Often I am told how surprised patients are when they are referred to pelvic floor physical therapy for their urinary symptoms. In reality, dysfunctional pelvic floor muscles are frequently a main contributing factor to many urinary symptoms. When dealing with stress urinary incontinence, weakness in the pelvic floor muscles must be addressed. Other bladder disorders, such as PBS/IC, retention, dysuria, urgency/frequency or urge urinary incontinence have the opposite problem. These patients typically have pelvic floor muscles that are working too hard and have become dysfunctional, often to the point where they are stuck and restricted in a shortened and overly tense position. Trigger points (areas of heightened irritability within a taut band of muscular or fascial tissue that is exquisitely tender when palpated and can refer pain and symptoms to another area of the body) in other muscles surrounding the pelvis can also affect the bladder and cause uncomfortable urinary symptoms. When it comes to treating bladder dysfunctions, your pelvic floor physical therapist will address any musculoskeletal or fascial restrictions or dysfunctions that can be affecting your urinary symptoms. Each patient will be educated on dietary management as well as behavioral modification techniques such as bladder retraining and the use of urge deference techniques. Manual therapy will be utilized along with individualized home programs specifically designed and tailored for each patient and their bodies.