About Us










You feel it coming, but you can’t stop it; that twitch in your pelvic floor perfectly timed to your sudden cough or sneeze, or the confirmation you’ve pushed that pigeon pose a little too far. Stress Urinary Incontinence (SUI) – involuntary leakage that occurs with increases in intra-abdominal pressure – is one of the more frustrating and embarrassing hallmarks of womanhood, the inescapable tradeoff for motherhood or a satisfying workout.

As a women’s health professional, I’ve spent years dispelling that myth. You don’t need to put on your (specially designed) big girl panties and deal with it; pelvic floor therapy can help you vanquish incontinence. But the best experts can admit they don’t have all the answers. You may be surprised to learn something that has come up in more recent research about Stress Urinary Incontinence that I’m passing on to my patients (and to you):

A weak pelvic floor may not be the culprit!

For a long time, pelvic floor muscle training has been the recommended treatment for many forms of incontinence. There’s a good reason for that; many patients – including mine – see dramatic results. But this past year, during a larger study, a group of researchers in New England collected data that is changing the way physical therapists think about, and treat Stress Urinary Incontinence.

Not all the study participants had Stress Urinary Incontinence; and the researchers were expecting to see significantly weaker pelvic floor muscles in those who did. As it turns out, there was a difference in muscle strength and mobility between the two groups; but it was in their hips, not their pelvic floors. They even found limited evidence to suggest hip strength and flexibility may serve as a coping mechanism for women with pelvic floor weakness who don’t experience Stress Urinary Incontinence.

What does that mean for you? First, if you’re already on top of your pelvic floor health, good for you. It’s still central to bladder control; so keep doing what you’re doing.

Think Beyond Kegels

  • Prioritize hip stretches and strengthening exercises (and watch your form!)
  • Work your IT band (foam rollers are a big help-check out which ones I recommend here)
  • Avoid sitting for long periods of time (take regular breaks during work)

And if you suffer from Stress Urinary Incontinence, ask your medical professional to follow the researcher’s recommendation to broaden your examination and treatment to include your hips – especially if pelvic floor exercises alone aren’t helping.

And if you’re still just dealing with the stress of Stress Urinary Incontinence? Make an appointment with a Femina PT therapist today. Fortunately, our philosophy has always been to treat the whole patient; and we’ve included hip, low back and whole body assessment and treatment (when necessary) in our pelvic floor therapy from the beginning. We’re glad to know we’re ahead of the game this time; but we are constantly reviewing the latest medical research – including the follow up to this study – as part of our ongoing commitment to patient care.


Hartigan, E., McAuley, J-A., Lawrence, M., et al. Pelvic Floor Muscle Performance, Hip Mobility, and Hip Strength in Women With and Without Self-Reported Stress Urinary Incontinence. Journal Of Women’s Health Physical Therapy. 2019. 43:4 160-169.

User Rating: 5 / 5

Star ActiveStar ActiveStar ActiveStar ActiveStar Active

** This information is for educational purposes only and is not intended to replace the advice of your doctor. **

Products Related to This Topic

Soul Source Vaginal Dilators
Heal Pelvic Pain by Amy Stein, MPT
Healing Painful Sex by Debrah Coady, MD

What They Say About Us

  • Testimonials

    • Testimonial by S.H., age 24

      I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be. It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally...

      Read more Testimonial by S.H., age 24

  • Testimonials

    • Testimonial by J.B.

      My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have...

      Read more Testimonial by J.B.

Subscribe To Our Newsletter

Get access to our free downloads and a 15% discount on Heather's book "Sex Without Pain"!
I agree with the Terms and Conditions and the Privacy policy