How to Stop Peeing When Exercising
You lace up your shoes for a run or you start your favourite HIIT class and before you know it, you are second guessing your choice on coloured leggings because you’re leaking urine with every impact.
You might laugh with your friends saying “well I’ve had kids, of course I have a weak pelvic floor!”
Or you are mortified because you haven’t had a kid yet and you are dealing with bladder leaks.
Why is this happening?
Stress incontinence is incredibly common in both postpartum individuals and athletes who have never had babies. Over 50% of female athletes in high impact sports (those with running and jumping) have reported bladder leaks during sport.[1]
In this blog post you will learn specific ways on how to stop peeing when exercising so you can stay dry during your favourite workout.
Why am I Leaking?
Before we jump into ways to stay dry when you exercise, let’s take a look at why stress incontinence might be happening in the first place.
Finding the root cause of why you have stress incontinence can be very helpful in figuring out what you specifically need to get rid of this pesky pelvic floor symptom.
Our bodies are sometimes more complex than an A + B = C situation.
The list below are some possible reasons on why bladder leaks happen but it’s not exhaustive and please keep in mind it doesn’t add in the nuance and context for each individual person.
The Pelvic Floor
The pelvic floor has a big job to do. These muscles act as an active sphincter to keep the pee in, which means that the muscles provide tension around the urethra so that the pee doesn’t escape when you aren’t ready for it.
There are a few reasons why the pelvic floor can be contributing to why you are peeing when you exercise.
1.The pelvic floor might be weak:
Pelvic floor strengthening exercises can help increase the strength of the squeeze to provide the right amount of tension needed to keep the pee in.
If you are truly weak, kegels can help!
But hold on, sometimes we think we might be weak and in fact we are not… read on.
2.The pelvic floor might be overactive or too tight:
This might seem a bit counter-intuitive because if you are leaking, you’re probably squeezing those muscles tight trying to keep the pee in. That’s a lot of tension.
However, muscles need to go through a relax/contract cycle in order to produce the right amount of tension that you need.
Sometimes, people hold too much tension in the pelvic floor muscles. Instead of having a nice supple, flexible group of muscles, it’s more like a rigid system. Those muscles never get a chance to relax.
We don’t want to be too rigid!
We want flexibility so we can absorb the force and impact of exercise.
I love to compare this to how a hammock works. Think about how a hammock responds to someone getting into it. The hammock gives under the weight of the human. And if it’s anchored well, it doesn’t buckle under the weight.
The pelvic floor has to do the same thing. It has to provide dynamic support which means it will lengthen or give a little (like a hammock) but still provide some tension for core stability AND continence, therefore keeping pee in.
The pelvic floor can’t be too tight because it needs to shock absorb impact by being flexible and strong like a hammock.
3.Muscle coordination:
The pelvic floor, just like other muscles, needs to be coordinated in order to have a good response.
These muscles are anticipatory, which means that the signal from the brain anticipates how much response is needed in each scenario. Then it sends that signal to the muscles AHEAD of the actual movement. This all happens (or should) without you consciously thinking about it.
Coordination can sometimes be off because of a few things like pain, surgery, pregnancy, delivery of a baby or a traumatic event.
When this happens, pelvic floor exercises can work on how to reconnect that fast automatic response.
The Surrounding Muscles
We love good neighbours and the muscles that surround the pelvic floor need to be just that.
There is a direct connection between hip strength and the pelvic floor function. [2] Meaning that if you are able to strengthen the muscles around the hip, they will help support the pelvic floor.
Think of it as sharing the load.
If the pelvic floor is spending all its effort on managing core stability, it might be maxed out and can’t also keep you dry.
So if we tap into some strength around the core to help the pelvic floor out, you might see a change and can exercise without peeing.
Your Movement Strategy
Sometimes, it’s the way you are using your body to manage the load and impact of exercise.
Our body is good at getting the job done. If you want to jump, run or lift, you can usually figure out a way to do it.
