Chartered Physiotherapists have a key role in the treatment of incontinence. Approximately 1 in 4 women experience incontinence at some time in their lives. Women’s health physiotherapy can help women regain control of their bladder, their bowels and improve the quality of their lives. Some women don’t seek help as they are too embarrassed and choose to suffer in silence. Physiotherapy is recommended as the first line of treatment to help with this problem and results are generally very positive.

Bladder Problems:

There are many conditions that can cause you to lose control of your bladder. The most common causes are weak pelvic floor muscles and a bladder that is irritable and used to being emptied too often.

The problem can become a vicious circle when you find your life revolving around the fear of not finding a toilet on time. It sounds ridiculous but your bladder starts to take control of your life.

Bladder Problems…Do you have a problem?

  • Do you leak when you run, jump, cough or sneeze.
  • Do you empty your bladder more than 6 – 8 times a day.
  • Do you get up more than twice in the night to empty your bladder
  • Do you feel a very strong urge to empty your bladder and find it hard to hold until you get to the toilet.

 Risk factors

 The following can increase the likelihood of experiencing bladder or bowel problems

  • Pregnancy
  • Childbirth
  • The menopause and ageing
  • Obesity
  • Jobs involving heavy lifting
  • Certain types of surgery
  • Chronic lung disease with regular coughing

Types of Incontinence:

Stress Incontinence: Leakage of small amounts of urine during physical movement (Coughing, sneezing, exercising)

Urge incontinence: Leakage of large amounts of urine at unexpected times including during sleep.

Overactive bladder: Urinary frequency with or without urge incontinence.

Mixed incontinence: Usually the occurrence of stress and urge incontinence together.

Why pregnancy and childbirth can cause weakness of the Pelvic Floor??

During pregnancy the pelvic floor can become stretched and weakened due to the weight of the baby leaning down on the pelvic floor. Further weakness can develop following childbirth as a result of muscle stretching, nerve damage, episiotomy.


Many women approach menopause with poor pelvic floor muscles. Hormone levels change during  menopause and this can result in a reduction of the quality of the tissues in the vagina, urethra and bladder area. Continence problems can become mire noticeable around this time in our lives.

Physiotherapy Input:

An initial assessment will be carried out to establish what type of incontinence you are suffering from. This will involve a detailed description of your symptoms, a full medical history, medications etc You maybe required to complete a bladder diary which will show the volumes of fluid you take in and the volumes and frequency of urine that you void. Based on diagnoses you will be commenced on a treatment program.

Treatment Options:

Pelvic Floor Re-education: If it is established that your problem is related to  weak pelvic floor muscles you will be commenced on a strengthening program. Many women don’t know how to contract the pelvic floor correctly so this may need to be learned. Doing pelvic floor exercises in the correct way is essential. Sometimes the patient may need extra help with strengthening the pelvic floor and this can be provided with biofeedback or muscle stimulation.

Bladder training: Some women with weak bladders fall into the habit of emptying their bladder too often. Bladder habits need to be examined and recommendations made to  return normal habits.