Pelvic Floor Symptom
Stress and Urinary Incontinence
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
You leak when you cough, sneeze, laugh, jump or lift. Or the urge comes so fast you do not make it in time. You may have been told to do Kegels, and maybe they did not help. Leaking is not always about weakness. A pelvic floor that is too tight or poorly coordinated can leak too, and the right treatment depends on which you have.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Urinary Incontinence
Stress incontinence is leaking with pressure: coughing, sneezing, laughing, jumping, running or lifting. Urge incontinence is leaking with a sudden strong urge. Many people have both, called mixed incontinence. It is common after childbirth, around menopause, after prostate surgery, and in high-impact athletes.
The pelvic floor needs to contract quickly and strongly at the right moment to prevent leaks. Weak muscles are one reason it fails. Just as often, the muscles are tight and fatigued. A pelvic floor that is always partly contracted has no reserve left to tighten further when you cough or jump, and it tires quickly. Trigger points can also slow its response. Tight pelvic floors also drive urgency, adding urge leaks.
A 2026 review in the journal Medicina by Barber and Biancaniello brought this research together. It proposes that trigger points in the pelvic floor send a steady stream of signals into the nervous system that can be felt as urgency, frequency or bladder discomfort, and it recommends checking the pelvic floor in people with these symptoms. Read the review.
Dr. Gordon assesses whether your pelvic floor is weak, tight, or both, releases tension and trigger points where needed, and coordinates with your pelvic floor PT for strengthening and timing.
Urinary Incontinence at a Glance
Types
Stress (with pressure), urge (with sudden urge), or mixed
Who it affects
Women after childbirth and around menopause, men after prostate surgery, athletes
Common triggers
Coughing, sneezing, laughing, jumping, running, lifting, sudden urges
Why Kegels may not help
A tight, fatigued pelvic floor needs to relax before it can strengthen
Main drivers
Weakness, tension and fatigue, poor timing, urgency from pelvic floor tone
The Gap in Care
What Tests Check, and What They Can Miss
Incontinence is usually treated as weakness. When the pelvic floor is tight or poorly timed, strengthening alone often fails.
What routine testing is looking for
- Infection
- Prolapse
- Prostate surgery effects
- Nerve conditions
What often keeps symptoms going
- A tight, fatigued pelvic floor with no reserve
- Trigger points that slow muscle response
- Poor timing between breath, core and pelvic floor
- Urgency from pelvic floor tone
- Breath holding and bracing during exercise
These are assessed with a direct pelvic floor exam, which is how Dr. Gordon determines the right approach.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Leaking with cough or sneeze
Small leaks with sudden pressure.
Leaking with exercise
Leaks during running, jumping or lifting.
Leaking with urgency
Not reaching the bathroom in time.
Leaking after urination
Dribbling after you finish, common in men.
Frequent trips to prevent leaks
Going often just in case.
Pelvic heaviness
A feeling of pressure or heaviness, sometimes with prolapse.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Weakness
Muscles that are weak or slow cannot close the urethra quickly enough.
Tension and fatigue
Tight muscles tire quickly and have no reserve to contract further.
Poor timing
The pelvic floor needs to contract just before pressure. Poor timing lets leaks through.
Urgency
Pelvic floor tension intensifies urge signals and leads to urge leaks.
Your First Visit
How Dr. Gordon Evaluates Urinary Incontinence
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your physician's findings, imaging, medications and past treatments so he knows what has been ruled out and what has already been tried.
Core and breathing assessment
Dr. Gordon looks at how breathing, core and pelvic floor work together under pressure.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Leak pattern review
Dr. Gordon reviews when you leak, how much, and what activities trigger it.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or stool
- Sudden, severe pelvic or abdominal pain
- Unexplained weight loss
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for urinary incontinence, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases tight, fatigued pelvic floor muscles and trigger points so they can respond quickly and strengthen effectively. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along sacral nerve pathways to support bladder control and reduce urgency.
See servicesBetween visits
Strength Plan & Team Coordination
Coordinated strengthening and timing work with your pelvic floor PT once tension is addressed.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"I had never done acupuncture and was very nervous to try it out. Dr. G eased my nerves as soon as I walked in by thoroughly explaining the process and answering all of my questions. He is really concerned about your health and genuinely wants to help you feel better."
Kaitlin Erikson, Google Review
Urinary Incontinence Questions
Answers About Urinary Incontinence
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
If your pelvic floor is weak, yes, with guidance. If it is tight, Kegels may make things worse. Dr. Gordon assesses first.
It is common, and it is treatable.
Yes, especially after prostate surgery. Pelvic floor care is a key part of recovery.
Yes. High-impact athletes commonly leak, often from a tight or poorly timed pelvic floor.
Most people need six to twelve sessions along with a strengthening program.
Many people improve with conservative care. Your physician can discuss surgical options if needed.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For urinary incontinence, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the internal pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped, and nothing internal is done without your clear consent. You can pause or stop at any time.
Yes. Urinary incontinence can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Stress and Urinary Incontinence
Book a full evaluation with Dr. Gordon and find out whether your pelvic floor is weak, tight or both.
Early morning, evening and weekend appointments available. Free on-site parking.
Further Reading
Pain After Prostate Surgery: The Pelvic Floor Side of Recovery
From the blog: Leaking gets most of the attention after prostate surgery, but pelvic pain can happen too. Why the pelvic floor can tighten, and how muscle care fits with PT.
Leaking When You Cough, Laugh or Run: Stress Incontinence Explained
From the blog: Leaking with a cough, laugh or run is stress incontinence. Why it happens, what works first, and why Kegels alone do not help everyone who leaks.