Why Physical Therapy Can Help With Bladder Leakage

How Physical Therapy Can Help With Bladder Leakage

Do you suffer from an overactive bladder or bladder leakage?

We describe an overactive bladder (OAB) as a more frequent than “average” urge to urinate throughout the day. People who suffer from this condition tend to wake up and visit the bathroom 3-4 times per night. Sometimes more. And, unfortunately, it can also lead to urinary or urge incontinence – a loss of bladder control and bladder leakage. 

The symptoms of an overactive bladder and associated urinary incontinence and bladder leakage usually manifest due to a miscommunication between your brain and bladder – the signals (messages) your brain is sending to your bladder.

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But we know that an overactive bladder and bladder leakage is not only a cause for discomfort, but it can also be painful and affect your quality of life.

However, do not despair. Specialized physical therapy and pelvic floor therapy effectively treat overactive bladder, urinary incontinence, and bladder leakage. 

What Is Urinary Incontinence?

We term any unintended urinary leakage (bladder leakage) as urinary incontinence. If you suffer from urinary incontinence, you may also have issues with starting and stopping your urine flow. But what causes it?

The all-important muscles of the pelvic floor that connect to the pelvic bones are responsible for incontinence. They stretch from the front of your body to the back and work like a hammock to support the pelvic organs inside your torso. These muscles are also responsible for: 

  • Providing support to your lower back 
  • Playing a vital role in sexual functioning 
  • Offering stability to the pelvic region 
  • Allowing you to control the sphincter muscles

Due to our physical differences and the stress and strains of childbirth and labor, women are more susceptible to urinary incontinence and bladder leakage. However, many men do also exhibit the symptoms for slightly different reasons.

To quantify this – as much as 80% of the 25 million Americans that suffer from urinary incontinence and bladder leakage are women. But that’s still 5 million men who suffer from this condition too, so if you’re a man who suffers, you’re certainly not alone either. 

The Different Kinds Of Urinary Incontinence

There are various kinds of urinary incontinence, including:

Stress Incontinence: The urethra (the tube where urine exits the body) is surrounded by the urogenital diaphragm and the pelvic floor muscles. These muscles help keep the urethra closed when there is pressure on the bladder. If the muscles are weak, they cannot close the urethra, which leads to stress incontinence. Any sudden movement or activity that causes stress on the bladder can cause leakage. Some of the causes of stress incontinence include:   

    • Lifting something heavy 
    • Any exercise or physical activity like running 
    • Coughing, sneezing, or laughing
    • Leading a sedentary lifestyle with little or no exercise 
    • Any injury to the pelvic floor 
    • Rectal surgery
    • Any inflammation in the pelvic floor 

Stress incontinence in women may specifically occur due to: 

  • Pregnancy and childbirth can lead to stress on the bladder and weaken pelvic muscles 
  • Vaginal surgery 
  • Damage to the perineal muscles at the time of childbirth  
  • Episiotomy during childbirth

Functional Incontinence: In the case of urinary leakage that isn’t associated with the pelvic muscles or the bladder, we call it functional incontinence. This incontinence can occur when certain factors lead to incontinence. E.g., using any walking aid that makes movement slow may result in an individual not reaching the bathroom in time. Consequently, this delay may cause leakage of urine. Some of the most common reasons for functional incontinence include: 

    • Any obstacles that prevent convenient access to the bathroom
    • Depression or extreme anger
    • Anything that impedes mobility – like crutches or other walking aid
    • Delirium or dementia 
    • Arthritic pain or stiffness that makes walking a challenge 

Urge Incontinence: This term describes when patients feel a sudden and overwhelming urge to urinate that causes them to experience bladder leakage before they reach the bathroom. Strong and healthy pelvic floor muscles that effectively contract the urethra prevent unintended urine flow. Those with urge incontinence may have weak pelvic floor or muscles spasms.

Anxiety can also cause people to experience urge incontinence more frequently. In some people, this condition develops over time. For example, if you have a habit of urinating as soon as you get home or going to the bathroom “just in case,” it can cause urge incontinence. Other causes of urinary urge incontinence include certain acidic foods. Smoking can also cause inflammation and aggravate the bladder, leading to incontinence.

