Treatment for Incontinence: Surgery is NOT Your Only Option!
You don't have to "just deal with" leaking when you laugh, cough, sneeze, or exercise, or feel like you need to rush to the bathroom the minute you put your key in the door. Many women, whether they have children or not, often hear that this is just a part of life. We want to assure you that this is not true.
Pelvic therapy can help you stop leaking with activities and allow you to go about your life without needing to wear black leggings and pads all of the time.
What is incontinence, and what are the types of urinary incontinence
There are several different types of incontinence. Three of the most common types of incontinence are:
Stress Urinary Incontinence (SUI): This is leakage that occurs with physical exertion or increased abdominal pressure (e.g., coughing, sneezing, laughing, jumping).
Urge Urinary Incontinence (UUI): This is a sudden, strong urge to urinate followed by involuntary leakage (“overactive bladder”).
Mixed Urinary Incontinence (MUI): This is a combination of stress and urge incontinence symptoms.
Oftentimes, it is referred to as "leaking" or the leaking of urine.
The good news: pelvic therapy can help with both stress and urge incontinence.
Stress Incontinence Details
Oftentimes, people leak when it feels like the bladder is empty (obviously, otherwise you'd have a trigger to go!) Leaking often occurs when you cough, sneeze, laugh, move around, or exercise.
Why it happens: When there is a rise of intra-abdominal pressure or mechanical “stress” onto or near the bladder without adequate pelvic floor support, strength, or coordination, stress incontinence occurs.
When it comes to "movement", some folks will notice that they leak when they transition postures, shift from sitting to standing, or when they rise up from sitting on or reaching for objects from the floor.
Fitness-forward folks may notice dribbling or incontinence with exercises like running, jumping jacks, double-unders, kettlebell swings, burpees or heavy lifting.
Incontinence after childbirth
No amount of urinary leakage, whether a few drops or full bladder emptying, should be taken as your “new normal” after having babies.
While there is camaraderie in affirming to a friend not to worry, you deal with that pesky leakage too…
There is even more power and womanhood in challenging your best friend that they don’t need to settle for any amount of incontinence or for wearing a panty liner for the rest of their life.
There’s something they can do to resolve that – and no, it’s not just by doing Kegel exercises.
After years and years of someone dealing with urinary leakage that now has grown children, that person may wonder, “Is it too late?”
You do not have to be newly postpartum to put an end to urinary incontinence.
There is an immense difference that can be made in your symptoms even 20+ years down the road.
Incontinence in folks who have not had children
Women (and men!) can struggle with urinary incontinence even when they have never been pregnant or given birth.
There is a common misconception that leakage is normal after having children, and while damaging on its own, it also leaves those without children wondering why they have incontinence or thinking that something must be seriously wrong with them.
There is a lot of shame that can underlie urinary concerns.
While “peeing a little” with sneezing may be more talked about in the postpartum population, the 17 year old girl dealing with incontinence during her gymnastics meet may feel even more isolated.
The 35-year-old guy without any prostate issue who is experiencing incontinence with CrossFit really may not know where to turn.
How about the woman-boss business executive, chugging her coffee, rushing between meetings without any history of pregnancy or childbirth… she might experience the floodgates opening just when she locked the bathroom stall door and was hurrying to pull her pants down.
She didn't quite make it in time and is scrambling in her purse to see if she brought her extra pair of underwear – in pure disbelief that this happened yet another time. What about her?
Incontinence doesn't just affect those who are postpartum and/or pregnant. And treatment for incontinence is available for everyone.
Urge Incontinence Details
Let's talk more about the hypothetical businesswoman we spoke about who was dealing with urge incontinence and leaking on the way to the bathroom.
This is when an overwhelming sense of urgency to empty the bladder accompanies the incontinence episode, rather than a cough, sneeze, laugh, or movement.
In fact, these folks may have no problem at all with leakage during any of those things.
Urge incontinence is more often seen during seemingly innocuous times of the day as people are partaking in day-to-day activities, such as doing the dishes, getting home from the grocery store, leaving a meeting, and more. They chalk it up to having bladder control problems and "accept" it, all the while feeling incredibly isolated because they never know when it's going to happen.
