapist will guide you in performing these exercises correctly to target the pelvic floor muscles. You can also learn how to do pelvic floor exercises here.

2. Bladder training:

Bladder training involves following a fixed schedule for urination and then gradually increasing the time between bathroom breaks. This trains your bladder to hold larger amounts of urine for longer periods, reducing urgency and frequency.

3. Biofeedback:

This technique uses monitoring equipment to provide real-time visual or auditory feedback on muscle activity. It helps you learn how to control your pelvic floor muscles and improve coordination between the brain and the bladder.

4. Electrical stimulation:

In some cases, electrical stimulation may be used to activate or strengthen the pelvic floor muscles.

5. Manual therapy:

Sometimes, hands-on techniques may be used to release muscle tension and improve mobility in the pelvic region, contributing to better bladder control.

Seeking Physical Therapy for Neurogenic Bladder

If you or someone you know is dealing with a neurogenic bladder, seeking physical therapy is a crucial step toward improving quality of life. Here's how you can get started:

1. Consult your doctor

Begin by discussing your symptoms and concerns with your family doctor or your primary doctor. They can provide a referral to a qualified physical therapist who specializes in pelvic health.

2. Find a skilled physical therapist

Look for a physical therapist with expertise in pelvic floor rehabilitation and neurogenic bladder. They should have the knowledge and experience necessary to develop a tailored treatment plan for your specific needs.

3. Initial evaluation:

Your first visit will typically involve a comprehensive assessment of your condition, including a review of your medical history and a physical examination. This evaluation helps the therapist understand your unique challenges and goals.

4. Develop a treatment plan:

Based on the evaluation, your physical therapist will create a personalized treatment plan that may include a combination of the techniques mentioned earlier. They will work closely with you to set achievable goals and monitor your progress.

5. Consistent follow-up:

Attending regular physical therapy sessions and diligently following your therapist's recommendations are key to achieving the best results.

Living with a neurogenic bladder can be physically and emotionally taxing, but when it’s followed closely and treated, you can see large improvements in your life. Seek support from healthcare professionals, connect with a skilled physical therapist, and begin your journey towards better bladder health.


What is the most common cause of neurogenic bladder?

The most common cause of neurogenic bladder is spinal cord injury. Other significant causes include neurological conditions such as multiple sclerosis, Parkinson's disease, stroke, and nerve damage resulting from diabetes. These conditions can disrupt the communication between the brain and the bladder, leading to impaired bladder function.

What is the best bladder training exercise?

Kegel exercises is one of the most well-known and widely recommended bladder training exercise. Kegels target the pelvic floor muscles and help strengthen them, ultimately enhancing bladder control. However, the "best" exercise can vary depending on an individual's specific needs and should be determined in consultation with a healthcare provider or physical therapist.

Who can benefit from physical therapy for a neurogenic bladder?

Physical therapy for a neurogenic bladder can benefit anyone experiencing symptoms such as urinary incontinence, retention, urgency, frequent urination, or difficulty emptying the bladder.

What is the male bladder training exercise?

Male bladder training includes Kegel exercises, which strengthen pelvic floor muscles. To do Kegels, identify your pelvic floor muscles, squeeze and hold them for 3-5 seconds, and then relax for 3-5 seconds. Aim for 3 sets of 10-15 repetitions daily.

What exercises are good for weak bladder?

To strengthen a weak bladder and the pelvic floor muscles, consider Kegel exercises, pelvic tilts, bridge exercises, squats, and wall sits. Maintain regularity and consult a healthcare provider or physical therapist for correct execution and personalized recommendations.