One of the physical therapists that was my instructor for a clinical did a lot of work in women's health and sees a lot of people for stress incontinence. I can tell you what I do remember and you could also see a PT if you don't see improvement on your own. I am really interested in women's health and I'm so glad you asked about this because most women think it's 'normal' or they just have to put up with it and you don't!

So here are some things:
1) What is your caffeine/artificial sweetener intake like? Reduced caffeine intake is almost always a big suggestion. Also artificial sweeteners can be a trigger.

2) What is a 'kegel' like to you? Most women think they know but are often doing it wrong. It should be a drawing up feeling, not bearing down, and if you are comfortable with yourself I recommend that you use internal feedback to see if you are doing it right. Also, how are you doing your kegel exercises? Honestly doing too many can actually stimulate your bladder. 10 times once, maayyybeee twice a day is probably enough, and do more of an up & hold for 5 seconds not a little twitch. One way to do it is to sit on the edge of a chair and you will be able to feel your pelvic floor lift up off of the surface like an elevator rising.

3) My instructor made every patient do a drinks/bowel/bladder log, which sounded tedious to me, but it was very helpful for a lot of them. Some people respond well to starting with a bladder schedule and then over time extending the time between each scheduled pee break.

4) Additional exercises that will help train other pelvic floor muscles & related stabilizers
a)ADIM
Lay on your back with your knees bent up comfortable, feet around shoulder width apart. Place your fingers right above your pelvis ("hip bone") where it sticks out in the front. Says "Hisssss" - you should feel a small muscle contract. Practice until you can contract this muscle on purpose without any pelvic tilt. This is your transverse abdominis and it wraps around and keeps your core and pelvic floor stable. This should be active any time you lift weights etc to keep your pelvic in a neutral position.
Progression: When you can contract your TA voluntarily without saying "Hiss" and can hold it while breathing with the pelvic staying in neutral, progress. Drop one knee out slowly to your side - only take it until you lose the contraction or see your hips become tilted. Your pelvis will try to wobble so you really have to control it. Bring it back in, do the other leg. This is much harder than it sounds to do correctly so don't let your pelvic go all wobbly, that won't help you!

b)Obturator Internus & Externus (These muscles connect to:
v1 - Sit in a chair with your knees slightly closer than shoulder width apart. Tie an exercise band or a belt around your thighs near your knees. Press your thighs/knees out against the band, then slowly turn your toes out, and back to neutral.. 10x, 3 sets, 1-2x day
v2 - Sit in the same position. Put a small ball between your knees and squeeze to keep it there. Now slowly turn your toes in, then back to neutral. 10x, 3 sets, 1-2x day.

c) Mini squat with rotations
Perform a tiny squat- maybe 1/4 way to parallel. In that position, roll your knees inward (like you never ever want to do in a true squat lol), then rotate your hips clockwise and counterclockwise. Do it with feet in neutral, turned in, and turned out.


In general with having specifically stress incontinence, you have to re educate your muscles and these exercises will help most people. Obviously tho you know, everyone is different so if you don't see improvement definitely see a PT! Exercises are slightly different if you have urgency, high tone, etc etc.

There are a ton of other exercises if you google but I would start with these... Sorry it's a totally wall of text, just msg me if you want, too! I figured a lot of the ladies might want to know this stuff anyway.

I have *heard* that gloves hurt your grip strength more than they help because they increase the circumference of what you are gripping (so actually they make it harder to do, which probably gives you a better workout for your grip strength but means you'll actually start having grip issues at lighter weights). But I know some people just find gripping the bar very painful so if you need them, use them, and then if you eventually need to add straps, add straps.

Belts are a more complicated answer. Do you ever NEED one? No. Can you use one - yes, but I'd recommend you not use one until its specifically your core strength that is holding you back from progressing, and at that point I'd only use it on your heaviest sets (But you'll have to learn to use it first with lighter sets as it will affect your form somewhat). I'd also suggest you not use one until you've really learned all the other ways to manage your core, working on keeping it tight, practicing your partial valsalva (inflating your core with air and then holding it trapped there ot provide extra stability), etc.

Soos,
Glad you found it helpful! Please don't get your bladder tacked unless you have exhausted all other options... I've seen ppl get it up too high and end up with urgency/frequency instead of incontinence... it just scares me. Your crazy pelvic injuries could most definitely be a factor!!

Tameko - thanks for the insight on gloves, I never really understood why they say not to use them before.

Agree about belts... best thing for safety is core stability... you have a 'belt' built into your body already if you learn to use it! And I see a lot of people (read: bros) at the gym using belts who still have terrible body mechanics so it's apparently not really keeping you in place.

Really great post. Bump for reference