There are many reasons for increased bladder sensitivity that are not directly related to the pelvic floor. They include medication or dietary changes, increased fluid intake, and psychological stress. These factors should be addressed with your primary care provider, but when this problem persists you may want to take a closer look at the muscles around your bladder.
The bladder sits in the front of the pelvic cavity, and is supported by the muscles of the pelvic with our reproductive and digestive organs close behind. When these muscles are shortened, it places more tension on the bladder, which stimulates the brain to initiate the contraction and emptying of our bladder before it is full.
The shortening of pelvic floor muscles can be voluntary, involuntary, or combined. Voluntary holding of the muscles occurs due to habit, occupation, or constant recruitment of the muscles to avoid urination and defecation. Involuntary holding can be due to painful conditions such as vulvodynia, vaginismus, or endometriosis. Trauma and gait abnormalities can also lead to shortening of muscles and ligaments within the pelvic floor. It may be difficult to get the original cause of the hyperactivation, but looking at a combination of factors is necessary.
The levator ani muscle group (puborectalis and pubococcygeus) form a sling at the base of the pelvic floor that brings the vagina and bladder neck up towards the pubic bone, providing reinforcement as a secondary sphincter for urine and fecal control. Long term muscle tension in the levator ani group leads to overactivation of the bladder, and eventually thickening of the detrusor muscle. This increase in muscle mass then induces the continuous urge to urinate, resulting in what is considered an overactive bladder.
Pelvic floor rehabilitation with an emphasis on neuromuscular education is the gold standard of therapy for women with nonrelaxing pelvic floor dysfunction. A specialist trained in treating pelvic floor dysfunction can also use manual techniques to release trigger points within different muscle groups and optimize their length. Exercises to ensure lumbopelvic stability and spinal function are also taught to improve overall bowel, bladder, and sexual function.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498251/
https://onlinelibrary.wiley.com/doi/full/10.1111/iju.12379
https://www.ncbi.nlm.nih.gov/books/NBK279384/
