The Role of Pelvic Floor Exercises in Managing Stress Urinary Incontinence

Tedi BeznaPelvic Floor Health Leave a Comment

Women around the world share the experience of urine leakage when they laugh, cough or do physical activity. 

This condition is known as stress urinary incontinence and is not limited to women. However, incontinence or loss of bladder controls affects twice as many women as men. This could be due to the fact women go through pregnancy, childbirth, and menopause, all of which make urinary incontinence more likely. It’s not a normal part of aging, and it can be treated.1

Stress urinary incontinence or SUI is the loss of control during an activity. SUI causes urine to be released without control because of increased pressure on the bladder. As a result, it often happens when a woman coughs, sneezes, or laughs, or during physical activity.2

Women with incontinence often suffer in silence, so it’s believed that SUI is under-reported and underdiagnosed. It impacts social and work life, with worries about being too far from a bathroom, or suffering an embarrassing leak while out in public.

What can be done about stress urinary incontinence? Pelvic floor exercises are a non-invasive, proven and effective way to manage stress urinary incontinence.

Stress Urinary Incontinence is a Common Condition

Stress incontinence is the most common type of urinary incontinence, creating leaks of urine during physical exertion—during exercise, coughing, laughing and sneezing, to name a few. 

The underlying cause is a sudden pressure on the bladder and urethra, causing the sphincter muscle inside the urethra to briefly open, allowing urine to come out. As a result, any activity—even as simple as bending over—may squeeze the bladder.3

Here are the risk factors that can lead to stress urinary incontinence:3

  • Pregnancy and childbirth (particularly vaginal birth).
  • Menopause.
  • Nerve injuries to the pelvis or lower back.
  • Obesity.
  • Pelvic surgery, such as a hysterectomy.
  • Chronic coughing.
  • Diabetes.
  • Uterine prolapse.

Some studies have shown a connection between stress incontinence and the number of pregnancies, age and obesity, as well as having a substantial impact on all aspects of quality of life measurements.4 

For instance, one study reported that among women with urinary incontinence, 30% reported moderate or severe symptoms, which were more common among older than younger women. In addition, 24% of women with urinary incontinence reported that the condition affected their daily activities.5

It’s believed that as many as 1 in 3 women will experience stress urinary incontinence at some point, and that it impacts up to half of women over age 65. But stress urinary incontinence is not a normal part of aging. It can get better with appropriate treatment.3

Why the Pelvic Floor Matters

A strong pelvic floor can help treat stress urinary incontinence. These muscles and ligaments form a hammock-like structure, spanning the bottom of the pelvis and supporting the pelvic organs—a woman’s bladder, bowel, and uterus.6

The pelvic floor also plays a role in voiding and enjoyment of sex. Contraction of the pelvic muscles lifts the internal organs and tightens the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows the proper passage of urine and feces. Voluntary contractions of the pelvic floor also contribute to sexual sensation and arousal, and provide support for a baby during pregnancy.6

The Role of Pelvic Floor Exercises in Managing Stress Urinary Incontinence

When those important pelvic floor muscles are weakened—such as after a vaginal birth—they can create issues for women, such as problems with bladder control.6

Here’s why.

When the bladder fills, the muscles around the urethra—the tube that urine passes through—should be tight. Exercises that strengthen these muscles can help prevent leakage. These pelvic floor exercises are commonly called “Kegel” exercises, named after the doctor who developed them. By toning and strengthening the pelvic floor muscles, these exercises can help prevent and treat urinary incontinence.2 

For instance, one study showed that a dedicated program of Kegel exercises before resistance training improved average pelvic floor muscle strength and was effective in reducing stress urinary incontinence among incontinent women.7 

Here are more research results:

  • An improvement of stress urinary incontinence symptoms in middle-aged women who did Kegel exercises which included objectively verified data. The results consistently showed the reinforcement of pelvic muscles and verified that Kegel exercises are indeed a safe method of intervention.8
  • A study concluded that home-based Kegel exercises, with no supervision, were effective in women with stress urinary incontinence and mixed urinary incontinence—which combines stress leaks with frequent urges to use the restroom. The improvement was more prominent in women with stress urinary incontinence.9
  • A study divided women into an exercise group and a control group. Pretreatment, 8-week and 6-month evaluations revealed that urinary incontinence “statistically and significantly” decreased in the treatment group compared to the control group. As well, a significant increase in pelvic floor strength was observed in the treatment group compared to the control group upon all evaluations.10
  • Another study recommended using supervised biofeedback to reduce stress urinary incontinence, as it was more effective than “unsupervised” Kegel exercises.11 In this case, women can work with a pelvic floor physical therapist.

Research seems clear, then, that pelvic floor exercises commonly known as Kegels help keep pelvic floor muscles “fit.” In fact, they can be performed as a preventive measure, or as treatment for women already suffering with stress urinary incontinence. In the same way that strengthening other muscles in the body boosts well being, Kegels provide benefits for the pelvic floor. 

Kegels are a way to keep the pelvic floor muscles strong, providing better control over the bladder and bowels, and preventing pelvic muscles from getting weak. They are also proven effective as a treatment for the weak pelvic floor muscles that can bring on stress urinary incontinence symptoms.

These exercises are performed by lifting the pelvic floor muscles, holding them, and then relaxing them. It’s recommended that women do a few Kegels at a time, gradually increasing both the length of time and the number of Kegels in each session.11

It’s important to do pelvic floor exercises correctly, which means finding the muscles and contracting them properly. Performing the contractions should not hurt—and should not cause pain in the stomach or lower back or head. Women who have trouble finding the pelvic floor muscles or who experience pain and discomfort performing them, should reach out to a healthcare provider for help.

Those doing Kegels correctly should notice symptoms gradually improving over several weeks.11

One option to properly train the pelvic floor muscles and non-invasively treat incontinence is with the INNOVO Urinary Incontinence Kit. This product—cleared by the FDA—is a pair of “smart shorts” designed to strengthen the pelvic floor muscles from the inside out. The kit enables women to perform 180 perfect Kegels in 30 minutes. 

A clinical study guided by the FDA had amazing results: 87% of women were defined as dry after just 12 weeks, and 90% of users would recommend the therapy to others.


Stress urinary incontinence has a major impact on the quality of life for many women. The condition may actually be underreported, as many women experience fear, shame, and avoidance of social activities.13 

Instead, communication and shared decision-making with health care providers are vital to developing a treatment plan, which can include pelvic floor exercises. If the condition is more severe, there are also surgical options, such as Caldera Medical’s variety of slings for treating incontinence.

Women’s Pelvic Health issues in general are often not talked about due to embarrassment or lack of knowledge, leading women to believe they are alone with their condition. Whether you’re a woman suffering from stress urinary incontinence or you’re treating someone with this condition, it’s important to remember that you’re not the only one. Don’t go through this journey alone. 

There’s plenty of support, guidance and treatment options, including minimally invasive treatments offered by Caldera Medical, to help women regain confidence and live life to the fullest.

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