“I have a weak bladder”. What does this mean and is your bladder really weak?

“I have a weak bladder”. What does this mean and is your bladder really weak?

When you come in to Physio for help with pelvic floor problems, we will ask you to talk though what the main problems and issues that you need help with.  

Bladder problems are high on the list of problems for which people seek help.  

A LOT  of people will tell us that they have a “weak bladder”.   By this, they mean that they go to the toilet more often than everyone else.  In other words, the bladder is weak because it can’t hold on.  

Well this isn’t entirely true……..

In order to explain what the real issue is, it is necessary to explain some facts about the bladder:

  1. The bladder is an internal organ of the body whose job is to store and hold urine until it is full.   At that point, we can find a toilet in our own time and empty the bladder.  
  2. The wall of the bladder stretches as it fills, and when there is a certain amount in the bladder (say, 400 mls or so) the bladder feels full and we start thinking about going to the toilet.  At this point, the bladder still has lots of stretch left so it can stretch more.  This means that we have time to finish what we are doing, to finish the lesson or the meeting or the walk we are on…..we have time to find the toilet without having to panic or rush.
  3. The walls of the bladder are made of several layers, one of which is MUSCLE.  But, it is not muscle like the muscles of your arms and legs which you can choose to contract or relax; it is special internal body muscle that it controlled by the body.  When you are in the right place, (and that is vital…the bladder should only empty when you are ready and in the right place)…. the bladder muscle contracts and so empties.  
  4. The pelvic floor muscles are muscles that we CAN control.  We can decide to tighten them or not.   If the bladder is telling us to hurry and find a toilet, we can use our pelvic floor muscles to calm the bladder and tell the bladder to hold on a little longer, just until we can get out of the meeting, shop, car….or whatever it is we are doing.   These muscles tell the bladder to calm down and relax.  The bladder is designed to be able to wait until we are ready. 

So based on this,  why do you feel that your bladder is weak?  The answer is that your bladder has stopped being happy to relax and fill.   For various reasons,  usually slowly over time, It starts to tell you to go NOW or you’ll be in trouble and have an accident.  You will most likely start to try and pre-empt the bladder and find a toilet before you do things that might prevent you from going…you start going “just in case”.   The bladder starts to want to go just because you are leaving the house or going into the meeting, or getting in the car etc etc.  Your bladder is not weak, it is just more frequent and urgent.  This is actually called “overactive bladder”.  


Well again, it isn’t your bladder that is weak, it is the pelvic floor muscles and the ring of muscle round the bladder exit called the bladder sphincter that have become weak for lots of reasons, one of which is childbirth, but other factors like chronic coughs and heavy lifting can weaken the pelvic floor too.   Bladder problems are not just women’s problems.  Men have bladder issues too.   Studies show that as many men as women have “overactive bladder” as shown above.  

We can help find solutions to this common problem.  If you think your bladder is “weak”, come and find out what’s really happening and what you can do to fix it!.

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