Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Always consult a qualified health professional for advice specific to your condition. © 2026 Better Physiotherapy Bundoora.
Urinary incontinence affects over 4 million Australians. It is one of the most common — and most undertreated — conditions in both women and men. Pelvic floor physiotherapy resolves or significantly improves most cases, and is recommended as the first-line treatment before medication or surgery.
Types of Urinary Incontinence
Stress Incontinence
Leakage with activities that increase intra-abdominal pressure: coughing, sneezing, laughing, jumping, lifting, or running. It is the most common type and occurs when the pelvic floor cannot generate enough closure pressure to prevent leakage. Contributing factors include childbirth, menopause, low oestrogen, and weak pelvic floor muscles.
Urge Incontinence
Leakage associated with a sudden, overwhelming urge to urinate that cannot be deferred. The bladder muscle (detrusor) contracts involuntarily. Contributing factors include bladder irritants (caffeine, alcohol), anxiety, conditioned responses (key-in-door, running water), and neurological factors.
Mixed Incontinence
A combination of both stress and urge components — very common. Physiotherapy addresses both types within the same program.
Why Physiotherapy Works
Pelvic floor muscle training (PFMT) strengthens the muscular closure mechanism for stress incontinence. For urge incontinence, physiotherapy also uses bladder training — gradually extending the interval between voids and using urge suppression strategies. The combination produces better results than either approach alone.
What a Pelvic Floor Assessment Involves
Your physiotherapist will take a detailed bladder diary history, assess your posture and breathing mechanics (which directly affect pelvic floor load), and perform an internal pelvic floor assessment (if appropriate and consented) to measure strength, endurance, and coordination. This information guides a personalised rehabilitation program.
Success Rates
With supervised pelvic floor physiotherapy: 70–80% of women with stress incontinence achieve significant improvement or cure. Urge incontinence responds well with 60–70% achieving significant improvement. These results are superior to medication alone and without the side effects. Surgery has higher cure rates for severe stress incontinence but carries risks — and physiotherapy should always be tried first.
Frequently Asked Questions
What is the difference between stress and urge incontinence?
Stress incontinence is leakage with physical activity that increases abdominal pressure — coughing, sneezing, jumping, running. It results from insufficient pelvic floor strength or closure pressure. Urge incontinence is leakage associated with a sudden strong urge to urinate that cannot be controlled. Both types respond well to physiotherapy — but the treatment approach differs.
Are pelvic floor exercises the same as Kegel exercises?
Kegels (named after Dr Arnold Kegel who described the exercise) are pelvic floor muscle contractions. However, effective pelvic floor rehabilitation involves more than simple squeeze-and-hold contractions. A physiotherapist assesses pelvic floor function (including the ability to relax), prescribes the correct exercise type and dose, and progresses the program in a way that generic Kegel instruction cannot.
Do men get incontinence? Can physio help?
Yes. Urinary incontinence in men most commonly occurs after prostate surgery (particularly radical prostatectomy) and affects up to 90% of men in the immediate post-surgical period. Pelvic floor physiotherapy — ideally starting before surgery (prehabilitation) — significantly accelerates recovery of continence. Most men achieve full continence with appropriate physiotherapy.
Is it normal to leak when I exercise or run?
Leaking during exercise is extremely common — but it is not normal or inevitable. It is a treatable sign of pelvic floor dysfunction. Many women accept leakage as a permanent consequence of having children or getting older, but physiotherapy resolves or significantly improves the vast majority of cases. The earlier you seek treatment, the faster the result.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora