“It Happened When I Laughed…” – What Bladder Leaks Say About Your Pelvic Floor
By Dr Diksha Saini
Laughter during a casual conversation. A sudden sneeze in the middle of the day. Picking up a heavy grocery bag. And then—a small, unexpected leak. It can be surprising, confusing, and often dismissed at first. But when it starts happening more frequently—while exercising, coughing, or simply going about daily life—it can lead to discomfort, self-consciousness, and even avoidance of social or physical activities. Many people silently adjust their routines around these moments, not realizing that help is available.
Understanding Incontinence
The pelvic floor is a group of muscles and connective tissues that form a supportive base for the bladder, uterus, and rectum. These muscles play a vital role in maintaining continence by helping to control the release of urine or stool and responding to changes in posture, pressure, or movement throughout the day.
When these muscles are not functioning well—either because they are too weak, overactive, or poorly coordinated—they may fail to respond effectively. Weak muscles may not provide enough support or closure, leading to leakage with everyday activities like coughing, laughing, or lifting. Overactive or tense muscles, on the other hand, may have trouble relaxing when needed, which can result in urgency, difficulty emptying, or leakage before reaching the toilet.
Pelvic floor dysfunction can arise for a variety of reasons. Pregnancy and childbirth can stretch or injure these muscles. Hormonal changes during menopause may reduce tissue support. Chronic straining from constipation, repeated heavy lifting, surgery, or even prolonged sitting and stress can also impact how the pelvic floor functions.
Incontinence can affect people of all ages and backgrounds—not just older adults or those who have given birth. Athletes, individuals recovering from surgery, and even young people experiencing stress-related tension can notice symptoms.
While common, incontinence is not something you simply have to accept—it is often a sign that the pelvic floor needs care and attention, and with the right approach, meaningful improvement is possible.
Is Your Body Sending You Signals?
· Do you leak urine when you laugh, sneeze, cough, or lift something?
· Do you feel urgency and sometimes cannot reach the toilet in time?
· Do you wake up multiple times at night to urinate?
· Do you plan your day around bathroom access?
· Do you avoid exercise or long outings out of fear of leakage?
· Do you strain to empty your bowels or experience accidental soiling?
· Do you leak when changing positions—like getting up from a chair?
These signs might be common, but they are not normal—and they can be addressed with the right care.
Pelvic Health Reimagined: Where Breath, Movement, and Strength Meet
Pelvic floor physical therapy is a holistic approach that looks beyond just the pelvic area. Incontinence is often related to how well the body manages internal pressure—especially during activities like lifting, coughing, or even standing. When the muscles that support the pelvis, abdomen, and spine are not working in harmony, it can place extra strain on the bladder and lead to leaks.
A pelvic health assessment typically begins by looking at how you breathe, how your body moves, and how your pelvic floor responds during simple tasks. Breathing retraining is often one of the first things we address. Coordinated breathing helps regulate pressure in the abdomen and supports the pelvic floor more naturally. When breathing patterns are shallow or held, it can increase strain and reduce the pelvic floor’s ability to respond.
Manual therapy may be used to reduce muscle tension, improve blood flow, and release areas of restriction that could be limiting pelvic floor function. This hands-on work can be
applied externally to the hips, lower back, or abdomen—and internally, if needed and only with consent.
As part of the process, we often include gentle, targeted movements that help your core and pelvic floor work together more effectively. These exercises are designed to restore coordination and control—not to push strength, but to support everyday activities like walking, bending, or lifting without placing extra strain on the bladder. Alongside physical techniques, we also focus on education. Learning how small adjustments in posture, bathroom habits, and daily routines can support your pelvic health is a key part of recovery.
Incontinence does not have to be a permanent part of your life—with the right guidance and care, pelvic floor therapy can help you take meaningful steps toward better pelvic health, improved wellbeing, and a more active, comfortable life.
