Bossy Bladder Program

Do you have a Bossy Bladder?!

Feel like you have to run to the bathroom-A LOT?

Always know where and when your next bathroom will be available?

Don’t worry, we’re here to help!

Bladder Urgency, or Overactive Bladder, can be all consuming and anxiety provoking. Pelvic floor physical therapy can help both address the reason for the urgency and help form better bathroom habits to reduce the anxiousness that comes from needing to pee.

We will take you through a comprehensive evaluation to determine what type of urgency you are experiencing. We will look at several factors known to be culprits for contributing to urinary urgency to find the root cause of the urgency as well as other aspects to address. Based on our findings, we will design an action tailored specifically to your symptoms, urgency type, and contributing factors to reduce the urgency and improve your quality of life!

At Level Up, Our Bossy Bladder program is designed to:

1. Identify the cause and type of urgency you are experiencing

2. Identify contributing factors to the bladder urgency

3. Create a holistic and specific action plan to address the root of the problem

4. Give you bathroom freedom!

Who Is This Program For?

• Feeling the sudden and uncontrollable urge to urinate throughout the day

• People waking more than 1x/night to pee

• Feeling like you are using the bathroom more than 8 times/day

• Constantly aware of your bladder fill, the next bathroom opportunity, or bathroom in sight

• Afraid of long waits for bathrooms-long car rides, flights, events

• Unsure what’s “normal” and what’s treatable

Bossy Bladder Program FAQs

What is urinary urgency?

Urinary urgency is a sudden, strong need to urinate that can feel difficult to ignore or postpone. You may feel like you need to find a bathroom immediately—even when your bladder isn't actually full.

For some people, urgency can become so predictable that they start planning their day around bathroom locations, limiting activities, or feeling anxious about being too far from a restroom. If this sounds familiar, you're not alone—and there are ways to improve it.

What is overactive bladder?

Overactive bladder (OAB) is a collection of urinary symptoms that can include a strong or sudden urge to urinate, frequent urination, waking up at night to urinate, and sometimes urinary leakage associated with urgency.

You don't have to simply live with these symptoms. Pelvic floor physical therapy can help identify factors contributing to OAB and teach you strategies to better manage your bladder.

What causes bladder urgency?

There isn't one single cause of urinary urgency. Your symptoms may be influenced by pelvic floor muscle tension or weakness, bladder habits, fluid intake, constipation, stress and anxiety, hormonal changes, medications, activity levels, or other factors.

That's why we don't use a one-size-fits-all approach. Your evaluation will help us understand what may be driving your urgency so we can address the factors that are most relevant to you.

Does bladder urgency mean my pelvic floor is weak?

Not necessarily! A common misconception is that bladder symptoms automatically mean you need to strengthen your pelvic floor.

Sometimes the pelvic floor muscles are weak, but sometimes they are too tense, overactive, or having difficulty relaxing and coordinating with the bladder. Your treatment plan will depend on what your body actually needs—not just on the presence of urinary symptoms.

Will I have to do Kegels?

Not necessarily. Kegels—or pelvic floor contractions—are not the right solution for everyone with bladder urgency.

Depending on your evaluation, your program may focus on pelvic floor coordination and relaxation, bladder retraining, breathing strategies, movement, behavioral changes, or other individualized techniques.

What happens during the Bossy Bladder evaluation?

We'll take a comprehensive look at your symptoms, bladder habits, lifestyle, medical history, and other factors that may be contributing to your urgency or frequency.

We'll work together to determine what type of urgency you're experiencing and identify the factors that may be keeping your bladder symptoms going. From there, we'll create an individualized plan to help you reduce urgency and feel more confident in your day-to-day activities.

Will I have to keep a bladder diary?

Yes-but only for 3 days. A bladder diary gives us valuable information about your fluid intake, bathroom habits, urgency, and other patterns that may be contributing to your symptoms.

Don't worry—we'll explain exactly what to track and why. The goal isn't to make you obsess over your bladder; it's to help us understand what's happening so we can create a more effective plan.

How can pelvic floor physical therapy help bladder urgency?

Pelvic floor PT can help you understand how your pelvic floor, bladder, breathing, habits, movement, and other factors interact.

Treatment may include education, bladder retraining, pelvic floor exercises or relaxation, hands-on treatment when appropriate, breathing and coordination strategies, and changes to daily habits. Your plan will be tailored to your specific symptoms and goals.

Will I have to stop drinking water or coffee?

Not necessarily. We don't believe in automatically eliminating everything, or anything, you enjoy.

Certain beverages, fluid habits, and dietary factors can contribute to bladder symptoms for some people, but everyone's bladder is different. We'll help you determine what may be contributing to your symptoms and make practical changes rather than giving you a long list of things you're not allowed to have.

What if anxiety about finding a bathroom is part of the problem?

This is incredibly common. When you've experienced urgency before, it's understandable to start thinking, “Where is the nearest bathroom?” before you even leave the house.

That anxiety can become part of the cycle. Our program addresses both the physical and behavioral aspects of bladder urgency so you can build confidence in your ability to respond to your bladder without letting it control your plans.

Is Bossy Bladder only for women?

No! Bladder urgency and overactive bladder can affect people of all genders. Our pelvic floor physical therapists work with all people experiencing bladder and pelvic floor symptoms.

What if I also have urinary leakage?

That's okay! Urgency and leakage can occur together, and your evaluation will help us determine what may be contributing to both. We'll build your treatment plan around your complete picture rather than treating one symptom in isolation.

How long will it take to improve my bladder symptoms?

Everyone's timeline is different. It depends on what's contributing to your symptoms, how long you've been experiencing them, and how your body responds to treatment.

Our goal isn't simply to give you a list of exercises. We want to help you understand your symptoms, develop strategies you can use in everyday life, and make meaningful improvements that last.

Do I need a doctor's referral?

No, if you are using out-of-network benefits or using our services as cash based, you don’t need a referral to get started. Per the state of California, we will need a referral after 45 days so if you have a urologist, urogynecologist, primary care, or gynecologist that could write a prescription it is worth getting one. If not, we’ll help you get one after your initial evaluation.

If you are going through Medicare benefits, yes. We need a prescription to start physical therapy.

Is Bossy Bladder right for me?

If you're frequently thinking about your bladder, rushing to the bathroom, planning your activities around restroom access, waking up multiple times at night to urinate, or avoiding activities because you're worried about having an accident, Bossy Bladder may be a good place to start.

You don't have to accept bladder urgency as something you simply have to live with.

Let's figure out why your bladder is being so bossy—and help you take back control.