Pelvic Floor and Incontinence Tips for the Ladies

Greetings from The Recycling Occupational Therapist! Now that I am a senior citizen ( 67 years young), I occasionally share aging related tips. This topic may especially interest my female followers and/or any therapist, friend or loved one who has challenges with urinary incontinence.  I found the following tips to be life altering for myself and hopefully, you will also...

I am sharing my personal story and nothing I write should be construed as advice, nor even correct. My expertise is in the areas of child development, developmental disabilities and sensory processing disorders. Check out my books!

I learned a lot about my anatomy and physiology from physical therapist, Dr. Amanda Olson who specializes in restoring the pelvic floor.


What is the Pelvic Floor?

According to Dr. Olson,

  • the pelvic floor muscles are a group of three distinct layers of muscles at the base of the pelvic girdle.
  • These muscles support the pelvic organs, rectum, uterus and bladder.
  • The terminal openings of these organs pass through, and in females result in the three sphincteric openings of the anus, vagina and urethra.

While there are many common pelvic floor issues that impact women of all ages, this post focuses on urinary incontinence in older women.

Urinary Challenges

Pelvic floor muscles may be too tight from chronically clenching them- they become tight, shortened and contribute to urinary urgency or  leakage. I have experienced  all of the following and am happy to report that the techniques taught in Dr. Olson's book have tremendously helped!

Urinary urgency is that feeling that you need the bathroom even when you don't or only end up producing a tiny amount of urine when trying to empty the bladder.

Stress urinary incontinence is a term that describes urinary leakage while coughing, laughing, sneezing or during physical activity. I have a friend who always makes me laugh and now I take proper precautions to make sure my bladder is empty when interacting with him.

Coital Urinary Incontinence is a term for urinary leakage during sex .

Incomplete bladder emptying- Rushing and tensing muscles during urination may contribute to incomplete bladder emptying.

How to Effectively Empty the Bladder

  1. Try to take your time!
  2. Sit on the toilet with chest open, shoulders relaxed and abdominal muscles activated for deep breathing.
  3. Inhale slowly, deeply through the nose.
  4. Exhale slowly through the mouth.
  5. Repeat 3-4 times until bladder is empty.

This process may sound too simple to be blogging about! However, I discovered that these simply steps enable me to completely empty my bladder.  I very seldom have any leakage and do not need to use the bathroom as frequently.

Breathing and Kegals 

A Kegal is simply a contraction of the pelvic floor muscles.

Kegals may be performed while in a variety of positions including sitting, supine with knees bent and even while standing. I have learned to perform Kegals while performing some Pilates exercises such as the one shown below and even while swimming. Options include using a cushion beneath my back or between my knees.

Dr. Olson describes the importance of proper breathing. NEVER HOLD YOUR BREATH...

Holding your breath will place pressure on the bladder and pelvic floor, thus making it difficult to contract your muscles properly. The breathing pattern for this exercise is to inhale and remain relaxed, then exhale as if you were cooling down hot food. Tighten the pelvic floor muscles during the exhale. In the above photo I simultaneoulsy  did a Kegal contraction and pressed my knees together while exhaling....

According to Dr. Olson, "research suggests that 80 Kegels per day are necessary to strengthen the pelvic floor and to keep women dry."  I try to do Kegals throughout the day - sometimes while engaging in movement or simply sitting in the car pretending to be listening to the driver.....

While I chose to focus this post on urinary leakage and Kegals, Dr. Olson also discusses in her book topics including

  • Use of vaginal weights and other interesting devices
  • how to train your bladder to decrease urinary frequency and/or urgency
  • how to avoid bladder irritants such as spicy foods
  • Impact of chronic conditions such as obesity, constipation or prolonged periods of heavy coughing that can cause pelvic organ prolapse (a condition when one or more of your pelvic organs presses into the walls of your vagina).
  • Impact of and treatment for  abdominal surgical scars .
  • Constipation
  • Pelvic pain
  • How to practice diaphramatic  or belly breathing
  • Body scanning for body awareness
  • Resources to find a pelvic physical therapist

Here are a few other health blog posts for older folks:

Here are a few other outdoor stretching tips:

and Tips for Hypermobility and Back Pain

Adult Outdoor Exercise Equipment


Learn about Dr. Olson's products, videos, support and more at her website


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