Pelvic Floor Series: What Is Urinary Incontinence?

Written by Kelsie Mazur, DPT

This week, we’re talking about something that a lot of people experience… but not a lot of people talk about: urinary incontinence. In simple terms, urinary incontinence is the involuntary loss of urine. That might look like leaking when you cough, sneeze, or work out, or feeling a sudden, strong urge to go and not quite making it in time.

And if you’re thinking, “wait… that’s not normal?” you’re not alone.

It may be common, but it is not something you just have to live with.

What’s Actually Happening in the Body?

Let’s zoom out for a second.

Your bladder is made up of a smooth muscle called the detrusor muscle. This muscle forms the wall of the bladder and allows it to expand as it fills and contracts when it’s time to empty. You don’t consciously control it the way you would your bicep. It is regulated automatically by your nervous system.

When everything is working well, your brain is constantly communicating with your bladder. As urine fills, the detrusor muscle stays relaxed so the bladder can store urine comfortably, while your pelvic floor stays active to maintain continence.

When it’s time to go, your brain sends the signal, the detrusor muscle contracts to push urine out, and your pelvic floor relaxes to allow that to happen.

With urinary incontinence, this coordination gets disrupted.

Sometimes the bladder contracts when it shouldn’t. Sometimes the pelvic floor isn’t able to provide enough support. And sometimes the communication between the brain, bladder, and pelvic floor is just off.

That’s where I (a pelvic floor DPT) come in.

The Three Most Common Types of Urinary Incontinence

1. Stress Urinary Incontinence

This is leakage with pressure.

 When pressure in your abdomen increases, like during coughing, sneezing, laughing, running, jumping, or lifting, the pelvic floor isn’t able to counteract that force effectively and leakage can occur. It’s less about emotional stress and more about physical stress on the system.

2. Urge Urinary Incontinence

This is the “gotta go right now” feeling.

You may feel a sudden, intense urge to urinate that is difficult to delay, even if your bladder isn’t very full. This is often related to overactivity of the detrusor muscle and changes in how the nervous system is signaling the bladder.

3. Mixed Urinary Incontinence

This is a combination of both.

You may notice leakage with movement as well as urgency or frequency. This is very common and very treatable.

Who Does This Affect?

Let’s clear this up right now…..Urinary incontinence is not just a “postpartum problem.”

Yes, pregnancy and delivery can play a role, but we also see this in athletes, lifters, and runners, in women who have never been pregnant, in women years removed from childbirth, and in individuals dealing with high stress or nervous system dysregulation.

If you have a bladder, you can have bladder symptoms.

You don’t need a specific life event to deserve care.

How We Treat It

This is where pelvic floor physical therapy makes a huge difference. Treatment is not just “do your Kegels.” In many cases, that is only one piece of the puzzle and sometimes not the starting point at all, or an inappropriate exercise for some. At the clinic, we focus on restoring how the whole system works together. That includes improving pelvic floor strength and coordination, while also making sure the muscles can fully relax when they need to. We look at how you manage pressure through your core, how you breathe, and how your nervous system responds to signals from the bladder. We also use bladder retraining strategies to help re-establish more normal patterns and reduce urgency and frequency.

When the brain, bladder, and pelvic floor start working together again, things begin to change.

Final Thoughts

If you’ve been leaking, rushing to the bathroom, or planning your day around where the nearest restroom is, I want you to know this:

You are not alone.
And you do not have to live this way.

Urinary incontinence is treatable, and with the right guidance, you can get back to moving, exercising, and living your life with confidence. And that’s exactly what we’re here for.

Let’s chat! Book an assessment and let’s get you back to feeling good in your body.

No referrals, no waiting, just answers. Did you know that we offer free 1-on-1 injury screens? Wattage Physical Therapy will take an in depth look at your ergonomics, posture, muscle tone, muscle weaknesses, and movement patterns to create a plan for YOU. If this article intrigues you, you can directly email me, Kelsie at Kelsie@wattagept.com. I would be happy to help you start the process of living a life free from pain.