Pelvic Floor Therapy for Urinary Incontinence in San Diego
Leaking isn't just a "mom thing." It's treatable.
You cross your legs before you sneeze. You skip the trampoline with your kids. You wear a pad "just in case." You've been told it's normal, especially after having babies.
It's common. But it's not something you have to live with.
Urinary incontinence affects millions of women, and pelvic floor physical therapy is the first-line treatment recommended by doctors and urogynecologists. I'm Dr. Ashlee Gendron, and I help women across North County San Diego stop leaking and get back to living without worrying about their bladder.
Types of Incontinence
Stress Incontinence
Leaking when you cough, sneeze, laugh, jump, run, or lift something heavy. This is the most common type I see, especially in postpartum women and active women.
Urge Incontinence
That sudden, overwhelming "I need to go NOW" feeling. Sometimes you don't make it to the bathroom in time. This often comes with going to the bathroom way more than you should need to.
Mixed Incontinence
A combination of both stress and urge. Many women deal with both.
Frequency and Urgency
Feeling like you always need to pee, even when your bladder isn't full. Running to the bathroom 10+ times a day. Planning your errands around bathroom locations.
More Than "Just Do Kegels"
Leaking is more often a coordination problem than a strength problem. If you leak when you cough, sneeze, or jump, the assumption is that the pelvic floor is weak. More often the pelvic floor is hypertonic (chronically tight), already constantly contracted, sitting above its baseline, unable to lengthen on the inhale or contract further when abdominal pressure spikes. That's not weak in the way most people think. It's stuck in the wrong position to respond. A common driver is shallow chest breathing, especially in patients with high-stress jobs, which keeps the diaphragm and pelvic floor from coordinating. Doing more kegels on top of that pattern usually makes the tension worse and the leaking more stubborn. I assess which way the dysfunction is running before prescribing anything.
Tells for a Tight (Hypertonic) Pelvic Floor
- Constipation
- Pelvic pain
- Pain with intercourse
- Recurrent UTIs
Tells for a Weak Pelvic Floor
- Urinary incontinence
- Pelvic organ prolapse
What a Real Kegel Looks Like
A kegel is a squeeze and a lift, all the way up like an elevator, because the pelvic floor controls both bowel and bladder. Most people who do them wrong only squeeze. There are also two fiber types involved: slow-twitch for endurance (the kind that holds continence while you run), and fast-twitch for the quick reflex that catches urine when you sneeze or cough. Training only one leaves a gap.
Full Assessment
Internal and external evaluation of your pelvic floor, core, hips, and breathing patterns. I figure out what's actually causing the leaking, not just treat the symptom.
Targeted Muscle Training
Strengthening what's weak, releasing what's tight, and retraining coordination so your pelvic floor responds when you need it to.
Bladder Retraining
For urgency and frequency issues, I help you retrain your bladder's habits so you're not running to the bathroom every 30 minutes.
Functional Training
We practice the things that cause you to leak, whether that's jumping, running, lifting your kids, or sneezing, so your body learns to manage pressure without losing control.
What to Expect
The initial evaluation is 90 minutes, one-on-one. I assess head to toe before I look at the pelvic floor, because the pelvic floor rarely fails in isolation.
Your Full Story
When the leaking started, what makes it worse, what you've already tried, and what you want to get back to doing.
External Assessment
I check posture, breathing patterns, the back, and the hips. Coordination problems often show up here before they show up in the pelvic floor itself.
Internal Exam (Optional, With Your Consent)
An internal pelvic floor exam is the most direct way to tell whether the muscles are tight, weak, or both. No speculum. One finger, to your tolerance. It should not be painful. I'm checking for muscle tension, tender points, weakness, and any signs of prolapse. If you would rather not, we work with what the external assessment shows.
Treatment, Same Visit
You leave with hands-on work done and a personalized plan, not a "come back next week and we'll start." Real progress begins day one.
You Don't Have to Plan Your Life Around Your Bladder
I see women who have been leaking for years. Some since their first pregnancy, some since menopause, some who never had kids at all. A lot of them leaked since their kids and never got help, until decades later when they realized it didn't have to be permanent. Almost all of them were told it was "just how it is."
It's not. Pelvic floor therapy works, and it works well. A typical course runs three to six months, depending on what's driving the leaking and what else is involved. Most patients notice meaningful change within the first few sessions, but the lasting work (retraining the coordination between breath, core, hips, and pelvic floor) takes time. It's worth it.
Incontinence Treatment Across North County
Available as a home visit anywhere in North County San Diego, in-clinic at Rancho Bernardo on Wednesdays and Fridays, or virtual.
See full service areas →Transparent Pricing
Initial evaluation $150-$200 (90 min) · Follow-up $125-$185 (60 min)
No immediate referral needed in California. I provide superbills for PPO insurance reimbursement.
See full pricing options →Urinary Incontinence FAQ
Yes. Pelvic floor physical therapy is the first-line treatment for urinary incontinence, recommended by the American Urological Association and the American College of Obstetricians and Gynecologists. Most patients notice meaningful improvement within the first several sessions, and a full course typically runs three to six months depending on what's driving the leaking.
That's one of the most common things I hear. Usually one of two reasons: your pelvic floor is too tight rather than too weak (in which case kegels make it tighter), or the kegel isn't being done correctly. A real kegel is a squeeze and a lift, all the way up like an elevator, because the pelvic floor controls both bowel and bladder. There are also two fiber types involved: slow-twitch for endurance like running, and fast-twitch for the quick reflex when you sneeze or cough. Training only one leaves a gap. I figure out which way the dysfunction is running before prescribing anything.
An internal exam is the most direct way to assess what your pelvic floor muscles are actually doing, but it's always optional and only with your consent. No speculum. One finger, to your tolerance. It should not be painful. I'm checking for muscle tension, tender points, weakness, and signs of prolapse. If you'd rather not, the external assessment still tells me a lot, and I can help you without one.
No. California is a direct-access state, so you can see me without a doctor's referral. I provide superbills for PPO insurance reimbursement. Most of my patients find me through word of mouth or referrals from holistic providers rather than through their OB, since in-network pelvic floor availability is hard to come by.
Medication can help with urgency, but overactive bladder isn't always the underlying problem, so jumping to it can miss what's actually driving the symptoms. I usually recommend trying pelvic floor therapy first. If you and your urologist decide medication is the right call, pelvic floor therapy can run alongside it. The two aren't mutually exclusive.
Not at all. I work with women who have been leaking for 5, 10, 20+ years. Your pelvic floor muscles can still be retrained. It's never too late to get help.
Ready to Stop Planning Your Life Around Your Bladder?
Start with a free 15-minute phone call. We'll talk through what's going on and whether pelvic floor therapy can help.