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Exercise to Support Bladder Health

Do you struggle with exercise for fear of not being in control of your bladder? Or have you been told that bladder leakage is "normal" and there is nothing you can do about it? The truth is that urinary issues are NOT NORMAL at any age and can be effectively treated and also prevented with the right exercise and breath control. The same exercises that help urinary dysfunction also help other problems such as back pain and pelvic girdle dysfunction which are typical conditions that coincide with bladder dysfunction.

Common bladder issues include:

- stopping at every bathroom or more than 8 trips in a 24-hour period (urinary frequency)

- the sudden and uncontrollable need to urinate (urgency),

- incomplete bladder emptying (urinary retention)

- involuntary loss of urine (urinary incontinence)

- waking in the middle of the night to void (nocturia).

- pelvic organ prolapse (organ descent of urethra, bladder, vagina or rectum).

There is evidence that doing Kegels, or pelvic floor exercises, can lower the risk of stress incontinence, which is the involuntary loss of urine with coughing, sneezing or exercise (Cochrane Review). However, exercise for the pelvic floor muscles should incorporate both lengthening and strengthening and can be part of your regular exercise program. Often the pelvic floor is tight and needs to attain its proper length before it can contract. To ensure the pelvic floor moves through its entire range of motion, therapeutic exercise that incorporates proper breathing along with deep core and hip strengthening is essential.

Breath control is one of the most important aspects of improve pelvic floor function. Lengthening of the pelvic floor occurs on the inhale as the pelvic floor descends like a hammock. Strengthening or contracting the pelvic floor occurs on the exhale as the diaphragm pulls the pelvic floor back inside the pelvis, making the pelvic floor hammock taut, like a trampoline (see diagram below). Breath holding from stress or habit does not allow the pelvic floor to move or function as it should. Pregnancy, child birth and/or adhesions from surgery, trauma/ falls or gut inflammation can disrupt pelvic floor function when the diaphragm is not able to move appropriately.

In addition, tension in the hips can disrupt pelvic floor function. The pelvic floor muscles act like a hammock and attach from the tailbone to the pubic bone front to back and to the obturator internus/ hip rotator muscles on each side (see photo below). Imagine pulling a hammock from both ends to lift a hammock. This is the same function that the hip rotators provide for the pelvic floor; to create a fascial lift from the sides. However, if one hip is tighter, the pelvic floor cannot contract properly and becomes dysfunctional. Hip range of motion and mobility is an important aspect of a pelvic floor evaluation. If the hips are tight, mobilization and instruction in exercise to improve hip mobility is essential for a healthy pelvic floor.

In addition to exercises that address pelvic floor and hip tension, there is evidence that general moderate exercise may lower the risk for urinary incontinence, most likely as a result of decreased weight on the pelvic floor. Modifying your workout until you have restored the pelvic floor to function may be necessary. A good pelvic floor therapist should be able to instruct you in appropriate exercise and modifications, whether you are doing Pilates, Boot Camp, yoga, weight training or any other fitness routine. See our BLOG on why crunches and sit-ups may not be the best core exercise and should be postponed if you have bladder issues.

If you or someone you know is struggling with bladder issues, request our FREE GUIDE, Three Steps to a Healthy Core by clicking here. Become empowered and stop covering up the problem with expensive pads and medications that come with unpleasant side effects. Strengthen your core, lose your belly pouch and do not celebrate that "pee happens" but rather kick incontinence to the curb!


Cochrane Data Syst. Review (2010), CD005654.

B. Engl J Med (2009). 360: 481.

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