Incontinence and physical therapy can help people regain bladder control and improve their quality of life without surgery or medication. In this article, you’ll learn how pelvic floor exercises, treatment techniques, and the right incontinence supplies work together to manage symptoms and support everyday comfort.
In this article, you’ll learn:
- What urinary incontinence is and the most common types, including stress, urge, mixed, and functional incontinence
- The most frequent symptoms of bladder control problems, and when to talk to a doctor
- Why pelvic floor physical therapy is one of the most effective, non-invasive treatments for incontinence
- How physical therapy improves pelvic floor strength, coordination, and bladder control
- What to expect during a pelvic floor physical therapy evaluation and treatment plan
- Common physical therapy techniques used to treat urinary incontinence
- The best pelvic floor exercises for improving bladder control at home
- When to consider seeing a physical therapist for urinary incontinence
- How to find a qualified pelvic floor physical therapist near you
- How incontinence products can support comfort and confidence during treatment
What Is Urinary Incontinence?
Urinary incontinence is the involuntary leaking of urine, and it happens when the bladder and pelvic floor muscles aren’t working together as they should. While many people feel embarrassed talking about it, it’s actually very common, affecting between 13 and 33 million adults in the United States, especially women after childbirth, men after prostate treatment, and adults as they age. The most common types of incontinence include:
- Stress Incontinence: This occurs when physical movement or pressure on the bladder, such as coughing, sneezing, laughing, lifting, running, or jumping, causes the leakage of urine.
- Urge Incontinence: This causes a sudden, intense urge to urinate, sometimes so strong that you can’t make it to the bathroom in time.
- Mixed Urinary Incontinence: A combination of both stress incontinence and urge incontinence.
- Functional Incontinence: Leaks happen because of mobility or cognitive issues rather than bladder problems. For example, not reaching the bathroom in time due to limited mobility.
Although symptoms are usually specific to the type of bladder control problem present, some of the most notable issues include:
- Leaking urine when you cough, sneeze, laugh, or exercise
- Sudden, uncontrollable urges to urinate
- Frequent urination (more than 8 times in 24 hours)
- Waking up multiple times at night to urinate (nocturia)
- Feeling like the bladder never fully empties
- Planning life around bathroom access
If you experience any of the symptoms above or notice any other changes in your bathroom habits, it's important to talk to your doctor about incontinence. In many situations, pelvic physical therapy can help, so the sooner you seek help, the faster you can find a treatment that works for you.
Why Physical Therapy Is a Great Treatment for Incontinence
Physical therapy, specifically pelvic floor muscle training, is considered one of the most effective, non-invasive treatments for urinary incontinence. Instead of masking symptoms, it addresses the root cause: weakened, tight, or uncoordinated pelvic floor muscles that support the bladder and help control urine flow. Some of the benefits of physical therapy treatment options include the following:
- Physical therapy strengthens the pelvic floor muscles that control bladder support. Physical therapists help you with exercises targeted to pelvic health and teach proper engagement so the pelvic floor can react when you cough, laugh, lift, or move.
- PT improves muscle coordination, not just strength. Many people do Kegel exercises incorrectly or accidentally focus on supporting muscles. A physical therapist may use tools like biofeedback to help you activate the right muscles that control your bladder and bowel.
- Physical therapists design treatment programs for different types of urinary incontinence. In addition to improving your pelvic floor strength, techniques like bladder retraining, urge-suppression strategies, and relaxation breathing work together to calm the bladder. This helps you delay urges and reduce sudden, overwhelming trips to the bathroom.
- It’s a non-surgical, drug-free option with fewer risks. Physical therapy avoids medication side effects and the recovery time associated with surgical treatments.
- Physiotherapy delivers long-lasting, sustainable results. Instead of masking symptoms, PT teaches skills and habits that carry over into daily life. Consistent practice helps maintain pelvic floor strength and improves bladder control over time.
Since your regimen is personalized to your needs, physical therapy can help improve your symptoms and quality of life both now and in the future.
What to Expect During Pelvic Floor Physical Therapy
Your first session focuses on understanding your symptoms, daily habits, and medical history. After that, the therapist evaluates the systems that work together with the pelvic floor to identify what’s contributing to urinary incontinence.
Depending on your comfort and needs, your therapist may perform an external or internal exam to assess pelvic floor strength and muscle tone. This helps determine whether the muscles are weak, overly tight, or not activating correctly. Your physical therapist will also look at your posture, breathing patterns, hip mobility, and core strength. These areas play a significant role in how your pelvic floor functions during everyday movement.
