Leaking with Sneezing, Coughing, and Exercising? Is It Just Pelvic Floor Weakness?
Have you ever sneezed, coughed, or jumped during a workout only to feel a small leak of urine? You’re not alone. Stress urinary incontinence (leaking with pressure or impact) is common, but it’s not something you just have to live with. It’s also not always about having a “weak” pelvic floor.
Why Does Leaking Happen?
Leaking with activity is a sign that your core system isn’t working together optimally. The pelvic floor, diaphragm, abdominal muscles, and back muscles form a team that should coordinate with your breathing and movement. When this system is off, leaks can happen.
Here are a few reasons why you might be leaking:
Core muscle coordination is off
The timing between your breath, pelvic floor, and abdominal muscles may not be in sync.Too much tension in the system
A tight pelvic floor doesn’t always mean a strong one. Overactive muscles can’t generate power effectively, which can lead to leaks.Muscle or connective tissue weakness
Pregnancy, birth, surgery, or chronic strain (hello constipation!) can reduce the support structures of the pelvic floor and surrounding core.Compensation from other muscles
Sometimes the glutes, inner thighs, or abdominals aren’t functioning optimally. This makes the pelvic floor overwork, leading to fatigue and leaking.
How Can Pelvic Floor PT Help?
A pelvic floor physical therapist looks beyond just “strength.” At your evaluation, we’ll assess:
How your pelvic floor contracts and relaxes
Your breathing pattern and core coordination
Muscle tension or restrictions in the hips, back, or abdominals
Posture, alignment, and movement strategies during daily activities and exercise
From there, treatment may include:
Teaching you how to coordinate your breath with movement
Relaxation techniques for an overactive pelvic floor
Targeted strengthening where it’s actually needed
Hands-on techniques to reduce tightness in the hips, back, or abdomen
Pelvic floor dry needling to decrease muscle tension, improve blood flow, and help muscles activate more effectively
Functional retraining so you can cough, sneeze, and exercise without leaks
The Bottom line: Leaking is common, but it is not normal and it doesn’t always mean you just need Kegels. Pelvic floor PT takes a whole-body approach including tools like breath training, manual therapy, and dry needling to restore coordination, strength, and balance so you can move confidently - without worrying about leaks.
Think pelvic floor therapy is the next right step for you? Give our office a call today or fill out an appointment form and we’ll be in touch!