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Bladder Leakage & Urinary Incontinence

Bladder leakage is common. It's also highly treatable.

If you cross your legs before you sneeze, plan runs around bathrooms, or keep a pad in every bag just in case, this page is for you.

Leaking with coughing, laughing, running, or jumping is a muscle and pressure-control problem, not an inevitable part of motherhood or aging. Our doctors of physical therapy specialize exclusively in pelvic health. We find why your bladder control is failing, then treat that specific cause. No surgery or medication in the vast majority of cases.

Book a Pelvic Floor Evaluation Take the 2-minute symptom quiz
A Vitality pelvic health doctor of physical therapy guiding a patient through resistance band exercise in the Tulsa clinic gym
What patients tell us
"I just didn't bounce back. I've never really bounced back."
Doctors of physical therapy, specialized in pelvic health
One full hour, one-on-one, every visit
The same provider from evaluation to discharge
500+ five-star reviews across the Vitality clinics
"I thought it was just normal."
Symptoms became part of daily life
"I kept waiting to bounce back."
Postpartum recovery felt incomplete
"I plan around sneezing and jumping."
Leakage changed normal choices
"I want to feel like myself again."
Comfort, strength, and confidence
Patient-language themes drawn from Vitality reviews and intake research. If any of these sound like you, you are in the right place, and none of it is something you have to live with.

Why leaking happens

Your bladder is controlled by a system: the pelvic floor muscles, the deep core, your breathing pattern, and how your body manages pressure when you move. Leaking means part of that system isn't doing its job. The cause differs from person to person.

Cause 01

A weakened pelvic floor

Most common after pregnancy and birth, and with the hormonal changes of perimenopause and menopause. The muscles simply can't generate enough force at the moment a sneeze or a jump demands it.

Cause 02

An overactive pelvic floor

Muscles held so tight, so constantly, that they have nothing left when you need them. This is far more common than most people expect, and it's why the standard advice fails so often.

Cause 03

Pressure mismanagement

The way you brace, breathe, or lift can route force straight down onto the bladder. Strong muscles still leak when the pressure system above them is working against them.

An OB visit or an annual physical isn't designed to evaluate any of this. A pelvic floor evaluation is.

If Kegels didn't work, you didn't fail. The diagnosis did.

Kegels strengthen the pelvic floor. But if your pelvic floor is overactive, meaning tight, guarded, and already working overtime, more squeezing can make leaking worse.

This is the most frequent pattern we see in patients who arrive after months of doing everything "right." The first step is finding out which problem you actually have. Then treatment is straightforward.

Prescribing Kegels without an exam is like prescribing glasses without checking your eyes. Sometimes it helps. Often it's the wrong lens entirely.
A pelvic health physical therapist guiding a patient through single-leg balance work with a resistance band

What a pelvic floor evaluation looks like

1

Your full history, heard in full

A one-hour, one-on-one appointment with a doctor of physical therapy, the same one at every visit. We ask about births, surgeries, training, symptoms, and what you want back.

2

A thorough, consent-based exam

We assess your breathing, core, hips, and pelvic floor function. Internal assessment is the most precise tool we have. It is always explained first, always optional, and external alternatives are available.

3

An explanation and a plan

You leave knowing what's causing the leaking, what we'll do about it, and a personalized home program in our app so progress continues between visits.

What treatment changes

  • Running without a pad, and without mapping the bathrooms first
  • Sneezing, laughing, and jumping without bracing for it
  • Sleeping through the night without urgency waking you
  • Trampolines, jump rope, and box jumps back on the table
★★★★★

"Urinary leakage has been an issue since I gave birth 20 years ago and I just accepted it as my lot in life. I'm now back to running and jumping without leakage. I'm so glad I invested in my body."

Sherylyn Y. · Google review

Read more patient stories →

A smiling patient with her Vitality pelvic health physical therapist in a treatment room

Specialists, not generalists

Pelvic health isn't a service line we added. It's the entire clinic. Your care comes from doctors of physical therapy with specialized pelvic floor training.

TS

Tristen Swengle

PT, DPT · Director of Pelvic Health

Leads the pelvic health practice and has guided hundreds of Tulsa women through leakage, postpartum recovery, and prolapse care.

NR

Nikki Randolph

PT, DPT · Pelvic Health Specialist

Treats the full range of pelvic floor conditions with a consent-first, whole-body approach.

DW

Deena Winham

PT, DPT, PCES · Pelvic Floor Specialist

Certified pregnancy and postpartum corrective exercise specialist focused on returning moms to the activity they love.

One more thing no other Tulsa clinic offers: Vitality also houses orthopedic physical therapy and functional medicine. If your leaking connects to hip pain or hormonal changes, your providers share one chart, and they actually talk to each other.

Questions people ask before they book

Do I need a referral from my doctor?
No. Oklahoma allows you to see a physical therapist directly, so you can book an evaluation without a referral.
Is the exam internal?
Only with your consent, and only when it's useful. Internal assessment gives us the most precise picture of your pelvic floor, but an external-only evaluation is always an option, and nothing happens without being explained first.
How many visits will I need?
It depends on the cause, which is exactly what the evaluation determines. You'll get an honest estimate at your first visit. Our goal is your independence, not indefinite appointments.
What does it cost? Do you take insurance?
We're a cash-pay practice. HSA and FSA cards are accepted, and we provide superbills you can submit to your insurance. This model is what allows a full hour with the same doctor at every visit instead of 15 rushed minutes with a rotating cast.
I've had this for years. Is it too late?
No. We regularly treat leakage that started decades ago. Muscles respond to the right training at any age, and so does the pressure system around them.

Find out what's actually causing it

One evaluation. A clear explanation. A plan built for your body and your goals.

Book a Pelvic Floor Evaluation

91st & Sheridan · Tulsa, OK