Have you ever felt a pang of worry or embarrassment from a sudden leak during a laugh, a sneeze, or while working out? Maybe you’ve even planned your walking or running route based on where the bathrooms are or intentionally chosen your outfit to conceal leaks or bulky incontinence underwear.
If this sounds familiar, you’re not alone—and the good news is, there’s a better solution than planning bathroom stops for every outing or relying on pricey incontinence products. Pelvic floor physio can address the root causes of incontinence, helping you ditch the incontinence underwear and regain your confidence.
Incontinence Underwear vs. Pelvic Floor Physiotherapy
Many people experience incontinence but hesitate to seek help, often assuming it’s an inevitable part of aging, having kids, or just life in general. This belief often leads them to rely on incontinence underwear, or other products, as a quick fix—masking the symptoms without addressing the underlying issues.
While products like incontinence underwear may hide leaks and can be a helpful temporary solution for busy moments or special occasions, they’re ultimately a short-term fix that doesn’t tackle the root causes of incontinence. Over time, the financial and environmental costs of these products can add up. In contrast, pelvic floor physio provides a long-term, sustainable solution, empowering you to reduce or even eliminate your reliance on incontinence underwear and pads entirely.
Understanding Incontinence: More Than Just “Leaks”
Incontinence means any involuntary leakage of urine or stool—even just a few drops count! It can show up in different ways, but any level of leakage is still considered incontinence. While many people associate incontinence with aging or childbirth, the reality is it can affect individuals of all ages and backgrounds.
A National Institute of Health study shows that incontinence impacts nearly one-third of women and around 15% of men. Addressing these leaks early through pelvic health physio can help improve symptoms significantly, giving you tools to restore bladder control without depending on incontinence underwear.
Leslie et al. (2024) provide an overview of the various types of incontinence including:
- Stress Incontinence: involves involuntary urine leakage due to increased intra-abdominal pressure during activities like exertion, sneezing, or coughing. Young women active in sports, as well as pregnant women and those who have given birth, are often affected. In men, stress incontinence can arise from complications after prostate surgery.
- Urge Incontinence: The involuntary leakage of urine is often linked to a strong urge to urinate, and it can occur at times without warning. It can also be triggered by hearing running water, consuming cold drinks, or being in cold environments (Curillo-Aguirre & Gea-Izquierdo, 2023).
- Mixed Urinary Incontinence: Mixed urinary incontinence involves involuntary urine leakage resulting from both stress and urge incontinence.
- Overflow Incontinence: When an overfilled bladder leaks because it can’t contract effectively or is blocked.
- Functional Incontinence: This occurs when urine leaks involuntarily due to environmental or physical obstacles that make it difficult to reach the toilet.
Why Does Incontinence Happen?
The causes of urinary incontinence can vary widely. Some common factors include:
- Weak Pelvic Floor Muscles: The pelvic floor muscles provide essential support for the bladder, uterus, bowels, and intestines. When they are not functioning optimally or have the strength needed to provide sufficient structural support, leaking can occur. Childbirth, hormonal changes, aging, surgery, or even core weakness can contribute to increasing the risk of leakage.
- Chronic Constipation: Chronic constipation is linked to urinary leakage. When you are constipated, the backup of the bowels and into your intestines increases the pressure on the pelvic floor muscle and bladder. It can also slow down muscle and nerve function, which can impact bowel movements. Increased pressure, combined with slower smooth muscle function and nerve function can increase your risk of experiencing incontinence. Managing chronic constipation is an important factor in the treatment of urinary incontinence (Nurko & Scott, 2011).
- Hormonal Changes: Hormonal changes can impact urinary incontinence. Changes in hormone levels are directly linked to muscle elasticity, stability, and support. For example, estrogen decreases during (peri)menopause which affects muscle elasticity and pelvic support, increasing the likelihood of incontinence in postmenopausal individuals (Kołodyńska et. al, 2019). Postpartum individuals experience a similar hormonal shift after birth while lactating individuals also experience increased pelvic laxity as a result of varied levels of estrogen and progesterone.
- Nerve Damage: Injuries to the pelvic area, surgeries, or even conditions like diabetes that affect nerve health can contribute to incontinence (Cunningham et al., 2017).
