At Indigo Physiotherapy, we believe that pelvic health is foundational to whole-body wellness—and that includes talking candidly about topics that are too often brushed aside. Incontinence is one of them.
It is widely thought that incontinence only occurs in older adults and is due to aging, but that is a myth. Incontinence can occur at all ages and in all genders. It is most prevalent among individuals in the prenatal or postpartum period, post-surgical recovery (such as after a prostatectomy), following cancer treatment involving pelvic or abdominal organs, and even in younger individuals during activities like running or heavy lifting.
Regardless of when it shows up, incontinence is a symptom of pelvic floor dysfunction—meaning the muscles that support the bowel, bladder, and reproductive organs aren’t functioning as they should. This dysfunction can lead to urinary, fecal, or gas leakage.
The Emotional and Physical Toll of Incontinence
Incontinence can feel very isolating. It’s not often talked about in social circles or even addressed adequately during medical appointments. It has also been historically over-normalized, especially in postpartum or older populations.
The cost is more than just emotional—it’s also financial and functionally limiting. Incontinence may mean:
- Spending on liners or pads
- Constant laundry
- Avoiding exercise classes or long outings
- Reorganizing your life around access to restrooms
- Avoiding intimacy
If you find that you are leaking in any way, it is time to seek treatment. And the good news is—treatment is often relatively straightforward, and does not typically require pharmaceuticals or surgical intervention. In fact, pelvic floor physical therapy is the number one evidence-based treatment for incontinence.
Why Pelvic Floor Physical Therapy?
Pelvic floor physical therapy is non-invasive and appropriate for any gender or age. Often, incontinence stems from:
- Weakness in the pelvic floor muscles
- Scar tissue from birth or surgery
- Poor bowel habits (chronic straining or constipation)
- Hormonal changes during perimenopause or menopause
- Muscle overactivity or poor coordination
A skilled physical therapist can address each of these and also will look at the entire system, not just the symptoms. That PT works to find root causes, collaborate with your broader healthcare team, and guide you back to full function—so you can participate fully in life again.
Just like PT for knee pain addresses the joint, muscles, nerves, and movement patterns, pelvic physical therapy applies the same full-body, integrative approach to the pelvis and core.
Understanding Incontinence
There are several types of incontinence, ranging in severity from minor leakage with a cough to full bowel or bladder loss. Understanding the type you’re experiencing is key to getting the right treatment.
Fecal Incontinence
Fecal incontinence involves leakage of stool, and it may show up in different ways:
- Not making it to the toilet in time
- Leakage after a bowel movement (often referred to as fecal smearing)
- Frequent wiping or a sensation of not feeling clean
- Unaware leakage, which can lead to significant social distress
Common causes include dietary factors, hemorrhoid treatments, hormonal changes, radiation or colorectal surgery, anal sphincter weakness, and traumatic birth injuries such as:
- Severe tearing
- Episiotomy
- Forceps or vacuum-assisted delivery
Pelvic floor physical therapy is often the first and most effective line of treatment for fecal incontinence.
Gas Incontinence
Gas incontinence occurs when someone feels the urge to pass gas but cannot control it. While it’s not healthy to hold gas in indefinitely, the ability to regulate and release gas as needed is important for social comfort.
This form of incontinence is often embarrassing and socially limiting, and it shares similar root causes and treatment strategies with fecal incontinence.
For both fecal and gas incontinence, pelvic physical therapists can also refer you to specialists in:
- Nutrition
- Colorectal health
- Gut health (including conditions like SIBO or leaky gut)
This interdisciplinary approach ensures optimal healing and long-term outcomes.
Urinary Incontinence
Urinary leakage presents in multiple ways:
- Stress Incontinence: Leakage from impact—running, coughing, sneezing, laughing, jumping, or even stepping off a curb.
- Urge Incontinence: Leakage when the urge to urinate becomes overwhelming, especially on the way to the bathroom or while undressing.
- Mixed Incontinence: A combination of stress and urge leakage.
- Functional Incontinence: Common in older adults with mobility challenges; occurs when a person cannot reach the restroom in time.
Urinary incontinence is common in individuals with:
- Endometriosis or adenomyosis
- Postpartum (vaginal or c section)
- Perimenopausal or menopausal hormone changes
- EDS (Ehlers-Danlos Syndrome)
- Post-operative healing (e.g., after prostatectomy, hysterectomy, or radiation)
Although incontinence may be common at certain life stages, it is not normal and it is treatable—most often with pelvic physical therapy alone.
The Role of Physical Therapy in Managing Incontinence
Your care journey starts with an in-depth intake and evaluation, including confidential questions about:
- Bladder and bowel habits
- Sexual and reproductive health
- Pain, lifestyle, and goals
These systems work in close coordination, so your therapist will look at how they influence each other—even if symptoms seem unrelated.
Your First Session May Include:
- A thorough review of your health history
- A musculoskeletal assessment (hip and core strength, posture, mobility)
- Lumbopelvic alignment and sensation testing
- A trauma-informed, consent-based internal pelvic floor evaluation (if appropriate), conducted with a gloved and lubricated finger—no stirrups or speculum
- Education and visual models to help you understand your anatomy and symptoms
- A proposed personalized plan of care
- A customized home program of stretches or exercises
Note: Kegels are often not the only answer or solution. If prescribed, your therapist will ensure you perform them without breath-holding or core bracing.
The goal is for you to leave your first visit feeling empowered, informed, and equipped with a plan for healing.
Benefits of Pelvic PT for Incontinence
- Improved muscle control
- Better hip and core strength
- Decreased pelvic, low back, or hip pain
- Improved sexual function
- Reduced or eliminated leakage and urgency
- Restored range of motion and functional movement
- Improved overall pelvic health
- Increased body confidence and autonomy
- Return to physical activity without worry
Indigo’s Approach to Care
At Indigo Physiotherapy, you’ll always receive care in a private, boutique setting with one-on-one sessions from a Doctor of Physical Therapy.
Your follow-up sessions may include:
- Manual therapy (myofascial release, scar tissue work)
- Alignment corrections
- Education and habit changes
- Home program progression based on your goals
We never use techs or aides. Each plan is uniquely tailored—we don’t do “cookie cutter” care. We treat the whole person and walk with you every step of the way.
Is Physical Therapy Right for You?
Ask yourself:
- Do you leak urine, gas, or fecal matter—even occasionally?
- Do you feel a sudden urge and can’t make it to the bathroom in time?
- Do you avoid exercise, outings, or intimacy due to leakage or fear?
- Do you leak without realizing it?
- Do you have pain with sex, tampon use, orgasm, or bowel movements?
- Have you had pelvic surgery, radiation, or injury?
- Do you have scar tissue from birth, a tear, or diastasis recti?
- Do you feel disconnected from your pelvic strength or function?
If you answered yes to any of these, pelvic physical therapy may be the right next step.
You Don’t Have to Live with Incontinence
Incontinence is common but very manageable and treatable. Pelvic physical therapy is a research based and informed treatment that does not require medications, surgery, or a large amount of time. Often bowel or bladder leakage is just a sign that pelvic floor dysfunction or weakness is present, and treatment of incontinence may help in prevention of other dysfunctions further down your road, such as hip and low back pain, decreased sexual function, pelvic organ prolapse, and others.
We invite you to schedule an initial consultation with us here, and explore how you can manage incontinence and improve your quality of life at any age.
You deserve to feel strong, confident, and in control of your body. And with expert care and personalized support, you can get there.
Pelvic physical therapy is the first—and often only—step you need.