But the strategy that you choose is influenced by a number of things like full body coordination, strength and conditioning, skill acquisition and your body mechanics or form.
Sometimes the most automatic way we do things isn’t always our best option or the most efficient and can lead to peeing when exercising.
Other things that can influence how we manage load & impact are things like:
Pregnancy
Postpartum recovery
General deconditioning or reduced overall physical fitness
Sports injuries
When these events happen, we need to gradually re-expose you to the demands of the load and impact so that your body can adapt and learn to tolerate things without pelvic floor symptoms.
Ok so now what…how can we fix the problem? How can we learn how to stop peeing when exercising?
How to Stop Peeing When Exercising
1. Learn to connect with your pelvic floor
Learning how to connect with your pelvic floor is an excellent first step.
Try this:
Start in either 4 point kneeling or in the yoga pose, Balasana (child’s pose).
Imagine that you have a flower right at your vaginal opening.
Take a breath in and visualize that flower opening up and blooming.
When you exhale, imagine that flower closing.
Pay attention to what you feel in the pelvic area. It can be quite subtle but as you practice, you may notice a change in tension.
This is pelvic floor awareness and it can be a great spot to start regardless of if you need to do pelvic floor strengthening, or the opposite: learn how to lengthen and relax your pelvic floor to reduce overall tightness.
2. Try stacking your rib cage right over your pelvis
One thing I see often is an upright position that actually brings your ribs farther behind your pelvis. Resist the urge to follow your mom’s advice of “shoulders back and stand up straight!”
Instead try stacking your rib cage right over your pelvis, or shoulders over toes.
This can feel like a forward lean for some people. It’s creating a different position for your pelvic floor and core to work in and can sometimes reduce how much force the pelvic floor needs to work against.
3. Breathe!
A breath hold is one way for people to feel strong and stable. It has its time and place during exercise but isn’t the best strategy for every single thing.
If you are leaking, try keeping a steady rhythm of breathing so that you aren’t also creating tension from a breath hold that your pelvic floor needs to manage.
You can go a step further and try to time an exhale during the hard part of a lift or when landing.
There is no “right way” to breathe. Play around with patterns to see how it influences your symptoms.
4. Get strong!
Getting strong does take time. Having a full body strengthening routine that incorporates hip and core muscles will create a situation where the pelvic floor has some help.
It’s important to work in a variety of different positions to make sure you are strong through a bunch of different ranges as the muscle goes through the lengthen/shorten cycle.
5. Change the demand
As you work away at some of the above strategies, a quick little fix can be to change the vertical load in some exercises.
For example:
If you leak during jumping jacks, try leaning on a chair instead of being in a standing position.
If you are leaking while running, try running on an incline or uphill.
These small changes can help reduce the forces through the pelvis ultimately allowing the pelvic floor to not work as hard.
Pairing this strategy together with a different breathing pattern or more awareness of your pelvic floor connection (as stated above) can help train the pelvic floor muscles.
6. Consult a pelvic health physiotherapist
As stated at the beginning, these above tips don’t replace individual context and nuance.
If you have resources available to you, going to pelvic floor physiotherapy can be very beneficial to provide long term solutions on how to stop peeing when exercising.
At HerSport Physio, we are incredibly passionate about helping athletes stay active through all phases of life and are thrilled to help many athletes of all abilities. If you are experiencing any symptoms with exercise or sport, we are here to help!
Want to learn more pelvic health things? Check out The Ultimate Pelvic Health Guide for Athletes.
[1] Thyssen HH, Clevin L, Olesen S, Lose G. Urinary incontinence in elite female athletes and dancers. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):15-7. doi: 10.1007/s001920200003. PMID: 11999199.
[2] Foster SN et al. Hip and Pelvic Floor Muscle Strength in Women with and without Urgency and Frequency Predominant Lower Urinary Tract Symptoms. J Womens Health Phys Therap. 2021 Jul-Sep;45(3):126-134. doi: 10.1097/jwh.0000000000000209. PMID: 34366727; PMCID: PMC8345818.