Urinary Incontinence Physiotherapy

Leaking urine is common, but it is not something you simply have to accept. Whether you notice leakage when you cough, sneeze, or exercise, or you feel a sudden, urgent need to get to the bathroom that is hard to control, pelvic floor physiotherapy offers an effective, non-invasive path to improvement for most types of urinary incontinence.

At InHealth Physiotherapy in Etobicoke, pelvic health care is led by Manisha Hansra, a physiotherapist specializing in pelvic floor rehab and women's health.

Understanding Urinary Incontinence

Urinary incontinence means any unintended loss of urine. It is more common than most people realize, affecting people of all ages, genders, and life stages and it is often under-reported because many people assume it is simply something to manage rather than treat.

The most common types include

• Stress incontinence: leakage triggered by physical exertion, coughing, sneezing, laughing, or lifting. It occurs when increased abdominal pressure exceeds what the pelvic floor and urethral sphincter can manage.

• Urge incontinence: a sudden, strong urge to urinate that is difficult to defer, often followed by leaking before reaching the bathroom. It is associated with an overactive bladder.

• Mixed incontinence: a combination of stress and urge incontinence, which is the most common presentation in women.

• Overflow incontinence:  incomplete bladder emptying that leads to dribbling or frequent small leaks.

Urinary incontinence can be related to pregnancy, childbirth (vaginal or caesarean), hormonal changes around menopause, pelvic organ prolapse, previous pelvic surgery, chronic constipation, or habitual bladder patterns that have developed over time.

How Pelvic Floor Physiotherapy Can Help

The pelvic floor is a group of muscles, ligaments, and connective tissue that supports the bladder, bowel, and uterus and plays a central role in continence. When the pelvic floor is too weak, too tight, poorly coordinated, or responding to increased pressure in a disorganized way, the result is often incontinence.

Pelvic floor physiotherapy at InHealth addresses the specific underlying pattern, not just symptoms. We do this through:

• Pelvic floor assessment: an internal and external assessment to evaluate the strength, tone, coordination, and endurance of the pelvic floor muscles, as well as how the surrounding structures are contributing (all internal assessments are fully optional and guided by your comfort)

• Pelvic floor muscle training: a personalized strengthening and coordination program; for stress incontinence, this is one of the most evidence-supported interventions available

• Bladder retraining: structured strategies to improve bladder control and reduce urgency for urge incontinence and overactive bladder

• Biofeedback: using real-time muscle feedback to help you find, activate, and coordinate your pelvic floor muscles more effectively

• Breathing and pressure management strategies: addressing how you manage intra-abdominal pressure during daily movement and exercise

• Lifestyle and bladder habit guidance: practical advice on fluid intake, bladder habits, and factors that are driving or worsening symptoms

• Pessary guidance and pelvic organ prolapse management: where prolapse is contributing to incontinence.