- Lifestyle Factors: High-impact activities, frequent heavy lifting, childbirth, and excess body weight may increase the risk of incontinence by placing excess pressure on the pelvic floor (Curillo-Aguirre & Gea-Izquierdo, 2023).
Identifying the cause of your incontinence is the first step in creating an effective treatment plan. This is where pelvic health physio comes in—it’s not just about managing leaks but uncovering and addressing their root causes.
Pelvic Floor Physio: A Proven Approach to Incontinence
Pelvic health physiotherapy, also known as pelvic floor physiotherapy, is a specialized branch of physiotherapy that focuses on assessing and treating dysfunctions of the pelvic floor muscles. Research shows that pelvic floor muscle training, guided by a pelvic health physiotherapist, can reduce incontinence symptoms by up to 80% (Kołodyńska et. al, 2019).
What Happens During a Pelvic Floor Physiotherapy Incontinence Assessment?
The assessment begins with a subjective component, where your pelvic health physiotherapist will take the time to understand your symptoms, health history, and goals. This is followed by an objective component, which involves a physical exam. Here’s a closer look at what to expect:
- Functional Assessment: Your physiotherapist will begin by observing how you walk and move your body, looking at things like gait, step length, squatting, lunging, or sitting and standing from a chair. Any movements where you’re experiencing incontinence will also be carefully assessed to understand how your pelvic floor is functioning during those activities.
- Assessment of Pelvic Floor Muscles: Your physiotherapist will assess the strength, coordination, and flexibility of your pelvic floor muscles. This typically involves an internal examination to check for tension, weakness, or asymmetry in the muscles. IIf an internal exam isn’t right for you, don’t worry. An external exam can still provide helpful insights. We can also use Real-Time Ultrasound to see your pelvic floor and bladder in action. Assessments are done in various positions—lying down, sitting, or moving. This helps us understand how your pelvic floor works during the movements or positions where you experience leakage.
- Personalized Treatment Plan: Based on your assessment, your physiotherapist will prescribe exercise(s) specifically for your needs. These exercises may target pelvic floor strength, core stability, and relaxation techniques to help improve bladder control.
- Bladder Retraining: If urge incontinence is a concern, bladder retraining may be part of your program. This often includes cognitive behavioral strategies and habit modifications to gradually increase the time between bathroom visits, reducing the frequency of urgency signals from the bladder (Leron et al., 2018). We may also incorporate tools like a bladder diary to track patterns and triggers, as well as customized voiding schedules to help re-establish healthy bladder habits.
- Education and Lifestyle Tips: Pelvic health physiotherapists provide valuable insight into lifestyle habits that can affect incontinence, such as dietary triggers, hydration practices, and constipation management.
Through pelvic flor physiotherapy, you’ll gain a deeper understanding of your pelvic health and the tools to achieve long-term relief from leaks—no more relying on incontinence underwear as a band-aid solution.
Practical Tips for Managing Incontinence at Home
While pelvic health physiotherapy is a cornerstone of treatment, you can also adopt several lifestyle changes to also help manage symptoms:
- Manage Fluid Intake: Staying hydrated is essential for overall bladder health and function. You should be drinking half your body weight in ounces of water per day, and remember to take frequent sips regularly as opposed to drinking an entire glass quickly. If you drink your water too quickly, you risk overloading your bladder and not absorbing the fluid. Also, it’s recommended that you avoid excessive caffeine and alcohol, which can irritate the bladder.
- Keep a Bladder Diary: According to Leron et al. (2018), using a bladder diary to track your daily bladder habits and urination patterns is one of the simplest yet most essential tools to provide insights into your bladder health and can be useful in examining why you leak. A bladder diary is an excellent tool for tracking the frequency, volume, and patterns of urination, as well as the number of leakage episodes. Keeping a record for just three to four days can offer a reliable snapshot of your bladder health, revealing valuable insights into patterns and behaviors linked to incontinence.
- Limit Constipation Triggers: As mentioned, chronic constipation can add excess pressure onto the pelvic floor. Incorporate fiber-rich foods, such as fruits, vegetables, and whole grains, into your diet to support regular bowel movements.
- Practice Good Bathroom Habits: When using public bathrooms, sit down to use the toilet. This allows for a relaxed and complete emptying. Do not “hover” when using public restrooms, as this can cause the pelvic muscles to tense. If you are worried about cleanliness, keep a package of Lysol wipes in your bag to give the toilet seat a quick wipe before you sit down.
