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Are you leaking power?

Updated: Nov 30, 2023

When a small sneeze turns into a big, embarrassing bladder leakage, activities like jumping rope are a big nope. Maybe it does not impact you personally, but the chances are high that you know many people who struggle with bladder leakage, also known as core dysfunction.

Statistics indicate that 25 million adult Americans suffer from incontinence, 75-80% of these individuals being women. With such an alarming percentage of adults impacted by incontinence, it is shocking that we avoid the topic of pelvic floor health. How familiar are you with your pelvic floor? Did you know that your core strength connects with your pelvic floor strength? Members of Align Athletics, Catherine Bragg and Amy Witt, recently sat down with Dr. Katelyn Bosch, a physical therapist that specializes in pelvic health, to get some of these questions answered.

Question: Who should be concerned about their pelvic health?

It’s a myth that only pregnant women or postpartum women need to be concerned with their pelvic floor. Everybody who has a pelvic floor could benefit from pelvic floor physical therapy. This includes kids experiencing bladder leakage or constipation, women and men in their 80s and 90s who are experiencing incontinence, or even an athletic soccer player that is experiencing hip pain.You don’t have to be pregnant or postpartum to experience issues. If you think something is wrong, contact a physical therapist.

Question: What is core dysfunction?

The core is made up of four primary muscle groups: transversus abdominis, pelvic floor muscles, spinal stabilizers, and the diaphragm. If one of these elements is not operating optimally, then an individual can experience core dysfunction. Core dysfunction can appear as back pain, pain with sex, bladder leakage, bowel dysfunction, abdominal pain, or diastasis recti.

Question: What are the primary causes of core dysfunction?

Core dysfunction is not gender specific. Athletic injuries and significant surgery can be significant factors that lead to core dysfunction. However, due to the shifts that women experience during pregnancy, childbirth, and postpartum, women are at higher risk of experiencing core dysfunction.

Question: If I wanted to strengthen my pelvic floor, what exercise would help me the most?

There is a misleading conception that, “If you just do your kegel exercises, then you’ll be okay.” However, if you are experiencing core dysfunction, you must first determine the underlying cause of the dysfunction. If you are experiencing leakage, the best thing that you can do for your body is to find a pelvic physical therapist that can teach you what is happening with your body. There is no cookie cutter exercise that will strengthen your pelvic floor. A good pelvic therapist will teach you physical movements that not only strengthen your deep core, but these movements will translate to more challenging lifts and exercises.

Question: As a pelvic floor therapist, what advice do you have for women?

Don’t delay treatment. As women, we are often caught up in taking care of others. It is easy to forget about our own self. Generally, women will delay necessary treatment whereas men are more likely to seek treatment immediately. It is important to take care of these issues now to avoid problems later.

Question: Who is the “ideal” candidate for pelvic floor therapy?

Just like with any rehabilitation program, a patient is going to be more successful if they are invested. Pelvic floor therapists can’t fix the problems of core dysfunction, but they can provide the necessary tools that improve the core function. Sometimes, physical therapists will also guide their patients to make lifestyle modifications, such as diet changes or water consumption goals, to improve physically. It takes two dedicated people - one that provides the tools and one that is invested in using the tools.

Question: Is leaking pee normal during a workout?

While it is common to see videos of women leaking during a heavy lift, it is not normal. Things are not coordinating the way that they need to be if an athlete is leaking during a workout. I like to teach my patients that if you are leaking pee, you are also leaking power. If athletes want to accomplish personal goals, pelvic floor physical therapy is necessary to teach the athlete how to progress the pelvic floor and increase their physical strength.

Question: Can you address the concerns that patients have about seeing a physical floor therapist?

Many people do not reach out due to limited funds, insurance, time, and space. Research shows that women can spend up to $58,000 in a lifetime for products related to pelvic floor dysfunction (i.e. incontinence pads). While it may require a time and financial commitment to receive therapy, it is an inexpensive cost that improves core function, decreases anxiety, and increases confidence. Additionally, some therapists can meet you at home. When I am working with patients, the first session is 1.5-2 hours long and follow up sessions are an hour long. This allows for faster recovery and fewer sessions. Payment plans are also a flexible payment plan option for patients.


Overall, as Dr. Katelyn Bosch explained, good health is a choice to invest in yourself. This includes your physical health, mental health, and even pelvic floor health. Seeking help is important. If you are experiencing an issue, do not normalize it and settle for anything less than the best version of yourself. Invest in yourself and embrace your power.


Katelyn is a local to the Lynchburg, VA area. She received her Bachelor of Science in Health Promotion: Clinical with a minor in Chemistry from Liberty University in 2012. She went on to earn her Doctorate in Physical Therapy from Lynchburg College in 2015.

She has a passion for assisting women in all phases of life whether not pregnant, pregnant, or postpartum in order to return to function, exercise, and work without pain or pelvic floor dysfunction. Her goal is to leave patients feeling empowered, educated, and equipped.


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