Urinary Incontinence Physiotherapy in Clapham

Urinary incontinence covers a range of symptoms, from leaks during exercise, coughing or sneezing to sudden urges and frequent or urgent trips to the toilet. There are three main types.

Stress incontinence

Stress incontinence is leaking when pressure on your bladder rises suddenly: when you cough, sneeze, laugh, lift, jump or run. It usually happens because the pelvic floor muscles and the tissues supporting the urethra aren’t providing enough support at the right moment. It’s the most common type after pregnancy and birth, and in women who do high-impact exercise.

Urge incontinence and overactive bladder

Urge incontinence is a sudden, strong need to pass urine that’s hard to put off, sometimes with leaking before you reach the toilet. It often comes with overactive bladder symptoms such as going more often than usual, waking at night to wee, or “key in the door” urgency. Treatment focuses on retraining the bladder and calming the urge, alongside pelvic floor work.

Mixed incontinence

Many women have elements of both: leaking when they cough, plus urgency. This is called mixed incontinence. Your assessment will work out which symptoms are driving the problem most, so treatment tackles those first.

Incontinence can develop for many reasons, and often more than one is involved.

Incontinence after birth

Pregnancy and vaginal delivery put a lot of strain on the pelvic floor, and leaking in the weeks after birth is very common. If it’s still happening at your six-week check or beyond, postnatal physiotherapy can help, whether your baby is three months or ten years old. It’s never too late to get your pelvic floor assessed.

Perimenopause and menopause

Falling oestrogen levels affect the tissues of the bladder, urethra and pelvic floor. Many women notice new leaking, urgency or more frequent trips to the toilet during perimenopause and menopause. A targeted pelvic floor programme can make a significant difference, and Olivia can advise when it may help to talk to your GP about other options alongside physiotherapy.

Leaking during running and exercise

Leaking during running, jumping, skipping or lifting is common, even among very fit women. It’s a sign your pelvic floor isn’t coping with the load, not a reason to stop exercising. Treatment builds strength, timing and endurance so you can return to the activity you love with confidence.

Gynaecological conditions

Some gynaecological conditions, such as pelvic organ prolapse, can also affect how the pelvic floor and bladder work. Olivia will take these into account during your assessment.

Pelvic floor physiotherapy is the recommended first treatment for most types of incontinence. With a personalised, evidence-based approach, Olivia will help you understand what’s behind your symptoms, regain bladder control and get back to life with confidence.

Your plan is tailored to you, but may include:

• Pelvic floor muscle training: a progressive programme to build strength, endurance and the reflex “knack” of tightening before you cough or lift
• Bladder retraining: gradually extending the time between toilet trips to reduce urgency and frequency
• Urge suppression techniques: practical strategies to calm a sudden urge
• Lifestyle and habit advice: fluids, caffeine, constipation and toileting habits that affect the bladder
• Return to exercise: a graded plan for running, gym or sport

Your first appointment lasts 60 minutes and takes place in a private, judgement-free room at our Clapham clinic. Olivia will:

• Talk through your symptoms, bladder habits, pregnancies, medical history and goals
• Assess your posture, breathing and core
• With your consent, carry out an internal examination to assess your pelvic floor’s strength, endurance, coordination and ability to relax. This is the gold standard for pelvic floor assessment, but it’s always optional and fully explained beforehand
• Explain what she has found and agree a treatment plan with you

You may be asked to fill in a short bladder diary before or after your first visit. It’s one of the most useful tools for understanding urgency and frequency.

NICE guidance recommends at least three months of supervised pelvic floor muscle training as the first treatment for stress and mixed incontinence, and bladder training for at least six weeks for urgency. Many women notice changes within the first few weeks, but muscles take time to strengthen, so sticking with your programme matters. Most women have a series of follow-up appointments spread out over this period, and Olivia will review your progress at each one.

Physiotherapy is safe to start straight away for most women. Speak to your GP if you have blood in your urine, pain when passing urine, recurrent urine infections, difficulty emptying your bladder, or a sudden change in your symptoms with no obvious cause. Olivia will also refer you on if anything in your assessment needs medical review.