Updated: Jul 29, 2021
Ladies - you should NOT be leaking pee when you run or exercise! No, it is not something you have to "deal with" because you have had a baby! For that matter, you should also not have feelings of "heaviness" in your pelvis, pain anywhere, worsening diastasis recti (abdominal separation) or any other symptoms that feel "off".
The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as "involuntary leakage on effort or exertion, or on sneezing or coughing". (Bø K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med. 2004;34(7):451-64. doi: 10.2165/00007256-200434070-00004. PMID: 15233598.) The majority of studies show that the average prevalence of urinary incontinence across all sports is 50%, with stress urinary incontinence being the most common. Athletes are constantly subject to repeated sudden increases in intra-abdominal pressure that their bodies have to control. Some examples of this are heel striking, jumping, landing, thrusting, and swinging a bat or racquet.
The reason why running and jumping increases the chances of stress incontinence is because of the increased impact that goes through our pelvic floor and inner core, the repetitive loading, and considerable rises in intra-abdominal pressure due to the load. The system has to be functioning optimally to be able to absorb the shock, stabilize the quick movement, and then transfer it back into energy to be able to push off the ground.
Leaking pee when you run, even just dribbles, is a sign that the pressure control system in your body is off. This includes your inner core and pelvic floor. Other symptoms that may indicate a pressure control problem are diastasis recti, hernia, prolapse, hip pain, low back pain, pelvic pain, reflux.....and the list can go on because this is truly the center of your body and contributes to your strength and stability!
BUT, it's not about just doing more kegels to solve the problem. Your pelvic floor/inner core can be weak, that's true. But it can also be too tight (or tight and weak), it could have lost some of it's ability to go through a full range of motion due to scar tissue or tension, or it could be strong but uncoordinated. Your breathing patterns may be off. There can also be a stability issue in your hips or ankles that is contributing. The point is, there are many factors that can be contributing to your body sprouting leaks, so it's important to get evaluated and discover your movement blind spots. Awareness can go a long way!
Look back at this blog for a reminder of what the muscle systems "down there" look like:
As for the awareness piece......running form also makes a big difference. There are things you can do to reduce pressure and the demand on the system, thereby giving it a better chance for success. Check out the video below that discusses one of the most common compensations I see in women who have had a baby (even if it was years ago):
The good news is these concepts actually can improve your running performance! It gives you some of your core and power back :)
Sometimes little shifts can make a big difference! If you want to explore this in your own body and make your running symptom-free and more efficient give me a call! Contact me for a free phone consultation!