The Bladder: More Than a Bubble
When you hear the word bladder, you probably think of it as a simple storage bag. A container that fills, stretches, and empties (a bit like that bladder of merlot inside the box that you squeeze at the end of a night).
But the story of the bladder is far richer, and more human, than that.
Even its name carries a clue. The word comes from Old English blǣdre, meaning bubble or blister. It’s a humble word for an organ that not only holds but listens, adapts, and responds to our emotions, posture, and lived experience.
What the Bladder Is Made Of
The bladder is a hollow, muscular organ. Its walls are formed from smooth muscle fibres called the detrusor, with a delicate inner lining (the urothelium) that acts like a living shield. Fascia wraps and anchors it to neighbouring structures.
But unlike a rigid container, the bladder is designed to move. As it fills, it rises above the pubic bone. As it empties, it contracts back down. This constant dance depends on its freedom to glide within the pelvic bowl ,something that can be lost after surgery, scarring, or even years of poor posture.
The Bladder and Its Neighbours
The bladder doesn’t live alone. It shares its home with the uterus or prostate, vagina, and rectum. They’re bound together by fascia, ligaments, nerves, and blood supply. If one organ shifts, scars, or sags, the others adapt, sometimes a little too much.
This is why a prolapse in one area may feel like a bladder problem, or why tension in the rectum can create urgency. The bladder is part of a community, not an isolated sac.
Picture of three visuals of a bladder one lax, one balanced and one to tight or hypertonic
The Bladder & Pelvic Floor Conversation
Picture the bladder as a balloon resting on a hammock, that hammock is your pelvic floor. As the bladder fills, it presses gently down into this muscular sling. How the pelvic floor responds shapes not only support, but also when your brain gets the message that it’s time to go.
If the pelvic floor is too tight (hypertonic): the hammock is already pulled taut. Even small amounts of bladder filling create pressure, sending the brain an urgency signal too soon. You might feel like you constantly need the loo, even when the bladder isn’t full.
If the pelvic floor is weak or lax (hypotonic): the hammock sags and doesn’t support the bladder well. You may not feel the signal until the bladder is very full, and then the urgency can hit suddenly, sometimes unfortunately too late to prevent leakage.
When the pelvic floor has balanced tone and coordination: the hammock responds with just the right amount of give and lift. The bladder fills with ease, and the signal to empty arrives at a comfortable threshold.
This is why pelvic floor training cannot just be only about “squeezing.” It has to be about restoring balance. To bring back the ability to contract, release, and coordinate with the diaphragm and deep core so that pressure is shared, not dumped onto the bladder alone.
Image of the nervous system controlling the bladder as a cartoon - the conductor, the gatekeeper and the alarm bell
The Nervous System Conversation
Here’s where things get really fascinating. Peeing isn’t just plumbing. It’s a finely tuned conversation between your bladder, spinal cord, and brain.
➡️ The pontine micturition centre in the brainstem coordinates when to release.
What is this? Hidden in the brainstem is a tiny but powerful hub called the pontine micturition centre (PMC). I like to think of it as the conductor of the bladder orchestra.
The bladder may be full, the pelvic floor may be ready, but nothing happens until the conductor raises the baton.
As the bladder fills, stretch receptors in its wall send rising signals up the spinal cord.
The PMC listens, but it doesn’t act alone. It checks in with the cortex (your conscious decision-making , is there a toilet nearby?) and with the amygdala (your emotional alarm system, is it safe right now?).
Only when the environment, body, and emotions all align does the PMC give the signal: relax the sphincter, contract the bladder wall, and allow release.
When this system is calm and connected, bladder emptying feels effortless. But when there’s nervous system stress, trauma, or tension, the conductor can be pulled out of rhythm. The signal to release may come too soon, too late, or not at all.
That’s why practices like breathwork, posture awareness, Hypopressives, and TRE® are so powerful. They help quiet the noise in the system, so the conductor can once again guide the orchestra smoothly, bladder, pelvic floor, and nervous system all playing in time.
➡️The Onuf’s nucleus, a tiny cluster of neurons in the sacral spine, controls the external urethral sphincter, the muscle that says yes or no to flow.
The Gatekeeper of Control
If the pontine micturition centre is the conductor, then Onuf’s nucleus is the gatekeeper at the doorway.
This tiny cluster of nerve cells sits in the sacral spinal cord, and its main job is to control the external urethral sphincter ,the muscle ring that keeps urine in or lets it out.
When the bladder is filling, Onuf’s nucleus keeps the gate shut, holding the sphincter closed so you don’t leak with every step or breath.
When the PMC decides it’s time to release, it sends a signal down to Onuf’s nucleus: open the gate. The sphincter relaxes, the detrusor muscle contracts, and the flow begins.
If the environment doesn’t feel safe, or if pelvic floor muscles are gripping too tightly, Onuf’s nucleus may resist opening, leading to hesitancy or incomplete emptying.
This tiny “doorman” has a huge role in continence. If it starts to falter through nerve damage, trauma, or nervous system dysregulation then bladder control starts to becomes erratic. Too strict a gatekeeper and you struggle to start or fully empty, too lax and you leak without warning.
By restoring balance through breath, posture, Hypopressives, and TRE®, we give the gatekeeper clearer instructions. Instead of slamming the door shut too soon or leaving it ajar, Onuf’s nucleus can once again coordinate with the conductor (the PMC) so the whole system works smoothly.