While urge incontinence episodes often take people by surprise, they often are able to identify patterns in the leakage as they are working together with a pelvic floor therapist to treat urge incontinence by mitigating bladder triggers and strengthening the pelvic floor muscles.
Treatment for Incontinence
There are different reasons people may experience urinary incontinence, and it is not only related to childbirth, as we have gone over.
Understanding the presentation of leakage, such as when it occurs, how much, or any associated patterns, as well as thorough history taking combined with a pelvic floor evaluation, can help to determine the root cause of urinary symptoms and the treatment necessary.
Whether it is the 17 year old gymnast, the 35 year old active dad, or the no-time-for-exercise coffee-chugging female business executive, there is a reason they are leaking and there is something that can be done about it.
Rarely in these circumstances is surgery or more invasive medical interventions necessary.
Some people are surprised to learn that even years after symptoms start, pelvic floor therapy is the first treatment. This approach can make a big difference and help people regain their confidence.
Before we talk about treatment... What's the deal with incontinence and black leggings?
Have you ever wondered why so many women opt for black leggings at the gym?
We never wondered either until we became pelvic floor therapists.
Now, all we can see is a sea of black leggings whenever we walk into a HIIT class, barre, yoga, or our favorite studio.
Many people will shy away from lighter, colored leggings or pants for fear of possible urinary leakage during their workout.
Some people say they cannot tell if they’ve leaked or are just sweating, so they wear a darker color just to be safe.
As pelvic floor therapists, we are all about helping you feel like you do not need to live your life “just playing it safe.”
Let’s pull the cobwebs off those Lululemon leggings in the bottom of the drawer and get you feeling your best. You don't have to deal with incontinence and only wear black, we promise.
The first 3 steps you can take to start tackling your urinary incontinence
Of course, if it were as easy as 1, 2, 3, then we would not be having this conversation.
Some people find that making these corrections starts to alleviate their symptoms right away.
More individualized recommendations provided by a pelvic floor therapist, based on evaluation and treatment, will help alleviate these symptoms not only in the short term but also in the long term.
Here are three things to try right now:
Make sure you are not arching your back or flaring out your ribs and chest when you are running, jumping, or engaging in more dynamic movements. Instead, think of your rib cage as a bowl and your pelvis as another bowl. Try to keep the rim of both bowls stacked on top of one another. Keep your gaze down towards the ground a couple of feet in front of you to help with this.
Make sure you are breathing! Holding breath can sometimes cause your low abdomen to inflate with all the air being held. When you combine that with impact, such as landing a box jump, it can result in the floodgates opening as your pelvic floor does not have the strength to meet this demand.
Unclench and untuck! If you find that you are clenching your pelvic floor, abs, glutes, or anything else for that matter when you are working out… Let it go!
Depending on the type of incontinence you have, different treatment strategies and exercises will be your key.
How pelvic therapy helps with incontinence treatment
Pelvic floor physical therapy is one of the most effective, non-invasive treatments for urinary incontinence.
A pelvic health therapist helps you identify and retrain weak or overactive pelvic floor muscles that contribute to leakage, urgency, or incomplete bladder control.
Through personalized full body exercises and pelvic floor muscle exercises for relaxation and strengthening, manual therapy, and education on bladder habits, bladder diaries, and bladder training, posture, and breathing mechanics, pelvic therapy restores strength, coordination, and awareness of the pelvic floor.
While "pelvic floor muscle training" is truly what we're doing, it's not just about strengthening these muscles. It's about helping the muscles coordinate better, improve their ability to lengthen fully, and also their strength and endurance.
Whether you’re struggling with stress, urge, or mixed incontinence, pelvic therapy addresses the root cause, not just the symptoms, so you can regain confidence and improve your quality of life.
Where to get pelvic floor therapy and treatment for incontinence in the St. Pete and Tampa, FL areas
If you are located in St. Pete, Lutz, or the South Tampa area and want to get started with pelvic health therapy or treatment for incontinence, we have three clinics for your convenience.
We offer pelvic floor physical therapy and pelvic floor occupational therapy for women, and all three of our clinics are taking new patients and would love to help you.
To get started, contact us! We offer free consult calls and have an easy booking experience.