Leaking urine when you cough, sneeze, laugh, jump or lift is called stress urinary incontinence. It happens when the pelvic floor and the structures around the bladder cannot hold against a sudden rise in pressure. It is common, especially after pregnancy, and it is treatable: supervised pelvic floor muscle training is recommended as a first-line treatment, and a pelvic floor physiotherapist can tailor it to you.
Key Takeaways
- Stress urinary incontinence is leaking with effort or pressure: coughing, sneezing, laughing, running, jumping or lifting.
- It is common after pregnancy and birth, but it is not something you have to accept as normal.
- In a Cochrane review, women with stress incontinence who did pelvic floor muscle training were eight times more likely to report being cured than those who did not (56% versus 6%).
- Many people do pelvic floor exercises incorrectly without realising it. An assessment checks that the right muscles are working and sets the right dose.
- Pelvic floor physiotherapy is private, one-to-one care. You do not need to have given birth to benefit.
In This Article
Leaking a little urine when you cough, sneeze, laugh, run or jump is called stress urinary incontinence. It is common, particularly after pregnancy, and pelvic floor physiotherapy is one of the most effective ways to treat it.
It is also one of the most under-reported problems we hear about. People put up with it for years, plan their exercise around it, or stop running altogether, often because they assume it is just part of having had children. It does not have to be.
What Stress Incontinence Actually Is
"Stress" here has nothing to do with feeling stressed. It means physical pressure.
Every time you cough, laugh, jump or lift, pressure inside your abdomen rises for a moment. Normally your pelvic floor muscles and the tissues supporting your bladder and urethra respond fast enough to hold against it. When they do not, a small amount of urine leaks out.
That is different from urge incontinence, where a sudden, strong need to go comes first and you cannot get to the bathroom in time. Some people have both, which is called mixed incontinence. Telling them apart matters, because the treatment plan is not the same.
Why It Happens
Common contributors include:
- Pregnancy and vaginal birth, which stretch and sometimes injure the pelvic floor
- Heavy or high-impact training without the pelvic floor strength to match it
- Chronic coughing, constipation and straining
- Changes around menopause
- Surgery in the pelvic area, including prostate surgery in men
Our complete guide to pelvic floor physiotherapy covers the wider range of pelvic floor problems. This post focuses on leaking with effort, because it is the one people most often assume they have to live with.
What the Evidence Says
Pelvic floor muscle training is the most studied treatment for stress incontinence. A 2018 Cochrane review, which pooled the randomised trials, found that women with stress urinary incontinence who did pelvic floor muscle training were eight times more likely to report being cured than women who had no treatment (56% versus 6%), and six times more likely to report being cured or improved (74% versus 11%). The reviewers concluded it could be included in first-line conservative management.
That is a strong result for a treatment with no drugs and no surgery. The catch is that it depends on doing the right exercises, correctly, for long enough.
Why "Just Do Your Kegels" Often Fails
Many people who say pelvic floor exercises did not work for them were never shown how to do them. Common problems include:
- Squeezing the glutes, inner thighs or abs instead of the pelvic floor
- Holding the breath or bearing down, which pushes the wrong way
- Only doing slow holds, and never training the quick squeeze needed for a cough or a jump
- Doing too much, too soon, and tiring the muscles out
- Stopping after a couple of weeks, before strength has had time to build
A pelvic floor physiotherapist fixes these by checking what your muscles are actually doing, then setting the right exercises and the right dose.
What Happens at a Pelvic Floor Physio Appointment
Your first visit is private and one-to-one. It usually starts with a conversation about your symptoms, bladder habits, pregnancies and births, exercise and general health. Your physiotherapist then assesses how your pelvic floor contracts, relaxes and coordinates with your breathing and core, and explains what they find.
An internal exam gives the most accurate picture, but it is always explained first and always your choice. You can say no, or stop at any point, and still get useful treatment.
From there you get a plan built for you. That usually means a specific exercise program with strength, endurance and quick-contraction work, plus practical strategies such as bracing before you cough or lift, and a gradual return to the activities you have been avoiding.
Getting Back to Running and Classes
Leaking is one of the most common reasons people stop running, skipping, or doing high-impact classes. Going back without rebuilding the pelvic floor first often means the leaking returns.
If you are postpartum, our GROWCO postnatal rehab program is built for exactly this stage. It is a small-group program for moms from about six weeks to 12 months postpartum that rebuilds core and pelvic floor strength before you progress to higher-impact training. Every participant starts with an initial assessment, and where leaking is part of the picture, one-to-one pelvic floor physiotherapy can run alongside the classes. If you have also noticed a gap or doming along the middle of your abdomen, our post on diastasis recti is worth reading too.
When to See Your Doctor First
Some bladder symptoms need medical assessment before physiotherapy. Book with your doctor if you notice blood in your urine, pain or burning when you pass urine, a sudden change in your bladder habits, or leaking with no clear trigger.
Pelvic Floor Physiotherapy in Keswick
Pelvic floor physiotherapy at Anchor Health & Fitness treats incontinence, prolapse, pelvic pain and postpartum recovery in a private, discreet setting on The Queensway South in Keswick. We see clients from across Georgina, Sutton, Jackson's Point and Pefferlaw. You do not need a referral to book, and you do not need to have had a baby to benefit.
Leaking is common. It is also treatable. Book an assessment or get in touch if you would like to ask a question first.
References
Ready When You Are
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