Urinary/Bladder Leakage

The most common complaint that women have when they come to pelvic health physical therapy is urinary issues, including urinary leakage and urinary urgency. Frequently they have tried hundreds of kegels and they still can’t seem to fix the issue. The problem is, urinary issues are not always due to pelvic floor weakness, so kegels may actually be making your issues worse! We discuss several different types of urinary issues so you can get a better idea of what you may be experiencing and why, as well as how pelvic health physical therapy may be able to help.

Stress urinary incontinence:  Stress urinary incontinence is the involuntary loss of urine that can occur with laughing, sneezing, coughing, changing positions, low or high impact exercise, or other daily movements.  This is commonly due to either pelvic floor weakness where the muscles are not strong enough to hold back urine or due to over-active pelvic floor muscles that are too tight to appropriately contract and hold back urine.  This type of incontinence is commonly resolved with soft tissue work to the pelvic floor muscles (if they are over-active) and then a strengthening regime in various different positions and with different exercises to re-train the pelvic floor muscles.

Urge Urinary incontinence: Urinary Urgency or Urge Urinary Incontinence is the feeling of incomplete control over the bladder and/or involuntary loss of urine when you have a strong urge to urinate. Some may make it to the restroom in time, whereas others may have difficulty getting to the restroom without a few drops of urine or completely wetting themselves. This is commonly due to poor bladder habits, bladder irritation, pelvic floor weakness, and over-active pelvic floor muscles.  This type of incontinence is commonly resolved with a detailed review of proper bladder habits and potential bladder irritants, soft tissue work to over-active pelvic floor muscles, strengthening exercises for weak pelvic floor muscles, and proper coordination of pelvic floor muscles to ensure they are relaxing and contracting appropriately for complete control of bladder.

There can be various other contributors of urinary incontinence including bladder spasms, vaginal prolapse, interstitial cystitis, c-section scarring, and neurological disorders, so if you do not find what you are looking for in the above descriptions, please feel free to reach out to our specialty trained pelvic health physical therapists for more information.

Urinary leakage can be a very embarrassing topic to discuss, however it is a very common concern that many women have, and we are here to help get you back to your active lifestyle without incontinence!


Do I need a referral from my physician?

North Carolina is a direct access state for physical therapy services therefore a physician’s referral is not required unless you are using Medicare insurance. We do communicate with your medical providers as needed to improve your care.

What will happen at the initial consultation?

A complete physical evaluation is completed based on your concerns. Often this includes examination of your movement, core and pelvic floor muscles as indicated. Treatment and begin the same day as the initial consultation.

How many sessions will I need?

Together we will develop your treatment plan based on your needs. The exact number of visits is unique to symptoms but on average our patients benefit from 6-8 treatment visits.