Stress incontinence — the leaking of urine during activities like coughing, laughing, sneezing, or exercising — is incredibly common, but it’s not something you just have to “live with.” Many people feel embarrassed or frustrated by it, but the good news is that effective treatment exists. One of the best options? Pelvic floor physical therapy.
What Is Stress Incontinence?
Stress incontinence happens when physical pressure (“stress”) on the bladder exceeds the strength of the muscles meant to keep urine in. These muscles are part of the pelvic floor — a group of muscles, ligaments, and tissues that support the bladder, uterus, and bowel.
When the pelvic floor is weakened or not functioning properly, it can’t fully close off the bladder during sudden increases in pressure. That’s when leaks happen, whether you’re running, jumping, sneezing, or even just standing up quickly.
Common causes include:
- Pregnancy and childbirth
- Aging and hormonal changes
- Surgery (like a hysterectomy or prostate surgery)
- High-impact exercise or repetitive heavy lifting
- Chronic coughing or constipation
How Pelvic Floor Physical Therapy Helps
Pelvic floor physical therapy (PFPT) focuses on restoring strength, coordination, and function to the pelvic floor and core muscles. Here’s how it can specifically help with stress incontinence:
- Strengthening the Pelvic Floor
A PT can guide you through specific exercises (like more targeted and effective Kegels) to build strength where it’s needed most. They’ll ensure you’re doing them correctly — something most people actually get wrong without guidance.
- Improving Muscle Coordination
It’s not just about strength — it’s about timing. PFPT helps retrain the pelvic muscles to engage automatically during activities that cause leaks, like sneezing or lifting.
- Optimizing Core Stability
The pelvic floor works together with your abdominal, back, and breathing muscles. A physical therapist addresses the entire core system to provide better bladder support.
- Releasing Overactive Muscles
Sometimes muscles are too tense rather than too weak. A therapist can teach techniques to relax overactive areas so the pelvic floor can function properly.
- Educating on Lifestyle and Behavioral Changes
Simple adjustments — like better bladder habits, posture corrections, and breathing strategies — can dramatically reduce leakage. A PT will tailor advice to your lifestyle.
What to Expect in Pelvic Floor Therapy
At your first visit, your therapist will take a detailed history and may perform a gentle physical exam (with your consent) to assess muscle strength, tone, and function. From there, you’ll get a customized plan, which might include:
- Pelvic floor and core strengthening exercises
- Biofeedback training
- Bladder retraining techniques
- Scar tissue massage (if relevant)
- Posture and movement retraining
Sessions are private, respectful, and focused on empowering you to take control of your symptoms.
You Don’t Have to Live With Leaks
Stress incontinence is common, but it’s not inevitable — and it’s absolutely treatable. If you’re tired of planning your life around bathrooms or worrying about leaks during activities you love, pelvic floor physical therapy can make a huge difference.
You deserve to feel confident, strong, and supported — starting from your core.
