Urinary Incontinence and Pelvic Pain

Therapy & exercise provides muscle strength

Contributed by Stacey Clarke, DPT

restroom signIt seems some women are resigned to losing the ability to control their bladder or living with pelvic floor disorders and pain. But, even though an estimated 20 million men and women will develop incontinence, it is not a normal part of aging. In fact, many of the questions women ask us are based on false information – what they’ve found online, seen on TV or heard from a friend. So we’ve decided to help set the record straight.

Urinary incontinence happens to every one.


The condition is common, but that doesn’t mean that it will happen to you. By definition, incontinence is involuntary loss of bladder or bowel control, or the inability to predict when and where urination and/or bowel movements will occur. It can be an emotional and stressful condition. Many women are hesitant to leave their homes, and feel too embarrassed to talk to their doctors about their experience.

I’ve had a baby, so I will wind up experiencing incontinence.

False – kind of.

Childbirth and pregnancy can increase your risk for developing problems with incontinence, but they do not necessarily mean you will experience it.

There are two types of incontinence and different risk factors for developing each. Stress incontinence is accidental leakage of urine when you sneeze, cough, lift a heavy object or do vigorous physical activity. Urge incontinence  refers to the sudden, strong urge to empty the bladder, and the inability to reach the bathroom before leakage occurs. Mixed incontinence includes symptoms of both.

The primary cause of incontinence is weak pelvic floor muscles. That weakness could be the result of damage to the muscles from childbirth, trauma, surgery or issues with aging. Risk of pelvic floor dysfunction increases for women who have had greater than 2 babies, large babies (over 8 lbs), a prolonged pushing phase of labor, significant vaginal tearing, or use of instrumentation with delivery (i.e. forceps, suction, episiotomy).  If you are experiencing “a little leakage” after having a baby, it is a good idea to address these issues early by talking with your gynecologist or seeing a pelvic health physical therapist to avoid severe leakage or prolapse of the pelvic organs later, which could require surgery to correct.  Pelvic physical therapy can be started as early as 6 weeks after delivering your baby (or 8 weeks if you have a C-section).

There’s nothing I can do to help improve my incontinence.


This myth is our favorite to dispel. There are many treatment options to help improve incontinence and pelvic pain – from kegel exercises, to diet changes, relaxation techniques and much more. And utilizing in-tone therapy, an approach that emphasizes a self-help program of exercise, patient education and muscle stimulation, that can strengthen the muscles that support the pelvic organs and relieve muscle tension and pain.

My best piece of advice to women experiencing these issues: Remember that you’re not alone. It happens to many women and it is a medical condition that can be improved with the proper treatment plan. Knowing your symptoms, medical history and concerns is the best way we can develop a plan that will work for you.

I have tried doing Kegels on my own but I still feel my pelvic floor muscles are weak and my urine leakage is not improving.  Is there any help for me?  


Studies show that 40% of women are unable to properly contract their pelvic floor muscles correctly when they try to do a Kegel. In addition to teaching you how to properly do a Kegel, how long to hold it and instructing you on how many you need to do to increase your strength, your pelvic health physical therapist will do a thorough assessment of your core muscle strength, posture, breathing pattern, and your body mechanics with daily activities such as getting up from sitting, lifting or carrying, and coughing or sneezing.  Correcting dysfunction in each of these areas will allow you to live your life worry and leakage-free!

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