Bladder Health Tips from a Pelvic Floor Therapist

Bladder health isn’t usually a topic people talk about openly (but we do as pelvic floor therapists!) Leaks, urgency, and discomfort are much more common than most people realize. In fact, about 1 in 3 women will experience urinary incontinence at some point in their lives. As a pelvic floor physical therapist, we see two main types of bladder leakage: stress incontinence and urge incontinence. While they may sound similar, they have different causes and require different strategies.

Stress Incontinence: Leaks with Pressure

Stress incontinence happens when urine leaks during activities that put pressure on the bladder—like coughing, sneezing, laughing, jumping, or exercising. It’s especially common after childbirth or during menopause when pelvic floor muscles and connective tissues lose some strength and support.

When the pelvic floor muscles aren’t strong enough or can’t respond quickly enough, they can’t counteract the pressure from the abdomen, and the bladder and urethra don’t stay closed.

What you can do:

• Practice pelvic floor strengthening (Kegels, but taught correctly—many people overuse or do them wrong).

• Work on coordination: quick squeezes can help prepare your muscles for sudden pressure (like before a sneeze).

• Exhale with effort: breathing out during a lift, jump, or crunch helps reduce downward pressure on the bladder.

• See a pelvic floor therapist:
  Every pelvic floor is different, and not all leakage is due to “weakness.” Sometimes the issue is poor timing, too much muscle tension, or even scar tissue from childbirth or surgery. A pelvic floor therapist can assess how your muscles are really functioning and create a program that retrains strength, coordination, and breathing—so you can confidently move, laugh, and exercise without worrying about leaks.

Urge Incontinence: The “Can’t Get There in Time” Leaks

Urge incontinence, sometimes called “overactive bladder,” is when you feel a sudden, strong urge to pee and can’t make it to the bathroom in time. You may also notice triggers—like hearing running water, unlocking your front door, or even just thinking about the toilet.

This usually isn’t about weakness—it’s about bladder signaling. The bladder muscle (detrusor) contracts too soon or too strongly, sending false alarms that it’s time to empty—even if it’s not full. Stress, hydration habits, bladder irritants (like caffeine, alcohol, or carbonated drinks), and pelvic floor dysfunction can all play a role.

What you can do:

• Try urge suppression strategies: when the urge hits, pause, take slow breaths, do 5–10 quick pelvic floor squeezes, and wait for the urge to calm before walking to the bathroom.

• Keep a bladder diary to track fluid intake, bathroom trips, and triggers.

• Limit bladder irritants like caffeine, artificial sweeteners, and alcohol.

• Avoid “just in case” peeing—this can train your bladder to signal urgency before it’s really necessary.

• See a pelvic floor therapist:
  With urge incontinence, it’s not just about the bladder—it’s about how the pelvic floor, core, and nervous system all communicate. A pelvic floor therapist can teach you how to retrain your bladder through relaxation techniques, urge suppression strategies, and proper muscle activation. This guidance helps calm an “overactive” bladder, so you’re back in control rather than rushing to the bathroom.

General Bladder Health Tips for Everyone

Hydrate Smartly

Many women try to drink less water to avoid leaks, but this can actually backfire. When you’re dehydrated, your urine becomes more concentrated, which can irritate the bladder lining and increase urgency or discomfort. On the other hand, drinking excessive amounts of water can overwhelm the bladder and lead to more frequent trips. Aiming for 6–8 cups per day is a good balance, adjusting based on your activity level and climate.

Don’t Strain to Pee

Straining, pushing, or bearing down on the toilet may feel like it helps you “go faster,” but it actually puts unnecessary pressure on the bladder, urethra, and pelvic floor. Over time, this pressure can weaken the tissues that support your bladder and even increase the risk of prolapse. Instead, focus on relaxing and letting the bladder do the work. Taking a few deep breaths and leaning slightly forward can help your pelvic floor release naturally.

Sit, Don’t Hover

Many women hover over public toilets to avoid touching the seat, but hovering keeps your pelvic floor in a semi-contracted state. This prevents the bladder from fully emptying, leaving residual urine behind. Incomplete emptying increases the risk of urgency, leakage, and even urinary tract infections. Whenever possible, sit fully supported on the toilet so your muscles can relax and your bladder can empty completely.

Go Every 2–4 Hours

A healthy bladder typically needs to be emptied every 2–4 hours during the day. Going too often can train your bladder to signal urgency prematurely, while waiting too long can overstretch the bladder muscle and weaken its ability to contract effectively. Paying attention to your body’s cues and establishing a rhythm helps maintain normal bladder capacity and healthy signaling between the bladder and brain.

Breathe Through Effort

Whether you’re lifting a heavy box, carrying groceries, or working out, how you breathe matters. Holding your breath or straining increases pressure inside the abdomen, which pushes down on the bladder and pelvic floor. Over time, this can worsen leakage or pelvic floor weakness. Try to exhale during effort (for example, breathing out as you lift) to protect your pelvic floor and keep pressure balanced.

Keep Your Bowels Regular

Your bladder and bowels share the same pelvic space, which means constipation directly affects bladder health. Straining to pass stool increases pressure on the pelvic floor and bladder, while a backed-up bowel can compress the bladder, making urgency or leakage worse. To keep things regular, aim for a diet rich in fiber, drink enough water, and move your body daily. Good bowel habits help protect both the bladder and pelvic floor.

The Bottom Line

Bladder leaks are common, but they are not inevitable—and they are treatable. Whether you experience stress incontinence, urge incontinence, or just want to keep your pelvic floor healthy, small changes in how you move, hydrate, and care for your body make a big difference.

If you’re struggling with leakage or urgency, pelvic floor physical therapy can give you tailored tools and guidance to get your bladder back under control.