Leaking with effort or impact
Small spurts with running, jumping, coughing, laughing or lifting, often worse when you're tired.
You leak when you cough, laugh, run, jump or lift. Some people also get a sudden urge they can’t delay. Leaking is a symptom with more than one possible source, and stress leaking and urgency leaking often overlap.
Stress leaking happens when pressure in the belly rises quickly. In that moment the pelvic floor has to respond and close at the right time. Tight or poorly coordinated muscles can miss that timing, even when they’re strong. Urgency leaking tends to involve a fast bladder signal from the nerves, sometimes with pelvic floor gripping on top. Breathing, bracing and hip muscles that tighten along with the pelvic floor also play a part.
I treat leaking mainly with dry needling, a form of acupuncture, and with electroacupuncture. The obturator internus can squeeze the pudendal nerve, and tight adductors in the inner thigh can press on the obturator nerve. Needling those muscles eases that pressure. For urges coming from the bladder’s own nerves, I use electroacupuncture. Fine needles near the sacral nerves that trigger bladder contraction carry a gentle current to help calm that signaling. The aim is better coordination and fewer surprises, alongside any exercise work you’re doing.
Most people have been told to do Kegels, and some have tried bladder medication or discussed surgery. Medication can calm urgency for some people but doesn’t change how the pelvic floor coordinates. Surgery suits selected cases and doesn’t address guarding or timing. If the pelvic floor is already tight, more strengthening can reinforce the same pattern. Pelvic floor PT is often the main care for leaking, but it can’t include needling here: New York keeps dry needling out of PT and chiropractic practice.
I ask what sets off leaking, whether urgency is part of it, and how training, coughing and stress affect it. Then the exam:
I work alongside pelvic floor PT, OB-GYN, urology and urogynecology on leaking. When a finding seems worth raising with one of them, I’ll say so and share the details.
Stress leaking follows a spike in pressure, like a cough, jump or lift. Urgency leaking follows a sudden urge that’s hard to delay, even when you’re still. Many people have both, so I map your triggers before deciding where to treat.
Not always. Some people leak because the pelvic floor can’t respond quickly under pressure, not because it’s weak. In others the muscles are already tight, and more strengthening can make urgency worse. Easing tension and restoring timing usually comes before building strength.
It can help when tight muscles and irritable nerves are part of the pattern. Needling the obturator internus and inner thigh muscles lowers their tone, which also frees up the pudendal and obturator nerves. Electroacupuncture at the sacral nerves aims to settle urgency. Mixed leaking often has more than one of these going on, so treatment is usually a blend.
Yes. PT is often essential for retraining and returning to activity. My work fits alongside it by treating tight muscle and nerve sources with needling. With your consent, I’ll share findings so your PT and I are working toward the same goals.
The usual goals are fewer leaks, better control of urges, and more confidence with exercise and daily life. Some people change quickly, while others need longer, especially with mixed patterns or postpartum changes. I can’t promise a specific result, and I’ll be honest with you about how you’re responding.
See a doctor promptly for blood in your urine, burning with urination, fever, or new severe pelvic pain. The same applies to rapidly worsening symptoms or new numbness or weakness. These can signal infection or other conditions that need medical testing.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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118 W. 72nd St, Rear Lobby, New York, NY 10023
Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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