Physical Therapy for Stress Incontinence: How PT Can Help You Stop Leaking

Leaking urine when you laugh, cough, sneeze, or exercise is extremely common. If you are one of the millions of women that experience urinary leakage, or stress incontinence, you’re not alone. Unfortunately many women choose to suffer in silence, or are brushed off and told that their symptoms are “normal”. This couldn’t be further from true. 

When a woman is dealing with stress incontinence, it is a sign that her body is not doing something it should. Stress incontinence can often be managed conservatively with pelvic floor physical therapy. 

Physical therapy for stress incontinence is a highly effective, evidence-based treatment that can help you stop leaking and feel confident again—without surgery or medication.

What Is Stress Incontinence?

Stress incontinence occurs when the muscles that support your bladder and urethra (also known as the pelvic floor muscles) don’t hold against the increased pressure of coughing, sneezing, laughing, or impact exercise like running and jumping. This could be due to weakness, or tightness in the muscles of the pelvic floor muscles. When pressure builds up in your abdomen—like during a laugh, jump, or sneeze—the muscles can’t keep the urethra closed, and a small amount of urine leaks out.

Common causes of stress incontinence include:

• Pregnancy and vaginal childbirth

• Hormonal changes in perimenopause and menopause

• Chronic coughing or constipation

• High-impact exercise

• Abdominal or pelvic surgery

How Physical Therapy Helps With Stress Incontinence

A pelvic floor physical therapist is trained to assess and treat the muscles that control bladder function, and are also trained in core strength and stability. Despite the common misconception, pelvic floor physical therapy shouldn’t require a patient to just “do more Kegels”. Since stress incontinence is often due to a lack of coordination with multiple body parts, good pelvic floor physical therapy includes treatment aimed at improving strength, coordination, and control in the entire pelvic system.

It is important to not only treat the symptoms, but to treat the thing that is causing the symptoms! Sometimes, the area that is causing you to leak is far from the pelvic floor! Weakness in the core, hips, and even the feet could be putting more pressure on the pelvic floor and can lead to stress incontinence. 

Here’s what a typical program might include:

1. Functional movement assessment and retraining

The first part of a goof pelvic floor therapy assessment includes watching the patient do the task that causes symptoms. This assessment can demonstrate changes in posture, coordination, and muscle activation that could be causing the symptoms. 

2.. Pelvic Floor Muscle Training

For certain patients, it is appropriate to work on coordinating the pelvic floor muscles with breath, and movement. The pelvic floor muscles should naturally contract when someone exhales and some patients are doing this backwards. Many women are actually contracting the wrong muscles, and need help figuring out which muscles to contract, and when. You’ll also learn how to strengthen and relax muscles in sync with your breathing and daily movements.

3. Core and Hip Strengthening

Your pelvic floor doesn’t work alone—it’s part of your “core canister” along with your abs, diaphragm, and back muscles. PT includes strengthening your hips, deep core, ribs, and even feet in order to support bladder control.

4. Bladder Retraining

If you’ve gotten into habits like peeing just in case, or emptying your bladder when it isn’t full, your therapist can help you retrain your bladder to stretch and hold normal amounts of urine again.

5. Lifestyle and Behavior Coaching

Your PT can also guide you on fluid intake, posture, bowel habits, and breathing patterns that support pelvic health.

How Long Does It Take to See Results?

Most women start noticing improvement in 4–6 weeks, with significant changes after about a few months of consistent work. The best results also come from consistent attendance in physical therapy so that your therapist can progress your strength, and challenge your body as your symptoms start improving.

Why Choose Physical Therapy Instead of Surgery or Medication?

Physical therapy treats the root cause of the stress incontinence such as muscle weakness and coordination—rather than masking symptoms. It’s non-invasive, drug-free, and has lasting results when you stay consistent. Many women who thought they needed surgery discover that PT alone restores their bladder function, and overall confidence with activity.

When to Seek Help

If you leak urine during exercise, laughing, coughing, or lifting, don’t wait until it gets worse. Addressing the symptoms early can make all the difference. A skilled pelvic floor physical therapist can evaluate your specific needs and guide you through a personalized recovery plan.

Take the First Step Toward Confidence

Leaking isn’t something you have to “just live with.” With pelvic floor physical therapy for stress incontinence, you can move, laugh, and live freely again.

If you’re in Newtown, PA or Doylestown, PA, our pelvic health physical therapists at Vivid Women’s Health offer one-on-one, discreet care to help you regain bladder control and confidence—naturally.

👉 Schedule your consultation today and start your journey toward a leak-free life.