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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)

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.

5 Reasons Why You Should Try Pilates

5 Reasons Why You Should Try Pilates 

Guest Blog by Allison Moss

Before I share Allison’s awesome blog post, I want to thank her and Club Pilates on Mercer Island for opening up their doors to us.  As a physical therapist, I am always trying to find ways for patients to either become more active or to diversify how they move to maintain a healthy movement system. Pilates is a great option, and Allison does a great job of explaining more…

Take it away, Allison.

Pilates has blown up in the U.S. these last few years and it has everyone wondering what it is about this system that has people flocking into the studios. Pilates is a progressive approach to modern-day fitness that helps people from all walks of life come into the studio with confidence that their instructor will know how to safely and effectively give them the best workout for their body. Whether you are dealing with an injury, recovering from a surgery or just wanting to add in another form of exercise; Pilates has you covered! So, let’s take a look at a few reasons you should consider trying Pilates.

  1. Pilates focuses on the powerhouse, which is the core and back muscles or the midsection of your body. These muscles initiate and support our every movement and also help to protect our spine by strengthening the muscles that surround it. The Pilates Method develops a significantly strengthened core through specifically targeted exercises using fun and integrated techniques to challenge you with every class.
  2. Pilates is a gentle workout that isn’t going to harm the body which is mainly done on an apparatus called a Reformer. The Reformer is a bed like structure and has a carriage that is on wheels and uses resistance via springs connected underneath. Laying down and being able to work out horizontally allows you to use a resistance that is lighter than your body which is very useful for anyone going thru physical therapy or with any medical conditions.
  3. Pilates provides a full-body workout, making sure that you leave every class feeling balanced, energized and focused. Paying attention to all planes of the body, Pilates offers a whole-body commitment in every class. Connecting your mind and body to each exercise helps you understand how and why you benefit from Pilates exercises and keeps you coming back for the same good feeling every time you leave.
  4. Pilates instructors really know their stuff. A major requirement for instructors is that they know anatomy and have knowledge of injuries and medical conditions and how Pilates can help with each one. They look at the why behind each exercise and provide safe progressions for those who are ready by layering on their exercises, this means by starting with the basic foundations of the movements and adding on progressions so that everyone gets the work out they are looking for.
  5. Every class is a new experience. Pilates instructors strive to bring new innovative techniques to keep the classes fun, engaging and challenging while still keeping all the original concepts and principles. Awareness, breath, control and efficiency play a huge part in every exercise and while they keep things fun and new these are always the upmost focus of each class.



3 bladder habits you should break

Bladder control issues?  Here are three habits you should break.

By Andrea Trask, DPT OCS

You likely don’t pay much attention to your bladder habits and urinary pattern unless it’s causing you problems, such as during pregnancy, postpartum, or prostate disease (or you’re potty training a toddler, like I currently am!). Many people don’t realize that the bladder is controlled both by reflex and conscious regulation from the brain, and it includes both voluntary (skeletal) and involuntary (smooth) muscle. Thanks to this design, our bladder “learns” much in the same way the rest of our muscles do – and it can learn some less-than-ideal habits, too. Try to avoid these three common mistakes – and please, seek help from a trained pelvic floor physical therapist if you have concerns about urinary incontinence or other bladder symptoms!

  1. Going “just in case.”

We all do this sometimes, when you’re about to get in the car for a long road trip, heading into a big meeting and feeling nervous, or trying to beat the rush before a sporting event starts. But frequently emptying your bladder before it’s truly full teaches your body to “reset” its perception of fullness – and will leave you regularly rushing to empty a partially-full bladder. Try to wait until you truly have a sense of urge before you go.

  1. Hovering or squatting.

Everyone has likely had to go somewhere less than ideal, where you’d rather keep your bare skin as far as possible from the toilet seat. But regularly squatting or hovering over the seat instead of sitting on it makes it difficult to relax your pelvic floor muscles, which can contribute to dysfunction of the muscles, and potentially lead to pelvic pain. If it makes you feel better, a recent study found that the average cell phone has 10x more bacteria than an average toilet seat.

  1. Consuming nothing but bladder irritants.

You start with coffee in the morning, switch to sparkling water mid-day, and have a glass of wine in the evening. Did you know all three of these beverages – caffeine, carbonation, and alcohol – are known bladder irritants, and can give you the urge to go more frequently? If you are struggling with urge-type urinary incontinence (not “making it to the bathroom” in time before urine leakage), bladder irritants may contribute to your symptoms. Other potential irritants include artificial sweeteners, so you may want to consider that gum and sugar-free sweets, too.


Andrea Trask, DPT OCS