Can Hip Strengthening Help Bladder Leaks?What the Trials Compared

A hip-strengthening video may promise to help bladder leaks by working the muscles around the pelvis. Before adopting the routine, check whether the study behind it tested hip exercises alone or added them to pelvic floor treatment.

That distinction runs through the research. The studies below evaluated combinations, with different amounts of supervision, equipment and exercise time. They do not establish that a few unsupervised leg exercises replace a pelvic floor assessment.

The first comparison favored only one of two diaries

A Brazilian trial published in 2020 randomized 47 women with stress urinary incontinence; 43 completed. Both groups received pelvic floor training for 20 sessions over ten weeks. One group also trained the gluteal and hip adductor muscles. Sessions lasted approximately 40 minutes without the hip work and 60 minutes with it.¹

The ongoing diary, recording leaks between treatment sessions, favored the combined programme. However, the three-day diary, quality-of-life questionnaires and pelvic floor strength assessments did not show significant between-group advantages. The trial therefore did not find the same benefit across its measures.¹

The study excluded dropouts from its final evaluation and had no later follow-up. Its groups also received different amounts of supervision.¹

A July 2026 trial found a pressure-measured strength benefit

The newer trial recruited 60 women aged 30–65 with stress or mixed incontinence; 55 completed. It compared six weeks of supervised, biofeedback-assisted pelvic floor training with the same training plus either hip rotator exercises or intravaginal electrical stimulation.²

The hip group had the greatest improvement in pressure-measured pelvic floor strength. The reported difference against pelvic floor training alone was 4.44 cm H₂O. Added-treatment groups’ advantages on the Oxford muscle grading scale and incontinence quality-of-life questionnaire were not statistically significant.²

The accessible publisher abstract identifies strength, grading and electrical muscle activity as primary outcomes. It does not supply a diary-based reduction in leak episodes that can be substituted for the pressure finding. A stronger reading is useful information, but it does not by itself quantify how much drier daily life became.²

Postpartum combination treatment asks a narrower question

A separate 2026 report randomized 142 postpartum patients, 71 per group, to pelvic floor training plus biofeedback electrical stimulation, with or without hip training. Its abstract reports better symptom and strength outcomes with the added hip programme.³

This is evidence about an addition to a particular postpartum treatment package. It does not compare hip exercises with no treatment, or establish the same benefit after menopause. The abstract’s “total efficacy rate” should not be presented as a percentage of women becoming completely dry without checking its full definition.³

The complete methods of these two newer reports were not available for this article. Their abstracts cannot supply an individualized exercise prescription or establish long-term durability.

An app study changed more than the hip exercises

The 2025 report examined records from 113 women, including 55 receiving conventional pelvic floor training and 58 receiving app-based pelvic floor training combined with hip work. This was a retrospective study, with groups determined by the treatment received.⁴

The combination group had better reported symptoms, pad-test outcomes and adherence. However, it also received a different delivery method. The study cannot isolate the contribution of hip exercises from the app, differences in participation or other differences between the groups.⁴

It is a reason to investigate a programme further, rather than proof that its hip component caused the improvement.

The broader review did not find a consistent extra quality-of-life benefit

The 2024 Cochrane⁵ review compared approaches to pelvic floor muscle training. Across seven trials involving 482 women, adding indirect exercises to direct pelvic floor training may have made little or no difference to incontinence-related quality of life. The evidence was low certainty.⁵

“Indirect” covered several exercise approaches, including resisted hip movement; it was not a pooled result for one standardized hip routine. The review distinguished these additions from deliberately contracting the pelvic floor during another body movement.⁵

Its searches ran through September 2023, so it cannot adjudicate the later trials. It supplies context for why a promising individual result still needs confirmation and why exercise categories should be kept distinct.⁵

Make any addition serve your treatment goal

UK NICE⁶ guidance recommends at least three months of supervised pelvic floor training for stress or mixed urinary incontinence. Supervision should assess both contraction and relaxation and tailor training to ability, discomfort and individual needs. It also recommends a review during the programme and another at its end.⁶

Use that assessment to discuss whether hip exercises have a purpose in your plan. Ask which muscles need training, how much extra time the programme requires and what result would justify continuing it. Pain, difficulty relaxing or an exercise that worsens symptoms needs discussion before adding repetitions.

Choose an outcome you can compare: leak episodes during walks, cough-related leaks, pad use or interruption of an activity. Keep muscle readings alongside those observations so an improved test does not obscure symptoms that remain troublesome.

Chapter 5, “The Squeeze You Can’t See,” in Laugh, Sneeze, Jump separates finding, checking and training a pelvic floor contraction. Bring that distinction to an exercise consultation: first establish what you can contract and relax, then decide whether another exercise belongs in the programme.