4 Pelvic Floor Exercises for Incontinence That Stop Bladder Leaks Fast—No Kegels Needed
Find out why focusing on your toes (yes, really!) is so important
Key Takeaways
- Bladder leaks are common, especially during menopause, but you don't have to live them
- Targeted exercises can help your pelvic floor respond better to pressure and reduce leaks
- Simple daily moves can improve strength, coordination and bladder control over time
A belly laugh with your best friend. A sneeze that catches you off guard. A quick jog to catch the bus. These everyday moments should bring joy, not worry about bladder leaks. Here’s the good news: Exercise isn’t just for building muscle or protecting your bones as you age. There are targeted moves that can strengthen your pelvic floor and stop bladder leaks for good. Just like you’d work your core or your glutes, your pelvic floor deserves the same attention—and the results can be life-changing. We asked leading pelvic floor experts to share the best pelvic floor exercises for incontinence you can start today.
What causes urinary incontinence?
“Bladder leaks, or urinary incontinence, are something many women experience but few talk about,” says Samantha Pulliam, MD, FACOG, urogynecologist and CEO & Chief Medical Officer at Axena Health. “Simply put, it’s the involuntary loss of urine: that unexpected trickle when you laugh, sneeze, cough or rush to the bathroom and don’t quite make it in time. Some women experience leaks during exercise. Others feel a sudden, urgent need to go that they can’t always control. And for many, it’s a combination of both.”
Dr. Pulliam says bladder leaks happen when the tissues and muscles that support the bladder, like the pelvic floor muscles at the base of the pelvis, are not working how they should.
Woman's World Answers
She adds several other risk factors include:
- Pregnancy and childbirth, as vaginal delivery can significantly strain the pelvic floor muscles and nerves
- Aging, due to natural muscle tone decreasing throughout the body, including the pelvic floor
- Hormonal changes, like menopause, including the decline of estrogen
“Nearly 46 percent of women experience bladder leakage during menopause,” explains Dr. Pulliam. “Estrogen is a hormone that does far more than regulate your cycle. It plays a critical role in maintaining the strength, elasticity and thickness of the tissues lining the bladder, urethra and pelvic floor muscles. As estrogen levels decline during perimenopause and menopause, those tissues begin to thin and weaken, resulting in less support for the bladder and a pelvic floor that’s working harder.” (Learn more about the types of urinary incontinence.)
4 pelvic floor exercises for incontinence
Pelvic floor muscle training can dramatically improve your quality of life by reducing incontinence symptoms. We asked two leading physical therapy experts—Milica McDowell, DPT, a musculoskeletal physical therapist focused on active women, and Caroline Packard, DPT, a pelvic floor physical therapist and yoga instructor—to share the most effective exercises for stopping bladder leaks.
360 breathing
“I start almost everyone in the same place: learning how to breathe and learning how to fully lengthen the pelvic floor first,” says Packard, noting the muscles need to move and relax before strengthening. This exercise helps your core and pelvic floor work together, she explains.
How to do it: Sit or lie comfortably with your hands on your ribs. Keep your jaw relaxed and your tongue resting on the roof of your mouth. Inhale through your nose, feeling your ribs expand all around, then exhale slowly as they come back down. As you get used to it, find your pelvic floor, letting it gently drop and soften on the inhale, she adds.
How often: Five slow breaths, three times per session. Repeat three times a day, she recommends.
Why it helps: Packard says this move helps the pelvic floor relax and start moving properly again. Since many women hold tension in this area, that tightness can make it harder for the muscles to respond when pressure hits, which can lead to leaks, she notes.
90/90 hip switches
This floor-based move helps improve hip mobility by taking each hip through internal and external rotation, which supports better movement around the pelvis, explains McDowell.
How to do it: Start seated on the floor with one leg bent in front of you and the other behind, both at roughly 90-degree angles. While keeping your sit bones grounded, your chest should stay lifted. From there, slowly rotate your hips to switch sides so your legs reverse positions. Move with control as you alternate sides, she says.
How often: Alternate sides for 10 total switches, completing one to two sets daily, McDowell recommends.
Why it helps: Limited hip mobility can shift the pelvis out of alignment, which affects how the pelvic floor muscles function, McDowell explains. Improving hip rotation helps the pelvis stay in a more neutral position, allowing those muscles to work the way they’re meant to and better support bladder control, she adds.
Ball squeeze + core activation
This move combines a gentle squeeze with breathing to help the inner thighs, core and pelvic floor work together to help control incontinence, explains Packard.
How to do it: Start on your back with your knees bent and feet planted on the floor, holding a small ball, pillow or rolled towel between your knees. As you breathe in, allow your ribcage to open up while your pelvic floor softens. As you breathe out, lightly press your knees inward and engage through your lower core as the pelvic floor lifts. Reset and fully release before the next rep, she adds.
How often: Complete five to 10 slow reps, twice per session, Packard recommends.
Why it helps: This exercise trains the pelvic floor to work in sync with the core and inner thighs rather than on its own. Packard says that kind of coordination helps the body respond better to pressure, like during a cough or movement, so the muscles don’t over-grip or react too late, which can reduce leaks.
Toe yoga
This targeted move activates the small stabilizing muscles in the feet that help support your arch and control how force travels up the body, explains McDowell.
How to do it: Sit with your bare feet flat on the floor, working up to trying it standing over time. Start by lifting just your big toe while keeping the other four down, then switch by planting the big toe and lifting the others. Alternate between the two, building up to about 10 reps each. Note: It’s normal if it feels difficult at first or if one foot is easier than the other.
How often: Practice daily for a few minutes, McDowell recommends.
Why it helps: McDowell explains that strengthening the feet supports pelvic floor function from the ground up. She says the muscles in the feet are connected to those in the pelvis through fascia and movement patterns, so improving foot strength can help the pelvic floor respond better, making this an often-overlooked way to reduce bladder leaks.
The bottom line on pelvic floor exercises for incontinence
Bladder leaks don’t have to steal your joy or hold you back from the moments you love most. With these simple, expert-backed exercises, you can strengthen your pelvic floor, regain control and get back to laughing, moving and living without worry.
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