Urinary continence—the ability to control your bladder and prevent involuntary leakage—is something many people take for granted until it becomes a problem. While it’s often joked about or brushed off (especially during pregnancy or after childbirth), urinary leakage is common, but it’s not normal—and it’s almost always treatable with the right support.
In this blog, we’ll break down what urinary continence is, the different types of incontinence, and why pelvic floor physical therapy can play a vital role in restoring bladder control.
Urinary continence refers to your body's ability to store urine in the bladder and release it at an appropriate time and place. This process relies on coordination between the brain, bladder, urethra, and pelvic floor muscles. When these systems are working well, you can easily delay urination until it’s convenient.
When there’s a disruption—due to muscle weakness, nerve dysfunction, pressure changes, or hormone shifts—you may experience urinary incontinence, or involuntary urine leakage. This can happen during exercise, sneezing, laughing, or even just when trying to get to the bathroom in time.
There are several different types of urinary incontinence, and understanding which type you’re experiencing is key to treating it effectively.
This is the most common type we see during pregnancy and postpartum. It occurs when increased pressure on the bladder (like during coughing, laughing, jumping, or lifting) overwhelms the pelvic floor muscles and leads to leakage. Stress incontinence often stems from under-recruited or overly tight pelvic floor muscles that can't adequately support the bladder and urethra.
Urge incontinence, sometimes called “overactive bladder,” involves a sudden, intense urge to urinate followed by leakage. It’s often linked to bladder signaling issues where the bladder contracts prematurely—even when it’s not full. This can be triggered by running water, unlocking the door, or even just thinking about the bathroom.
Many people experience a combination of both stress and urge incontinence, known as mixed incontinence. For example, someone might leak when sneezing (stress) but also struggle with strong, urgent sensations (urge). Treatment for mixed incontinence requires addressing both muscle support and bladder behavior.
Less common but important to mention, overflow incontinence occurs when the bladder doesn’t empty completely, causing frequent or constant dribbling. This can be related to nerve issues, prolapse, or muscle dysfunction, and usually requires more specialized medical assessment.
Functional incontinence is not due to a problem with the bladder or pelvic floor directly, but rather a difficulty getting to the bathroom in time. This can be caused by pain, mobility limitations, poor coordination, or even environmental barriers. For example, someone recovering from a cesarean birth may struggle to move quickly enough, or a toddler at home may slow down your ability to respond to your body’s cues. Addressing this type often involves improving strength, coordination, and modifying the environment to remove barriers.
During pregnancy, your growing uterus puts additional pressure on the bladder and pelvic floor, and hormonal changes affect tissue elasticity. After birth, whether vaginal or cesarean, muscles, nerves, and connective tissue may be stretched, weakened, or uncoordinated. All of these factors can lead to temporary or long-term changes in continence.
The good news? Urinary incontinence is not something you have to "just live with." Pelvic floor physical therapy can be highly effective in restoring control by retraining muscle strength, timing, coordination, and breath support.
If you’re experiencing any kind of leakage—whether during workouts, while sneezing, or when you feel a sudden urge—it’s a sign that your pelvic floor could use support. You don’t have to wait until it's severe. The earlier you address it, the easier it is to resolve.