None of these sensations are normal, and no one should have to live with any of the aforementioned symptoms! It is important to keep in mind what is considered “normal,” and that includes voiding 6-8x/day, 0-1x/night, and a feeling of complete emptying of the bladder after urinating. In addition, one should never feel straining or pain while urinating.
If you can relate to any of the symptoms described in the first paragraph, it may be indicative of pelvic floor muscle dysfunction. The pelvic floor muscles play an important role in elimination of urine (and feces). The pelvic floor muscles contract in order to “hold it in”, i.e. to maintain urinary continence, and they relax in order to allow for complete emptying of the bladder. If the pelvic floor muscles become tight (ex. due to prolonged sitting, stress, or previous trauma, to name a few causes), the muscles may not be able to fully relax for complete emptying of the bladder. The analogy I tell my patients is to imagine that the pelvic floor muscles are like a fist squeezing around a hose. In my analogy, the hose represents the urethra, the opening through which urine exists the body. If the fist remains stuck and is unable to open around the hose, it will be difficult for water to pass from one end of the hose to the other end. So too with the pelvic floor muscles; if the pelvic floor muscle “fist” remains clenched tightly around the urethra, it will interfere with elimination of urine through the urethra. This can result in many of the aforementioned symptoms.
You are probably wondering, “So great. I now understand WHY I am experiencing these symptoms. But how do I open up that fist up around the hose? How do I fix the problem?” PELVIC FLOOR PHYSICAL THERAPY is an excellent and effective intervention to help stretch the tight pelvic floor muscles and restore normal resting tone. Pelvic floor PT also includes trigger point release of any “muscle knots” which may be present in the pelvic floor, and the skilled practitioner can also provide myofascial release and connective tissue mobilization of tight structures, including tendons, ligaments, and nerves. In addition, appropriate home exercises are taught which will enable you to maintain the benefits gained between sessions, and they will allow you to progress your healing process. If you think that YOU may benefit from pelvic floor physical therapy, please speak to you doctor about its appropriateness for you. I would love to have the opportunity to help you!