Stress Incontinence



Stress Incontinence

December 15, 2020

Urinary incontinence is the medical term for having a strong desire to urinate followed by the involuntary loss of urine …  in other words, peeing your pants on a regular basis! I know this seems like a laughing matter, but it is way more common than you would ever imagine. In fact, according to the American Urological Association, it is estimated that 1 in 4 individuals suffer from some form of urinary incontinence1. As pelvic floor physical therapists’ urinary incontinence is easily the number one symptom we treat.

Stress incontinence is defined as the “involuntary loss of urine with physical exertion.2” In other words, this means leaking with exertional activities such as exercising, running, lifting, jumping, standing up from a chair, etc. It also is the diagnosis with urine loss from actions that cause changes in your intra-abdominal pressure such as coughing, sneezing, or laughing. So, if trampolines are your worse nightmare right now, or you are having to run to the bathroom right before jumping jacks in your workout class then you most likely are currently experiencing stress incontinence.

What causes stress incontinence? There can be multiple factors that can contribute to stress incontinence including:

  • Pregnancy and Childbirth (both vaginal and C-section)
  • Weak pelvic floor muscles
  • Over-active pelvic floor muscles (muscles overly toned or imbalanced in strength)
  • Improper breathing / holding your breath during exertion
  • Chronic coughing / sneezing
  • Smoking
  • Overweight
  • Dehydration
  • Medications
  • Menopause
  • Weakened muscles around the bladder

You might hear during pregnancy or postpartum that it is “normal” to pee your pants with activity, but this makes us physical therapists cringe! Yes, it is a common symptom maybe the first 6 weeks after delivery but anything past that means that you have an imbalance and should seek pelvic floor retraining. Women should not have to carry a second pair of underwear and pants in the car or avoid outings due to fear of peeing their pants. Having incontinence after your first pregnancy (or even before pregnancy), puts women at a 50% more risk of suffering from chronic incontinence symptoms later in life (and is an even higher percentage with multiple childbirths.

 So, what can you do now to reduce your symptoms? Here are some tips and tricks:

  • Proper breathwork during exertion:
    •  Make sure you are not holding your breath when performing an activity such as standing from sitting, rolling out of bed, lifting an object, etc. We tell our patients that preparing your body for the activity can help reduce leakage and focusing on exhaling when lifting or performing the movement and keep a balanced intra-abdominal pressure and reduce leakage.
  • Performing Kegels correctly (This means contraction as well as full relaxation)
    • You want to think of gently lifting the muscles of the pelvic floor up and in during exhale as if lifting a small little pea or blueberry up. Feel the muscles rise. Then, on inhale you want to release the muscles and let them come back down to start position. Imagery works great with pelvic floor contraction and relaxation, so we recommend setting some time for yourself and picture those muscles raising up (like a flower closing) and then relaxing (like the flower is blossoming).
  • Make sure you are staying hydrated
    • Dehydration can cause our muscles to not properly contract and relax and can train the bladder to feel the urge even if it is not full.
  • Perform the Stronger as a Mom online postpartum training program
    • Our program is designed specifically to improve pelvic floor and core strength with natural and appropriate progressions to help get you back into normal activities such as lifting, running, jumping without leakage. It also provides guided videos, handouts, and education on proper breathwork, lifting mechanics, and how to efficiently contract and relax the pelvic floor during functional movement patterns. For more information, our program is linked below.
  • Find a pelvic floor physical therapist near you if still suffering symptoms.  
    • If you are still having urinary leakage symptoms after performing our online program, we highly suggest finding a pelvic floor physical therapist in your area using the link below.

Link to our program Stronger as a Mom HERE

Link to pelvic floor therapist near you HERE


  1. Urology Care Foundation. Incontinence: Symptoms & Treatment – Urology Care Foundation ( 2020
  2. International Continence Society. ICS | International Continence Society. 2020.

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