- Seek Support: Living with incontinence can be emotionally challenging (Curillo-Aguirre & Gea-Izquierdo, 2023). Engaging in open conversations with loved ones about your experiences or a registered clinical counsellor can be incredibly beneficial and emotionally healing. You could also consider joining a support group as well, where you can find encouragement and exchange valuable tips with others who understand your experiences. This sense of community can foster connection and provide you with the support you need on your journey.
Why Not Incontinence Underwear?!
While incontinence underwear may provide short-term convenience by managing leaks, it doesn’t tackle the underlying causes of incontinence. Instead, it often becomes a crutch, focusing on symptom management rather than offering a pathway to resolution. In contrast, the tools we recommend actively support your pelvic health efforts, so you can move toward lasting relief—not just symptom management.
Uresta Vaginal Device
One highly effective option is the Uresta, a vaginal device designed to help with stress urinary incontinence. Made from hypoallergenic medical-grade resin, it’s both safe and comfortable to use. By gently pressing against the vaginal wall, the Uresta helps close off the urethra, preventing leaks during activities like exercise, sneezing, or laughing.
Kegel Weights
Vaginal weights, often called Kegel weights, are another fantastic tool for strengthening pelvic floor muscles. These weights encourage better connection and engagement during pelvic floor exercises, targeting both incontinence and overall pelvic muscle function. Curious to learn more? Check out our blog post all about Kegel weights and their benefits here.
Explore Our Favourite Kegel Weight Set
These tools aren’t just about symptom management—they’re practical, empowering aids that work alongside your physiotherapy to address the root causes of incontinence. By focusing on active solutions rather than quick fixes like incontinence underwear, you’re investing in long-term strength, confidence, and freedom.
Take Charge of Your Bladder Health
Pelvic floor physio isn’t just about stopping leaks; it’s about restoring your confidence and improving your quality of life. By addressing the root causes of incontinence, pelvic health physiotherapy empowers you to ditch incontinence underwear for good and enjoy the freedom of leak-free living.
Are you ready to take the first step toward lasting relief? Contact us today to learn more about how pelvic health physiotherapy can help you regain control and confidence.
~the Bump team
Bump Physio & Co. is a community of healthcare providers committed to transforming the approach to pelvic health and other ‘socially taboo’ conditions. With clinics in New Westminster, Port Moody, and Langley, BC, we offer services including pelvic health, physiotherapy, RMT, kinesiology, and clinical counselling. Our team is trained in Pelvic Health, Orthopedics, Obstetrics, Clinical Pilates, and Active Rehabilitation, providing personalized care to support you through all stages of life.
Resources
The Canadian Continence Foundation
International Incontinence Society
National Association for Continence
References
Curillo-Aguirre, C. A., & Gea-Izquierdo, E. (2023). Effectiveness of Pelvic Floor Muscle Training on Quality of Life in Women with Urinary Incontinence: A Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania), 59(6), 1004. https://doi.org/10.3390/medicina59061004
Dumoulin, C., Cacciari, L. P., & Hay-Smith, E. J. C. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews.
Kołodyńska, G., Zalewski, M., & Rożek-Piechura, K. (2019). Urinary incontinence in postmenopausal women – causes, symptoms, treatment. Przeglad menopauzalny = Menopause review, 18(1), 46–50. https://doi.org/10.5114/pm.2019.84157
Leron, E., Weintraub, A. Y., Mastrolia, S. A., & Schwarzman, P. (2018). Overactive Bladder Syndrome: Evaluation and Management. Current urology, 11(3), 117–125. https://doi.org/10.1159/000447205
Leslie SW, Tran LN, Puckett Y. Urinary Incontinence. [Updated 2024 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559095/
Milsom, I., Altman, D., Lapitan, M. C., Nelson, R., Sillen, U., & Thom, D. (2021). Epidemiology of urinary (UI) and faecal (FI) incontinence and pelvic organ prolapse (POP). International Urogynecology Journal, 32, 243-261.
Nurko, S., & Scott, S. M. (2011). Coexistence of constipation and incontinence in children and adults. Best practice & research. Clinical gastroenterology, 25(1), 29–41. https://doi.org/10.1016/j.bpg.2010.12.002
NIH. (2019). Urinary incontinence in adults: Clinical practice guideline, part 1.