Treatment Techniques Used in Physiotherapy for UI
Once the evaluation is complete, your physical therapist can start to design treatment programs to improve your symptoms. Some of the most common treatment techniques that can be used include:
- Pelvic floor exercises
- Muscle relaxation and coordination drills
- Core strengthening exercises
- Hip and pelvic mobility exercises
- Functional movement training (e.g., lifting, bending, coughing techniques)
- Posture and alignment correction
- Biofeedback for muscle awareness
- Electrical stimulation to identify the correct muscles
- Real-time ultrasound to see contractions of the pelvic floor and ensure proper coordination
- Manual therapy for muscle tension or trigger points
- Bladder retraining and urge-suppression strategies
Best Pelvic Floor Exercises for Incontinence
Strengthening and properly coordinating your pelvic floor muscles is key to managing urinary incontinence. If you want to try some of these exercises at home, consider the following:
1. Kegel Exercises
Kegels are the foundation of pelvic floor training. When doing them, try to focus on engaging only your pelvic floor, not your glutes or abdomen. This can take practice, so keep trying and seek help if necessary.
- Tighten the muscles you would use to stop urine flow.
- Hold for five to 10 seconds, then relax for the same amount of time.
- Repeat 10 to 15 times per session, two to three times daily.
2. Quick Flicks (Fast Contractions)
Quick flicks improve muscle responsiveness and help with sudden urges. They're a form of Kegels that can help target the fast-twitch muscles.
- Contract the pelvic floor muscles quickly for one to two seconds, then release immediately.
- Repeat 10 to 20 times, several times a day.
3. Pelvic Floor Relaxation and Breathing
Relaxation exercises help muscles that are too tight or overactive. Even if your muscles are not overly tight in the resting position, these can help you gain better control in the long run.
- Take deep breaths while gently releasing pelvic floor tension.
- Practice during daily activities like sitting, standing, or walking.
4. Bridge Pose with Pelvic Floor Engagement
This exercise strengthens the glutes, core, and pelvic floor simultaneously.
- Lie on your back with knees bent and feet flat.
- Lift your hips while gently contracting your pelvic floor.
- Hold for five seconds, then lower slowly. Repeat 10 to 15 times.
5. Core and Functional Movements
Integrating pelvic floor activation into everyday movement can also improve bladder control. So, try to practice engaging your pelvic floor while lifting objects, bending, or standing from a chair. This can give you a better understanding of how to help muscles respond automatically during real-life activities.
When to Consider Physical Therapy for Incontinence
Living with incontinence or an overactive bladder can be hard on your mental health, as symptoms may make you less likely to engage in activities you enjoy. Therefore, pelvic floor therapy with a physical therapist is often recommended as a first-line treatment for individuals who may struggle to identify and activate pelvic muscles on their own. Kegels and other pelvic floor exercises are effective and can drastically improve symptoms, so it's important to talk to your doctor if you're struggling with them.
In general, you should consider seeing a physical therapist for UI if you notice:
- Leaking urine during daily activities. Coughing, sneezing, laughing, or exercising triggers leaks that interfere with your life.
- Urgent or frequent urges to urinate. If you often feel a sudden, overwhelming need to go or find yourself rushing to the bathroom, PT can help train bladder control.
- Disruption to sleep or routines. Frequent nighttime trips to the bathroom (nocturia) or planning activities around bathroom access are signs to seek professional guidance.
- Postpartum or post-surgery issues. Childbirth, hysterectomy, or prostate surgery can weaken pelvic floor muscles, making PT especially beneficial.
- Ineffective self-management. If exercises at home or lifestyle changes aren’t helping, a physical therapist can provide a personalized evaluation and targeted treatment.
How to Find a Pelvic Floor Physical Therapist Near Me
Treating incontinence is possible, especially when you focus on strengthening weak pelvic floor muscles. The key is finding a good physical therapist to help you through the process. Luckily, it's easier than you might think to find one. You can ask your doctor, OB-GYN, or urologist for recommendations or simply search online for “pelvic floor therapist near me” or “men/women’s health physical therapist” in your city. Many clinics list their specialties, so you can confirm they have experience with urinary incontinence.
The American Physical Therapy Association (APTA) also offers a Find a PT tool where you can filter by pelvic health or women’s health specialists. Byram Healthcare is here to support your journey as you strengthen the muscles of the pelvic floor. We carry a range of reliable incontinence products to manage urine leaks as you regain bladder control. Browse our product catalog or contact us today for more information.