➡️The amygdala, our emotional smoke alarm, influences urgency. Fear or anxiety can make the bladder twitchy. Sometimes, in moments of true terror, the bladder or bowel empties altogether.
The Amygdala: The Alarm Bell
If the pontine micturition centre is the conductor and Onuf’s nucleus is the gatekeeper, then the amygdala is the alarm bell hanging in the hall.
The amygdala sits deep within the limbic system of the brain, constantly scanning the environment for threat or safety. Its job is simple but powerful, decide if you’re safe right now.
When the amygdala senses danger , whether real (a car swerving toward you) or perceived (a stressful meeting, a noisy environment, or unresolved trauma) it can send the bladder into overdrive. The urgency signal gets amplified, sometimes even before the bladder is truly full.
In moments of extreme fear, the amygdala may flip the whole system into survival mode, where both bladder and bowel release suddenly. This isn’t weakness, it’s biology. Emptying makes the body lighter and sharper for fight or flight.
On the flip side, when the amygdala senses safety, it allows the conductor (PMC) and gatekeeper (Onuf’s nucleus) to do their jobs without interference. The bladder fills, the pelvic floor responds, and release happens calmly and rhythmically.
This is why practices that soothe the nervous system ,deep breath, Hypopressives, TRE®, somatic release, and posture that communicates safety to the body ,are so effective for bladder health. They quiet the alarm bell, so the bladder doesn’t keep sending false alarms.
This means the bladder is wired into our emotional landscape. Safety, or the lack of it, is felt right here.
(👉 See the very bottom of this blog for more info on : Fear, Safety, and the Bladder & Bowel)
When Things Go Wrong
Bladder pathologies are common, and yet rarely spoken of. Some of the most frequent include:
Overactive bladder/urgency – constant signals to go, often tied to nervous system sensitivity.
Stress incontinence – leaks with coughs, laughs, or jumps, usually linked to pressure mismanagement.
Interstitial cystitis/painful bladder syndrome – a mix of inflammation and nervous system overdrive.
Prolapse-related dysfunction – when neighbouring organs change the bladder’s position.
Post-surgical adhesions – scar tissue that tethers the bladder, reducing glide.
These aren’t just physical problems. They’re also emotional ones, stirring shame, worry, and fear.
Creating Harmony with Breath and Movement
Here’s the good news: while we can’t change the fact we all have a bladder, we can change how it behaves by shifting the environment around it.
Breath
When the ribcage expands 360°, pressure is balanced. The bladder is no longer forced downward with every inhale. Instead, it is supported from all sides.Posture
A collapsed chest or tucked pelvis restricts bladder mobility. Aligning the ribcage over the pelvis restores space for it to move naturally.Hypopressives
Through apnoea and rib expansion, Hypopressives reduce intra-abdominal pressure, train the pelvic floor to respond reflexively, and create lift — easing strain on the bladder.TRE® (Tension & Trauma Releasing Exercises)
Tremoring calms the amygdala, softens nervous system alarms, and unwinds fascia. Many people find urgency reduces simply because their body feels safe enough to wait.Somatic awareness
Learning to sense the true fullness of the bladder — rather than reacting to every anxious signal — is deeply empowering. It turns the bladder from a noisy alarm into a trusted companion.
Extra info…
Fear, Safety, and the Bladder & Bowel
The bladder and bowel aren’t just plumbing, they’re tightly wired into our nervous system. How and when we release depends less on volume and more on whether the body feels safe.
Acute fear (life-or-death threat)
In moments of extreme danger, the amygdala and brainstem send a surge of sympathetic signals. One survival reflex is to let go, urine (and sometimes stool) may be released. Think of animals startled into urination. The body is literally lightening its load to prepare for escape or combat.Chronic anxiety (the “always on” modern state)
Most of us don’t face tigers , we face deadlines, arguments, and constant low-level stress. Here, the bladder doesn’t usually empty uncontrollably. Instead, it becomes irritable, sending premature “I need to go” signals. For some, the bowel tightens into constipation; for others, it tips toward urgency and IBS-like flares.Safety and rest (ventral vagal state)
When the nervous system feels safe, parasympathetic pathways allow the bladder and bowel to empty in a coordinated way. This is why relaxation, breath practices, Hypopressives, and TRE® can be so powerful , they shift the body back into a state where these organs can do their job without alarm.
➡️ In other words:
Terror can make you release.
Chronic stress can make you feel you need to go all the time.
Safety allows healthy, rhythmic emptying.
Closing Thought
The bladder is not just a bubble of urine waiting to be emptied. It is a responsive, emotional organ in constant conversation with your breath, your posture, your pelvic floor, your nervous system, and your sense of safety.
When we learn to listen, release, and move with it, the bladder shifts from being a source of fear and frustration to a part of us that can live in harmony.
Ready to bring your bladder back into balance?
If urgency, leaks, or discomfort are holding you back, know this: your bladder isn’t unfixable, it just needs the right support. Through breath, posture, Hypopressives, and TRE®, you can retrain the whole system to work in harmony again.
👉 Start today with my Beginner’s Programme (£29.95) this is a short, gentle introduction to release work, breath foundations, and the first Hypopressive poses. It’s the perfect step toward reclaiming comfort and confidence.
