Can Physical Therapy Help With Leakage?


Dear Dr. Ruth,

Heeeeelp. I’ve had issues with leaking ever since I gave birth to my daughter a few years ago. Soon after it started, I mentioned it to my friends who all said it was totally normal. So, I just lived with it. But it’s really affecting my confidence. I don’t want to go for runs, I don’t want to go out dancing, and I barely want to have sex. I finally got up the courage to talk to my primary care doctor about it and he mentioned physical therapy might be able to help. Honestly, I was too mortified to ask more questions. Can physical therapy really help me?


Embarrassed and Tired of Leaking


Dear Embarrassed and Tired of Leaking,

Yes. Many women have pregnancy-induced stress incontinence because of the stretching of the muscles and connective tissue in the pelvic floor that is needed to allow the baby to pass through the birth canal. Computer modeling shows that these muscles can stretch up to three times their normal length during labor, leaving them unable to contract. You have little to no support down there after having a baby. So when you cough, sneeze, or even bend down to pick up your baby, you’ll involuntarily leak. That’s because those activities increase the pressure in the abdominal area and the weakened pelvic floor is unable to provide enough resistance to counteract this pressure.

To address this, kegel or pelvic floor exercises are highly recommended as a first-line treatment. The problem with pelvic floor exercises is that up to 50 percent of women either can’t do them at all or they can’t do them appropriately. Since the muscles are hidden inside the pelvis and out of sight, it’s difficult to get confirmation of doing them correctly. A physical therapist can help you learn how to perform the contractions appropriately. The therapist can palpate the tailbone with their finger—even over light clothing—while the person tries to do a contraction. If the tailbone doesn’t move at all, no pelvic floor contraction is occurring. If the tailbone moves forward and away from the finger, that’s confirmation of a pelvic floor contraction. If the tailbone moves backward and toward the finger, the wrong muscles are contracting.

Another option is to use INNOVO. It’s a non-invasive solution (it’s a pair of bike shorts) that delivers 180 perfect Kegels per session and strengthens your pelvic floor all from the comfort of your own home. No doctor visits required or prescription needed. You wear the shorts for 30 minutes a day, five days a week and you can be one of the 87% of women who have eliminated their bladder leaks in 12 weeks or less.


Dr. Ruth