Specialist Women's Health Physiotherapy IN Ealing.

Continence Issues

Continence refers to the ability to control bladder and bowel function. When this control is lost, it can significantly impact quality of life, confidence and daily activities and is far more common in women than many realise.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles and ligaments that support the bladder, rectum and uterus, helping to control bladder and bowel function and allowing you to hold on until you are ready to void. When these muscles are poorly coordinated or overactive, the result can be frequent, urgent and uncontrollable bladder/bowel symptoms.

The Most Common Types Affecting Women

Stress urinary incontinence

Which is leakage during exercise, coughing or sneezing. 

Urge incontinence

Which is a sudden overwhelming need to urinate.

Mixed incontinence

Which can be a combination of both.

Bowel incontinence

This is the involuntary loss of bowel control that can occur and range from uncontrolled wind to complete evacuation issues.

Overactive bladder (OAB) and Urinary Frequency

This is one of the most common and disruptive continence conditions in women. It involves the overwhelming urge to urinate immediately, followed by loss of urine before reaching the bathroom. Even without leakage, urgency and urinary frequency can significantly interfere with work and social life due to the constant need to find the bathroom. Triggers for OAB can include running water, ‘key-in-the door’ syndrome, cold weather, anxiety and alcohol. Nocturia (waking at night to urinate) is also a common and disruptive symptom.

Why are women affected?

Pregnancy and childbirth can weaken the pelvic floor making women more susceptible to incontinence. Hormonal changes in menopause can cause pelvic floor weakness or exacerbate pre-existing issues. Despite being highly prevalent, incontinence remains widely underreported, with many women suffering in silence due to embarrassment or unawareness that effective treatment options exist.

How Physiotherapy Can Help

Physiotherapy can make a real difference for continence issues. Key strategies include:

The Benefits of Specialist Physiotherapy

Research consistently shows that supervised physiotherapy leads to significantly better continence outcomes compared to self-managed programmes alone. Your physiotherapist will assess your individual needs and build a personalised plan that works for you.

What to expect

Not sure what happens at an assessment for incontinence issues? You're not alone. Here's what to expect so you can arrive feeling informed and at ease.

Detailed Consultation

Your first appointment is focused on understanding your symptoms, medical history and how your condition affects your daily life. Your physiotherapist will create a welcoming, confidential environment and may ask you to complete a bladder diary to help identify patterns and guide your treatment.

Physical assessment

A physical assessment will be carried out, which may include an internal pelvic floor assessment - but only with your full consent.

Treatment plan

Your treatment plan will be tailored to your symptoms and goals, and may include pelvic floor exercises, bladder retraining, lifestyle advice and biofeedback guidance. Most women notice improvements within 6–12 weeks with regular treatment and home exercises. Everything discussed is completely confidential, and you’ll be supported in a safe, caring environment.

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Frequently Asked Questions

Is it normal to leak urine after having children?

While leaking urine is common it is not something you simply have to accept as a normal part of life. Many women suffer silently due to embarrassment or unawareness that effective treatment options exist, but with the right physiotherapy support, significant improvement is achievable for most women.

Yes. Research shows that patients who participated in supervised physiotherapy demonstrated significantly better continence outcomes compared with those following self-managed programmes. Most women see meaningful improvement with a consistent tailored programme.

Results vary depending on type and severity of incontinence, but most women begin to notice improvement within 6 to 12 weeks of consistent exercise and treatment.

Overactive bladder involves an overwhelming and immediate urge to urinate which can, but doesn’t always, result in leakage. Even without leakage, urgency and urinary frequency can significantly interfere with work and social life. It is a distinct condition but often treated with similar physiotherapy strategies.

Absolutely. Fluid intake, bowel habits and daily activity all play a role in continence. Bladder irritants such as caffeine, alcohol and carbonated drinks can worsen urgency and frequency. Your physiotherapist will provide personalised lifestyle advice as part of your treatment plan.

Book your Women’s Health Assessment today

Our Women’s Health Assessment will thoroughly address your continence concerns, identify the cause of your symptoms and provide the most appropriate treatment plan for you.