Women's pelvic health · Northern California
Physical therapy for overactive bladder in Northern California
Running to the bathroom ten times a day, waking twice a night, and the sudden urge that comes out of nowhere are the signs of an overactive bladder. Bladder retraining and pelvic floor therapy are the first-line treatment, before medication.
- Private pay with superbills for out-of-network reimbursement
- No referral needed for the first 45 days or 12 visits
- Video visits anywhere in Northern California
About the condition
Overactive bladder, urgency and frequency: what is going on.
An overactive bladder sends urgency signals before it is actually full. Over time the bladder is trained to hold less, the pelvic floor tightens in a constant effort to hold on, and the cycle feeds itself. Many people also have urge incontinence, leaking before they reach the toilet. The condition is common in women and men and becomes more common with age, but it is not something that has to be accepted.
Behavioral treatment, meaning bladder retraining, urge suppression techniques, pelvic floor coordination, and fluid and dietary adjustments, is recommended as first-line care in urology guidelines, ahead of medication.
Common experiences
What people with overactive bladder, urgency and frequency often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
Sudden, strong urges to urinate
Going more than eight times a day
Waking more than once a night to urinate
Leaking before reaching the bathroom
Urgency triggered by arriving home, running water, or cold
Knowing where every bathroom is
Treatment
How physical therapy addresses it.
The program teaches techniques that calm an urge in the moment, a schedule that gradually lengthens the time between voids, pelvic floor training aimed at the right balance of relaxation and control, and the fluid and dietary changes that make the most difference. A bladder diary tracks progress.
What a video visit looks like
Everything in bladder retraining is education and practice, which is why it works so well by video. Dr. Shalem reviews the diary each visit and adjusts the schedule and techniques.
Coverage in California
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
Private pay
Visits in California are private pay. We provide a superbill you can submit to your insurer for out-of-network reimbursement. HSA and FSA cards accepted. Rates are quoted on the free discovery call.
Referrals
California allows you to start physical therapy without a referral for up to 45 days or 12 visits. If care continues beyond that, we help you get a signed plan of care from your physician.
The Bay Area, Sacramento, the Central Valley, the North Coast, the Sierra foothills, and the far north are seen by video, including military families at Travis AFB and Beale AFB.
Questions
Questions people ask about overactive bladder, urgency and frequency
How it works
How a virtual visit works
Everything in bladder retraining is education and practice, which is why it works so well by video. Dr. Shalem reviews the diary each visit and adjusts the schedule and techniques.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Overactive bladder, urgency and frequency questions in Northern California
Do I need to stop drinking coffee?
Not necessarily. Caffeine, carbonation, alcohol, and artificial sweeteners irritate some bladders. The diary shows which ones matter for a given person, and the change is targeted rather than total.
Can this replace bladder medication?
For many people behavioral treatment reduces or removes the need for medication. That decision belongs with the patient and their physician, and we coordinate.
Does it help men too?
Yes. The same program is used for male urgency and frequency.
Do I need a referral for physical therapy in California?
California allows you to start physical therapy without a referral for up to 45 days or 12 visits. If care continues beyond that, we help you get a signed plan of care from your physician.
What insurance do you take in California?
Private pay: Visits in California are private pay. We provide a superbill you can submit to your insurer for out-of-network reimbursement. HSA and FSA cards accepted. Rates are quoted on the free discovery call.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in California.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.