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Bladder or bowel control problems are common for men and women of all ages. Rushing to the toilet or ‘leaking’ when you cough, laugh or exercise is often caused by weak pelvic floor muscles. This summary explains how physiotherapy can help. 

What is incontinence?

Do you or someone you care for need treatment? 
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Urinary incontinence is a fairly common problem. It affects an estimated 20% of people over 40 years old.  Bowel incontinence is when you have an urgent need to empty your bowel, experience soiling or lose faeces from the bowel.

Incontinence can often be treated without drugs or surgery through exercises that improve the strength of your pelvic floor muscles.

File 118701

How can physiotherapy help?

The evidence

Read our evidence briefing:
File 118899Physiotherapy works: Urinary incontinence

One of the main causes of incontinence in both men and women is weak pelvic floor muscles. If your incontinence is due to a weak pelvic floor, try physiotherapy first to strengthen these muscles before considering an operation. Physiotherapy can help with both bladder and bowel incontinence.

Research has shown that pelvic floor muscle training is cheaper and more effective than one of the main incontinence drugs. Other research compared non-surgical treatments. This found that intensive pelvic floor muscle training, plus lifestyle changes, was the most effective method for treating urinary and bowel incontinence. 

Physiotherapists can:
  • teach you how to use your pelvic floor muscles correctly
  • show you exercises to strengthen them
  • look at how your diet may be affecting your bowel control
  • give you advice on what and how much to drink
  • discuss possible lifestyle changes which will help you manage the problem

Physios are the third largest health profession after doctors and nurses. They work in the NHS, in private practice, for charities and in the work-place, through occupational health schemes.

What will happen when I see a physiotherapist?

Your first session with a physiotherapist will include a detailed assessment, advice and possibly a physical treatment. Everything you tell the physiotherapist will be completely confidential.
To find out how your pelvic floor muscles are working, your physio will probably need to give you an internal examination.
Your physio will discuss this with you and the examination will only take place with your permission. You may have an escort or chaperone with you during this examination if you wish.
If you do have a physical examination, your physio will need you to remove some clothes and underwear, so it’s a good idea to dress comfortably.

How can I help myself?

The best way to help yourself is to make your pelvic floor muscles stronger by exercising them.
Drinking plenty of water, eating a healthy diet and avoiding too much alcohol and caffeine will also help.   This will all help your bladder and bowels work properly.

Top tips to help prevent incontinence

  • Follow the simple exercises in our free leaflets to strengthen your pelvic floor
  • Try to prepare for coughing, sneezing or any exertion such as getting up a chair by tightening your pelvic floor muscles first
  • When you finish using the toilet, lift your pelvic floor to empty the bladder fully
  • Try to drink 1.5 litres (3 pints) of fluid per day
  • Don’t drink too much alcohol as it can make you pass water more frequently
  • Avoid too much tea or coffee, as caffeine can affect how the bladder works
  • Eat a healthy diet to avoid constipation - straining to empty the bowel will weaken the pelvic floor muscles

Guidance and evidence for physiotherapy

Links and further information


The content on this page is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation. The CSP is not responsible for the content of any external sites, nor should selection be seen as an endorsement of them.


Last reviewed

13 June 2014
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