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How to Not Pee Your Pants When Laughing –
Cure Incontinence with Advice from a Pelvic Health Physical Therapist on Pelvic Floor Muscle Training (aka Kegels)
by Julianne Simpson, DPT

A whopping 25-45% of women experience urinary incontinence in their lifetime1. Even though it is common, leaking when you sneeze, jump, cough or on your way to the bathroom is NOT normal! A new review article says that pelvic floor muscle training (PFMT), as prescribed by a physical therapist, can cure or reduce incontinence.2 

There are three main types of urinary incontinence: stress (urine loss with cough, sneeze, jump or laugh), urge (difficulty making it to the bathroom on time with strong urge) and mixed (combination of stress and urge incontinence). The study authors found that PFMT can help all three types of urinary incontinence. 

Female pelvic floor muscles

If you are looking for your pelvic floor muscles, you can find them at the bottom of your pelvis. These muscles stop the flow of urine, feces and gas and support your bladder, uterus and rectum. No surprise here, but both women and men have pelvic floor muscles. PFMT involves contracting and then relaxing the pelvic floor muscles, sometimes called doing Kegel (KEY-gul) exercises. These muscles can be weakened by inactivity, pregnancy or childbirth. Like any muscle, they become stronger and larger with exercise. The authors of the review suspect that larger muscles are more effective at closing off the urethra, the tube urine takes from your bladder out of your body. In addition, the stronger muscles could provide better support to the bladder, reducing movement with jumping or sneezing. 

According to the study, PFMT can change women’s lives. Women with all types of urinary incontinence experienced improvement in their quality of life. That’s more women out running, laughing and coughing with dry underpants! The women in the PFMT groups (vs the control groups) with: 

  • Stress urinary incontinence were eight times more likely to report their incontinence cured  
  • Urge urinary incontinence were two times more likely to report cure or improvement.  
  • Any type of urinary incontinence were five times more likely to report cure.  

The authors conclude, 

We can be confident that PFMT can cure or improve symptoms of stress urinary incontinence and all other types of urinary incontinence. 

A quick side note: PFMT can also help men and can reduce fecal and gas incontinence. Ask your physical therapist with a specialty in pelvic health for more information. Please watch here for upcoming blog posts with advice from a pelvic health physical therapist for men and strategies to reduce fecal and gas incontinence! 

If you are experiencing incontinence of any type, a pelvic health physical therapist is your best choice to help train your pelvic floor muscles. These specially trained physical therapists are experts at assessing pelvic floor muscles along with helping you with the critical integration of the pelvic floor with your entire movement system. A pelvic health physical therapist at Movement Systems will listen to you and collaborate with you to get you back to meaningful activities without leaking, whether it’s walking the dog, CrossFit, lifting your child or gardening, even if you sneeze!


Julianne Simpson, DPT, holds a BA from Oberlin College and a Doctorate of Physical Therapy from Eastern Washington University. A general orthopedic and pelvic health therapist, she is passionate about helping people move more and empowering her patients to live healthier lives. She dreams of raising kind children, cycling over the Alps and surfing in Alaska.


1 Abrams,P, Cardozo, L, Wagg, A, Wein, A. (Eds) Incontinence 6th Edition (2017). ICI-ICS. International Continence Society, Bristol UK, ISBN: 978-0956960733.
2 Dumoulin C, Cacciari LP, Hay‐Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD005654. DOI: 10.1002/14651858.CD005654.pub4.

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