Bladder leaks, also known as urinary incontinence, are more common than you think. Millions of people experience them, with a wide variety of causes, regardless of age or gender. Whether it’s a little dribble during a sneeze or a sudden, urgent need to go, bladder leaks can be frustrating and embarrassing. The good news is, there are plenty of ways to reduce their frequency and manage the symptoms. Your pelvic floor physical therapists are here to help!
Here’s a breakdown of what causes bladder leaks and some practical tips and tricks to help you take control.
Why Do Bladder Leaks Happen?
Bladder leaks can result from a variety of causes:
- Weak pelvic floor muscles (common after childbirth or with age)
- Overactive bladder (a strong, sudden urge to urinate)
- Stress incontinence (leaks from coughing, sneezing, laughing, and lifting)
- Medical conditions (such as diabetes, urinary tract infections, or neurological disorders)
- Certain medications (diuretics or muscle relaxants)
How about in Pregnancy and Postpartum?
Your body goes through tremendous changes during pregnancy and birth. These changes affect the pelvic floor muscles, which provide support for your bladder, uterus, and bowel.
Some common causes of bladder leaks in this stage of life include:
- Hormonal shifts (especially the hormone relaxin, which loosens ligaments)
- The weight of the growing uterus places pressure on the bladder
- Stretching or weakening of the pelvic floor muscles during vaginal delivery
- C-section recovery, which can also affect core and pelvic stability
- Nerve irritation or injury during childbirth
- Diastasis recti (abdominal separation), which can affect pressure control in the core and pelvic floor
Tips from a Pelvic Floor PT to Reduce Leaks
1. Learn to Do Kegels Correctly (Quality Over Quantity)
Kegels can help, but only if done correctly. Many women are told to “do their Kegels,” but without proper guidance, they may be ineffective or even counterproductive.
How to check if you’re doing them right:
- Imagine gently stopping the flow of urine and lifting a blueberry with your vaginal muscles. (Pro Tip – DO NOT try to do this while you are urinating. This can interrupt your body’s natural reflexes for urination.)
- You should feel a gentle “lift” inside, not bearing down.
- Breathe naturally—don’t hold your breath.
A Pelvic Floor Physical Therapist can assess your technique. Not everyone needs to “strengthen”; some people need to lengthen and/or coordinate their pelvic floor. That’s where a professional examination of your pelvic floor is key to treatment.
2. Incorporate Your Pelvic Floor into Movement
Bladder leaks often happen during activity. That’s because your pelvic floor needs to respond reflexively to pressure, like when you lift your baby or laugh unexpectedly.
Try this simple strategy:
- Exhale + Engage: Before lifting, sneezing, or squatting, exhale while gently engaging your pelvic floor and deep core.
- Think: “Blow before you go.”
This helps manage intra-abdominal pressure and protect your pelvic floor from overload. A Pelvic Floor Physical Therapist can help assess your coordination of a protective contraction and also help with training your deep core strength and endurance.
3. Avoid “Just In Case” Bathroom Trips
It might feel smart to pee before every outing or errand, but this can train your bladder to signal urgency prematurely.
Stick to timed voiding every 2–4 hours if possible, and gradually stretch the time between bathroom visits.
4. Stay Hydrated—But Watch the Triggers
Don’t fall into the trap of limiting water to prevent leaks. Dehydration concentrates your urine and irritates your bladder lining.
Instead:
- Drink enough water throughout the day. The general recommendation is to drink half of your body weight in pounds in oz of water (i.e., if you are 100 lbs, you drink 50oz). Generally, it is about 6–8 cups per day.
- Cut back on common bladder irritants like caffeine, carbonated drinks, alcohol, citrus, spicy foods, and artificial sweeteners.
5. Support Healing Postpartum
Your pelvic floor and core need time and intentional rehab after childbirth, just like any other major physical event.
Here’s what can help:
- Early postpartum:
- Gentle diaphragmatic breathing
- Body alignment awareness
- Light core engagement with exhalation
- See our blog post about early postpartum exercise.
- 6+ weeks postpartum (with provider clearance):
- Progressive pelvic floor and core strengthening
- Functional movement retraining (lifting, walking, returning to exercise)
Don’t jump back into intense workouts or high-impact movements without rebuilding the foundational support. With high-impact movement comes high-impact on your pelvic floor muscles.
6. Use Protection if Needed—Without Shame
If leaks are interfering with your daily life, it’s okay to use absorbent pads or leak-proof underwear while you work on recovery. Think of it as a temporary tool, not a permanent solution.
7. See a Pelvic Floor Physical Therapist
If you’re leaking, having pelvic pain, feeling a “heaviness” or bulging sensation, or just not sure how to rehab your core and floor properly, we’re here to help.
We can:
- Assess your pelvic floor muscle tone, strength, endurance, and coordination
- Assess hip, pelvic, and spine muscle strength, tone, and flexibility – it is all connected!
- Help to strengthen your deep core
- Tailor exercises to your specific needs and functional activities
- Help guide you back to the activities you love—leak-free
You Don’t Have to Live with Leaks
Bladder leaks are more common than you’d think, but that doesn’t mean we should normalize them! Bladder leaks are highly treatable and not something you should tell yourself you have to live with! With proper education, support, and a guided rehab plan, most people see significant improvement or full resolution of symptoms.
Need help?
If you’re struggling with bladder leaks and want a personalized evaluation and treatment plan, make an appointment with one of the Pelvic Floor Physical Therapists at The Pelvic Health Center in Madison, NJ. We’re trained to help identify and treat the causes of your incontinence!
