Regain Confidence with Pelvic Health Physiotherapy

Leaking urine can be frustrating, embarrassing, and incredibly common—but it is not a normal part of life.

Many women are told that bladder leakage is simply something to expect after having children, during menopause, or as they get older. While urinary incontinence is common, it is highly treatable, and for many women, physiotherapy is recommended as the first line of treatment before considering medication or surgery.

At Alpine Physiotherapy, our Women’s Health Physiotherapists provide compassionate, evidence-based assessment and treatment for all types of urinary incontinence. Our goal is to help you feel confident, return to the activities you love, and improve your quality of life.

What is Urinary Incontinence?

Urinary incontinence is the involuntary leakage of urine. It can range from leaking a few drops during exercise to experiencing a sudden urge that makes it difficult to reach the toilet in time.

Bladder leakage affects women of all ages, including:

• Young athletes
• New mums
• Women during pregnancy
• Perimenopausal and menopausal women
• Older adults

Many women delay seeking help because they feel embarrassed or assume it is “just part of getting older.” In reality, most women can significantly improve their symptoms with the right assessment and treatment.

Types of Urinary Incontinence

Stress Urinary Incontinence

Stress urinary incontinence occurs when pressure inside the abdomen increases faster than the pelvic floor muscles can respond.

You may leak urine when:

• Coughing
• Sneezing
• Laughing
• Running
• Jumping
• Lifting
• Playing sport

This is the most common type of incontinence seen in physiotherapy.

Contributing factors may include:

• Pregnancy
• Childbirth
• Pelvic floor weakness
• Menopause
• High-impact exercise
• Chronic coughing
• Previous pelvic surgery

Urge Urinary Incontinence

Urge incontinence occurs when you experience a sudden, overwhelming need to urinate and cannot always make it to the toilet in time.

You may notice:

• Frequent trips to the toilet
• Strong urgency
• Night-time urination
• Leakage on the way to the toilet

This often involves an overactive bladder rather than simply weak pelvic floor muscles.

Mixed Urinary Incontinence

Many women experience a combination of both stress and urge incontinence.

For example:

• Leaking while running
• Also struggling with urgency and frequent toilet visits

Your physiotherapist will identify which symptoms are most significant and tailor treatment accordingly.

Why Does Bladder Leakage Occur?

Bladder control relies on many systems working together.

These include:

• Pelvic floor muscles
• Bladder function
• Core muscles
• Breathing mechanics
• Nervous system control
• Lifestyle habits

Sometimes the pelvic floor is weak.

Sometimes it is actually too tight.

Sometimes the muscles simply aren’t coordinating well enough during movement.

This is why an individual assessment is so important.

How Can Pelvic Health Physiotherapy Help?

Every woman is different.

Your Women’s Health Physiotherapist will complete a thorough assessment to understand what is contributing to your symptoms.

This may include:

• Bladder history
• Fluid intake
• Toilet habits
• Pregnancy and birth history
• Exercise routine
• Pelvic floor muscle assessment (with your consent)
• Core and breathing assessment
• Hip and lower limb strength

From there, we develop a treatment plan specific to your goals.

Pelvic Floor Muscle Training

Pelvic floor muscle training is one of the most effective treatments for urinary incontinence.

However, effective treatment is much more than simply doing “Kegel exercises.”

Research shows that many women perform pelvic floor exercises incorrectly or train muscles that are already overactive.

We assess:

• Strength
• Endurance
• Coordination
• Relaxation
• Timing

This allows us to prescribe exercises that are appropriate for your body.

Returning to Exercise

Many active women experience bladder leakage while:

• Running
• CrossFit
• Netball
• Tennis
• Skiing
• Gym training

Stopping exercise isn’t the answer.

Instead, we help identify why leakage is occurring and develop a plan to help you return confidently.

Treatment may include:

• Pelvic floor rehabilitation
• Strength training
• Load management
• Running assessment
• Return-to-impact progression

Our aim is to keep you active while reducing bladder symptoms.

Pregnancy and Postnatal Bladder Health

Pregnancy and childbirth place significant demands on the pelvic floor.

Physiotherapy can help:

• Reduce bladder leakage during pregnancy
• Improve recovery after birth
• Prepare for returning to exercise
• Support pelvic floor recovery
• Reduce long-term symptoms

Early intervention often leads to better long-term outcomes.

Bladder Training

For women experiencing urgency or frequent urination, treatment may also include bladder retraining.

This involves gradually improving the bladder’s ability to comfortably hold urine while reducing urgency and frequency.

Combined with pelvic floor rehabilitation, bladder training can significantly improve symptoms without medication.

When is Further Treatment Needed?

Most women respond well to physiotherapy.

However, if your symptoms require further investigation, your physiotherapist can refer you to your GP or an appropriate specialist.

Further assessment may be appropriate if there is:

• Blood in the urine
• Recurrent urinary tract infections
• Significant pelvic organ prolapse
• Persistent bladder pain
• Neurological conditions
• Symptoms not improving with conservative treatment

We work closely with GPs, continence nurses, gynaecologists and urogynaecologists to ensure you receive the most appropriate care.

You Don’t Have to Live with Bladder Leakage

Many women plan their day around knowing where the nearest toilet is.

Some stop running.

Others avoid exercise altogether.

Many quietly wear continence pads without realising effective treatment is available.

Bladder leakage is common—but it is not something you simply have to put up with.

At Alpine Physiotherapy, our Women’s Health Physiotherapists provide a safe, private and supportive environment where you can discuss your concerns openly and receive evidence-based care tailored to your individual needs.

Whether you’ve recently noticed bladder leakage or have been managing symptoms for years, we’re here to help you regain confidence and return to the activities you love.