Mixed Incontinence: Some individuals suffer from both urinary urge and stress incontinence. 

Urinary Frequency: This term describes the need to visit the bathroom more frequently throughout the day and multiple times throughout the night. The increased urinary frequency could be due to an infection of the urinary tract (UTI). Some drinks and food may also cause urinary frequency. If you think you might have a UTI, the symptoms to look out for are:

  • Urgency or an increased need to urinate, or the feeling of wanting to urinate again right away. 
  • Difficulty passing urine: having to strain or a “stopping and starting” or slow urine flow. 
  • Pain after urination or feeling like you haven’t fully emptied your bladder – or repeatedly going to the bathroom just to pass a few drops of urine. 

How Physical Therapy Can Help With Bladder Leakage 

If you’re worried about bladder leakage, we recommend you book an appointment with your doctor or a physical therapist who specializes in this condition who can diagnose and treat your symptoms. To locate the cause of your symptoms, we conduct a detailed physical examination. We also ask you about your symptoms and evaluate the following:

  • Your flexibility, strength, and coordination 
  • Any pain related to the pelvic floor, lower back, hips, and pelvic muscles 

There might also be a need for additional medical tests to diagnose the cause like: 

  • MRI or ultrasound to check the condition of your pelvic floor 
  • A urodynamic test to determine the functioning of your bladder

Once we pinpoint the root cause of your bladder leakage, we move on to treatment. The treatments we use to help improve your bladder function include:

    • Helping you to locate and “activate” your pelvic floor muscles 
  • A tailormade therapeutic exercise regimen based on your root cause – with the primary objective being to strengthen your pelvic floor muscles and improve your bladder control. 

Your treatment plan for bladder leakage might also include:

Improving muscle strength: Arguably the most critical aspect of physical therapy for bladder leakage; Building your natural muscle strength can dramatically improve your bladder control. We do this using a combination of movements and exercises that will enhance the flexibility and strength of pelvic floor muscles. 

Biofeedback: This part of your treatment is specific to your symptoms. But in general terms, it involves placing sensors to measure and examine the activity in your pelvic floor muscles. For example, when you squeeze your pelvic floor muscles, a reading will display on the computer screen that tells us whether you’re activating the right muscles. This treatment helps you become more aware of your pelvic floor muscles and strengthens the connections between your brain, bladder, and pelvic floor muscles. 

Pelvic floor movements: These specific movements – to strengthen the pelvic floor muscles are sometimes called Kegel exercises. We teach you how to do them correctly and get the most benefit from them. They involve contracting your pelvic floor muscles (the muscles you use when urinating to stop the flow). During the exercises, we first advise you to tighten and “activate” the pelvic floor muscles, hold for a couple of seconds, and then release. 

Electrical stimulation: Sometimes, we may use gentle electrical stimulation to make you more aware of your pelvic floor muscles. 

Ultrasound: Lastly, we may also use ultrasound equipment to examine your abdominal wall and pelvic floor muscles coordination. This part of the treatment also helps to make you more aware of your abdominal and pelvic muscles and functioning.

Are you ready to take action?

Stop The Embarrassing Symptoms Of Bladder Leakage

Founded by Dr. Dawn Andalon and Dr. Oscar Andalon, LEVEL4 PT & Pilates helps people just like you in Encinitas heal their bodies and enjoy life again – without medications or surgery.

We invite you to book a free consultation with a women’s health specialist now. Find out how we help you say goodbye to bladder weakness. Cure urinary incontinence, painful sex, and the uncomfortable and embarrassing symptoms associated with weak pelvic floor muscles.

Stop stockpiling incontinence pads and running to the bathroom every five minutes. Let us help you instead.

Finally, don’t feel embarrassed about reaching out for help. Bladder problems do not make you a freak of nature, or any less human. We know that postpartum issues can also play a part in bladder leakage, and you can find out more about our women’s health services on this page.

Together, we will get you back to health. It’s time to talk about you and get life back in shape!


Dawn Andalon, DPT, MTC, CPI

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