By. Dr. Amy Medlock

As a pelvic floor physical therapist and woman, I have experienced firsthand the embarrassment, frustration, and anxiety of urinary incontinence, or peeing during exercise. Unfortunately, this is an all-too-common problem that affects women of all ages and fitness levels. In fact, studies have shown that up to 80% of female athletes experience some degree of urinary incontinence with exercise. This is a concerning statistic, as peeing during exercise can be embarrassing, uncomfortable, and even lead to decreased participation in physical activity.

Why do women pee during exercise?

So why do some women pee during exercise? One of the main reasons is due to the increased pressure on the pelvic floor that occurs during high-impact activities such as running or jumping. If your pelvic floor muscles are overactive, they do not adequately contract and relax with repetitive activities such as running and jumping. Consequently, as the bladder moves up and down during these activities, instead of being supported by the suspension system of the pelvic floor muscles, it hits a proverbial brick wall of muscle, causing leakage. Conversely, if your pelvic floor muscles are under-active and weak, they may not be adequately supporting the pelvic girdle and bladder, leading to increased risk of pelvic organ prolapse, and urinary and/or fecal incontinence.

Pelvic floor therapy can address peeing during exercise.

The good news is that there are a variety of pelvic floor therapy interventions that can help prevent and treat peeing during exercise. Here are a few of the most effective techniques that I use with my patients:

Pelvic Floor Evaluation: This involves intravaginal assessment of the pelvic floor muscles to determine the tone, strength, endurance, speed, and irritability of the pelvic floor muscles. During this evaluation, testing can also be done to identify if a pelvic organ prolapse of the bladder, uterus, and/or rectum is present.
Manual Therapy: This involves both intravaginal techniques to address trigger points within the muscle and fascia in the pelvic floor as well as external manual therapy to address any other musculoskeletal dysfunction that may be affecting the pelvic floor muscles.
Pelvic Floor Muscle Training: This involves performing exercises that specifically target the pelvic floor muscles, which can help to strengthen them and improve their function. These exercises can be done at home, and typically involve contracting and relaxing the pelvic floor muscles for several seconds at a time.
Core Strengthening: A strong core can help support the pelvic floor and reduce the pressure placed on it during exercise. Physical therapists can work with patients to develop a personalized core strengthening program that is tailored to their individual needs.
Behavioral Modifications: In some cases, making changes to diet, exercise routines, and/or hydration habits can help to reduce the occurrence of urinary incontinence. For example, modifying the amount/type of high-impact exercise or reducing consumption of foods/drinks that are bladder irritants prior to exercise may be effective strategies.
Biofeedback: This technique involves using sensors or devices to monitor and train the pelvic floor muscles. This can provide valuable feedback to patients and help them learn how to properly engage and relax their pelvic floor muscles.
Education: Finally, education is key when it comes to preventing and treating urinary incontinence with exercise. Pelvic floor therapists can teach patients about the anatomy and the function of the pelvic floor, as well as strategies for maintaining good pelvic floor health.

Urinary incontinence with exercise is a common problem among women regardless of age or whether they have experienced pregnancy/childbirth, but it is not one that has to be accepted as a normal part of physical activity. With the right pelvic floor therapy interventions and support, women can continue to enjoy the benefits of exercise without the discomfort and embarrassment of urinary incontinence. If you find yourself peeing with exercise, I encourage you to contact me today to learn more about your pelvic floor therapy options.

About the author: Dr. Amy Medlock is certified in pelvic floor therapy evaluation and rehabilitation. She earned a Doctor of Physical Therapy degree from Regis University and practices at The FAST Lab in Denver, Colorado.