Blog: I Laughed So Hard that Tears Ran Down My Leg.


Kim Johnson, MPT

If you find the title of this rings even slightly true for yourself or someone you know, then physical therapy with a pelvic specialist would be beneficial. A therapist that specializes in the pelvic floor can work with a variety of diagnoses and conditions including: pelvic pain, post-surgical care (post-prostatectomy, post-hysterectomy to name a few), pregnancy and post-partum, and by far the most widespread condition we treat is urinary incontinence.

Incontinence can present itself in a variety of ways, for example, “I only leak when I cough, laugh, or sneeze” or “I just can’t seem to get in the house fast enough when I get home.” The most common types of incontinence are stress, urge or a mix of both.

Stress Incontinence relates to physical stressors which can cause leakage. Stressors include but are not limited to: coughing, laughing, sneezing, lifting, running, changing position, and squatting down. Often times with stress incontinence there is a small volume loss of urine. Stress incontinence is typically a product of pelvic floor muscle weakness or motor dysfunction, and can be treated very successfully with conservative physical therapy.

Urge incontinence occurs when you have a very strong and immediate urge to urinate. Essentially the bladder contracts at the wrong time. Typically with urge incontinence there is a large volume of urine lost, compared to stress incontinence. Treating urge incontinence sometimes requires a combination of strengthening, soft tissue work, habit retraining, and possibly medication intervention..

Many people actually suffer from a mix of both stress and urge incontinence. Your physical therapist will work to provide a thorough physical therapy diagnosis of each individual’s situation, and together with the patient will develop a customized treatment plan based on that patient’s case. The treatment can include strengthening, bladder retraining, manual therapy, breathing work, relaxation, dietary recommendations, and biofeedback. What a person is eating and drinking can play a huge role in continence. For example, caffeine is a bladder irritant. Sometimes just removing most caffeine from a diet can calm the bladder and allow a person to sleep through the night instead of being woken multiple times to urinate. Often time people don’t consume enough water through the day and that also can cause issues. Water will dilute urine, making it less irritating to the bladder wall. This can reduce frequency, urgency and urine leakage.

Time and time again I have had people say that their leakage is “normal.” I would disagree; incontinence is common but definitely not “normal.” Just because you have had a baby or are over the age of 65 does not mean that you should have to deal with incontinence. So many men and women live their lives around their incontinence, and it does not have to be so. Therapy is a non-surgical option, which can be very helpful and liberating. Please seek out one of our Pelvic Floor therapists if you, or someone that you know, is suffering with incontinence.

For more information visit our site at