Urinary Incontinence: Exercises and Treatment for Women

Urinary incontinence is common but not inevitable. This comprehensive guide explains types of incontinence, provides effective exercises, and offers practical treatment strategies to regain bladder control and confidence.

Understanding urinary incontinence

What is it?

• Involuntary loss of urine
• Very common in women
• Not normal part of aging
• Treatable condition
• Don't suffer in silence
• Help available

How common?

• Affects 1 in 3 women
• More common with age
• After childbirth
• During menopause
• Often unreported
• Very treatable

Types of incontinence

Stress incontinence

Most common type

• Leaking with cough, sneeze, laugh
• Leaking with exercise
• Leaking when lifting
• Weak pelvic floor muscles
• Very responsive to exercises

Urge incontinence

Overactive bladder

• Sudden strong urge to urinate
• May not reach toilet in time
• Frequent urination
• Waking at night
• Bladder training helps

Mixed incontinence

• Combination of stress and urge
• Common
• Treat both components

Overflow incontinence

• Bladder doesn't empty fully
• Constant dribbling
• Less common
• Needs medical assessment

Causes and risk factors

Common causes

• Pregnancy and childbirth
• Menopause
• Aging
• Obesity
• Chronic coughing
• Constipation
• Heavy lifting
• High-impact exercise
• Previous pelvic surgery
• Neurological conditions

Pelvic floor exercises (Kegels)

Why they work

• Strengthen pelvic floor muscles
• Improve bladder control
• Support pelvic organs
• 70-80% success rate
• First-line treatment
• No side effects

Finding the muscles

1. Sit or lie comfortably
2. Imagine stopping urine mid-flow
3. Squeeze and lift internally
4. Should feel tightening
5. Don't hold breath
6. Don't squeeze buttocks

Exercise programme

Slow exercises

1. Squeeze and lift
2. Hold 5-10 seconds
3. Relax completely
4. Rest 5-10 seconds
5. 10 reps, 3 times daily

Quick exercises

1. Quick squeeze and lift
2. Hold 1 second
3. Relax
4. 10 reps, 3 times daily

Progression

• Start with 3-5 second holds
• Build to 10 seconds
• Increase reps gradually
• Takes 3-6 months for full benefit
• Must be consistent
• Lifelong practice

The Knack technique

What is it?

• Pre-contraction before stress
• Squeeze just before cough/sneeze
• Prevents leaking
• Very effective
• Practice regularly
• Becomes automatic

When to use

• Before coughing or sneezing
• Before lifting
• During exercise
• Any activity causing leaking

Bladder training

For urge incontinence

• Gradually increase time between voids
• Resist urge to go
• Use distraction techniques
• Pelvic floor squeeze helps
• Build up gradually
• Takes 6-12 weeks

Bladder diary

• Record fluid intake
• Note toilet visits
• Record leaking episodes
• Identify patterns
• Track progress
• Share with physiotherapist

Lifestyle modifications

Fluid management

• Drink 1.5-2 litres daily
• Don't restrict fluids
• Spread throughout day
• Reduce before bed
• Avoid bladder irritants

Bladder irritants to limit

• Caffeine
• Alcohol
• Fizzy drinks
• Artificial sweeteners
• Spicy foods
• Citrus fruits (for some)

Bowel health

• Avoid constipation
• High-fiber diet
• Adequate fluids
• Don't strain
• Regular bowel habits

Weight management

• Lose weight if overweight
• 5-10% loss improves symptoms
• Reduces pelvic floor stress
• Combined with exercises

Smoking cessation

• Chronic cough worsens incontinence
• Affects tissue health
• Quitting helps

Good bladder habits

Do

• Wait for normal urge
• Take time to empty fully
• Sit properly on toilet
• Relax pelvic floor
• Double void if needed

Don't

• Go "just in case"
• Hover over toilet
• Push or strain
• Rush
• Hold on too long

Exercise and incontinence

Modifying exercise

• Empty bladder before exercise
• Use The Knack
• Avoid high-impact until improved
• Build up gradually
• Pelvic floor exercises essential
• Don't avoid exercise

Safe exercises

• Walking
• Swimming
• Cycling
• Pilates
• Yoga
• Low-impact aerobics

Return to high-impact

• Only when symptoms resolved
• Strong pelvic floor
• Gradual progression
• Use The Knack
• Professional guidance

Products and aids

Temporary aids

• Pads for security
• Not long-term solution
• Continue exercises
• Aim to reduce reliance

Vaginal weights

• Progressive resistance
• Hold weight in place
• Strengthens muscles
• Use with guidance

Advanced treatments

Physiotherapy treatments

• Biofeedback
• Electrical stimulation
• Vaginal weights
• Specialized programmes
• High success rate

Medical treatments

• Medication (for urge incontinence)
• Pessaries
• Botox injections
• Nerve stimulation
• Surgery (if conservative fails)

When to seek help

See physiotherapist if

• Any leaking of urine
• Urgency problems
• Affecting quality of life
• Unsure if doing exercises correctly
• No improvement after 3 months
• Want to return to sport

See GP if

• Blood in urine
• Pain when urinating
• Constant dribbling
• Sudden onset
• Neurological symptoms
• Not improving with physiotherapy

Prevention

Lifelong pelvic floor health

• Regular pelvic floor exercises
• During pregnancy
• After childbirth
• Through menopause
• Into older age
• Never too late to start

Healthy habits

• Maintain healthy weight
• Don't smoke
• Avoid constipation
• Good bladder habits
• Appropriate exercise
• Seek help early

The role of physiotherapy

Elderly Rehabilitation & Exercise provides specialist women's health physiotherapy including:

• Comprehensive assessment
• Internal examination (if appropriate)
• Personalized exercise programme
• Correct technique instruction
• Biofeedback training
• Bladder training guidance
• Lifestyle advice
• Ongoing support
• High success rate

The bottom line

Managing urinary incontinence requires:

• Correct pelvic floor exercises
• Daily practice (3 times)
• The Knack technique
• Bladder training (if urge)
• Lifestyle modifications
• Good bladder habits
• Patience (3-6 months)
• Professional guidance
• Don't give up

Urinary incontinence is common but very treatable. Don't accept it as inevitable or suffer in silence. With proper exercises, lifestyle changes, and professional support, most women can significantly improve or completely resolve their symptoms.

About Lizzie Thornton

Lizzie Thornton is a specialist community physiotherapist with over 15 years of experience in women's health and pelvic floor rehabilitation. She is HCPC registered and a member of the Chartered Society of Physiotherapy. Lizzie provides physiotherapy across Staffordshire Moorlands and Cheshire East.

View Lizzie's profile