How many times have you heard OR thought to yourself “after birth that’s normal to dribble while laughing” or “it’s just part of getting old”?
Urinary incontinence (the unintentional leakage of urine) is one of the most common yet least talked about health issues in the UK. It affects millions of people, both women and men, and can have a huge impact on confidence, physical activity, and quality of life.
- 1 in 3 women experience Urinary incontinence.
- 1 in 5 men over 40 report lower urinary tract symptoms
Many people continue to live with bladder leaks in silence. The truth is, it isn’t. As pelvic health physiotherapists, we see every day how effective the right assessment, exercises, and education can be in helping people regain control and return to the activities they love.
The more we talk about pelvic health, the more we normalise it – and empower others to seek support. It’s never too late to start strengthening your pelvic floor and taking control of your bladder health.
What Is Urinary Incontinence?
Urinary incontinence simply means leaking urine when you don’t intend to. It can range from a small dribble when you cough or sneeze, to a sudden and strong urge that’s difficult to control.
The main types include:
- Stress incontinence: Leaking with physical exertion, such as coughing, sneezing, laughing, or exercise.
- Urge incontinence (overactive bladder): A sudden, intense need to urinate that’s hard to hold back. This can often be associated with triggers. For example like putting key into the front door, turning on the shower
- Mixed incontinence: A combination of stress and urge symptoms.
- Overflow incontinence: When the bladder doesn’t empty properly, and leakage occurs as it overfills.
Why Does It Happen?
The causes of urinary incontinence vary, but often involve changes in the muscles, nerves, and connective tissues that support the bladder and urethra.
In women, these changes are commonly linked to:
- Pregnancy and childbirth (which can stretch or weaken the pelvic floor)
- Menopause and hormonal changes
- High-impact exercise or heavy lifting
- Chronic coughing or constipation
- Being overweight
In men, urinary incontinence is often related to:
- Prostate surgery or enlargement
- Pelvic floor muscle weakness
- Bladder or nerve problems
- Certain medications or medical conditions
In both sexes, lifestyle factors like caffeine, alcohol, smoking, and poor hydration can aggravate symptoms.
The Role of the Pelvic Floor
The pelvic floor is a group of muscles that sit like a hammock at the base of your pelvis, supporting your bladder, bowel, and (for women) uterus. These muscles play a key role in bladder control – they tighten to help you hold urine in, and relax to allow you to pass it. When the pelvic floor is weakened, tight, or not working in coordination, it can lead to bladder leaks, urgency, or feelings of incomplete emptying.
How we can help:
- Thorough Assessment
We start with a detailed conversation about your symptoms, lifestyle, and medical history. We’ll also assess your movement and breathing. With your consent, an internal assessment may be performed to check pelvic floor muscle strength and coordination, allowing us to tailor your treatment plan. - Personalised Pelvic Floor Exercises
Pelvic floor exercises are not one-size-fits-all. Some need strengthening, others relaxation. Using biofeedback and hands-on guidance, we’ll teach you effective and safe activation or release techniques. - Bladder Training and Education
We help identify habits and triggers affecting bladder control (e.g., caffeine, “just in case” rushing). Together, we retrain your bladder and rebuild confidence in its natural rhythm. - Lifestyle and Movement Advice
Your pelvic floor is impacted by movement, breathing, lifting, and hydration. We’ll guide you on posture, safe lifting, and bowel/bladder habits to support daily pelvic health.
When to Seek Help
You don’t have to wait until symptoms become severe to see a pelvic health physiotherapist. Signs that it might be time to book an appointment include:
- Leaking urine during coughing, sneezing, or exercise
- Rushing to the toilet and not always making it in time
- Going to the toilet more than 8 times a day or waking frequently at night
- Feeling like your bladder doesn’t empty fully
- Avoiding social or physical activities due to fear of leakage
- Prior to pregnancy to help with prevention.
Early intervention often leads to the best outcomes — and many people notice improvement within just a few weeks of consistent pelvic floor training.
Written By Caitlin Irving | Pelvic Health Physiotherapist
References:
Cardozo, L, Rovner, E, Wagg, A, Wein, A, Abrams, P. (Eds) Incontinence 7th Edition (2023). ICI-ICS. International Continence Society, Bristol UK, ISBN: 978-0-9569607-4-0.
NICE LUTS guidelines (CG97); EAU 2024 Male LUTS Guidelines; Berry et al., J Urol 2020
The Urology Foundation 2024; Perry et al., Primary Health Care Res & Dev, 2022