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Is Leaking with Exercise REALLY Normal?

Leaking with activities like running, jumping, or lifting (also referred to as stress urinary incontinence or athletic incontinence) affects many people- whether they have been pregnant or not. Studies show that 48.5% of adolescent females and 41% of pregnant people struggle with stress urinary incontinence. While this data shows leaking with exercise is common, it is certainly not normal.

Many athletes feel as if this isn't an issue, and use diapers or pads to absorb any leakage or "just in case" pee before a workout with triggering movements. However, leaking with exercise is the result of a movement fault, similar to shoulder pain with pull ups or knee pain with squats. Leaking with exercise reflects a loss of tension in your brace, as your brace should include pelvic floor muscles for a full 360 degree brace. As most lifters understand, a loss of tension in your brace can result in some pretty significant injuries, which is why it is important to fix.

What Causes Leaking with Exercise?

Leaking with exercise comes down to 3 different factors: coordination, timing, and strength.

Are you aware of what your pelvic floor is doing? Try this now: take a seat and bring your attention to how your pelvic floor moves with a deep inhale, then with a slow exhale. You should have felt your pelvic floor drop with the inhale and rise with the exhale. Take this awareness and try the movement that provokes your leaking- does it feel like your pelvic floor drops? That is likely why you are leaking with that exercise. Try pulling your pelvic floor up during that exercise to see if it helps. Having trouble conceptualizing a pelvic floor contraction? Think about trying to stop a stream of urine- that will fire the right muscles.

Are you contracting the pelvic floor during the right part of your symptomatic movement? Can you perform a quick contraction if needed? Timing your pelvic floor contraction to when you have symptoms (at the bottom of a squat, as you land from a jump) can help reduce leaking. The pelvic floor should automatically do this, but when you are struggling with pelvic floor dysfunction, the muscles may not fire automatically. The good news? The muscles can be retrained to fire automatically with practice.

If your pelvic floor is not strong enough to match the stress placed on it or it doesn't have the endurance to hold for the time your body requires, the coordination and timing won't help. Kegals are often thought of at the only way to strengthen the pelvic floor, but performing it while under load (like doing a barbell squat) is a great way to improve that strength functionally for when you are leaking.

How Do I Know What My Issue Is?

It is very difficult to assess which of these factors is causing your specific issues on your own, which is why we recommend getting an assessment from a pelvic floor physical therapist. This way you can get dialed in on the right track as soon as possible.

Interested in a pelvic floor assessment? Click this link and book with Dr. Sam to start getting better today.
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