Unwanted bladder leaks are frustrating and embarrassing. But whether you pee a little (or a lot) while running, urinary stress incontinence isn't something you have to endure. Use these pro tips to run without worry.

What is urinary stress incontinence?  

Urinary stress incontinence occurs when physical movement or activity – such as running, coughing, laughing, sneezing, or heavy lifting – puts pressure (stress) on the bladder, causing it to leak urine. 

Stress incontinence occurs when the pelvic floor muscles and other tissues that support the urethra, as well as the urinary sphincter muscles that control the release of urine, begin to weaken. As the bladder fills with urine, valve-like muscles in the urethra – the short tube that carries urine out of your body – stay closed, preventing the leakage of urine until you urinate. But if those muscles weaken, then anything that exerts force on the abdominal and pelvic muscles puts pressure on the bladder and causes it to leak urine.1

Although this isn’t a topic commonly discussed around the dinner table, urinary stress incontinence is not uncommon. The fact that special underwear has been developed to absorb bladder leaks is evidence of just how prevalent urinary incontinence is. 

And while both pregnancy and childbirth can be triggers, it's not just a mom problem. One study found that 45 percent of female athletes experienced some symptoms – and 76 percent of those surveyed hadn't given birth.2 

Stress incontinence is not the same as urgency incontinence and overactive bladder (OAB). If you have urgency incontinence or OAB, then your bladder muscle contracts, which causes a sudden urge to urinate before you can get to a bathroom.1 

Start with your breathing

Many people think leaking while running is caused by a weak pelvic floor and they need to do more Kegels to strengthen it. Heather Dunfee, a physical therapist in the Mayo Clinic Healthy Living Program and a certified Pregnancy and Postpartum Corrective Exercise Specialist, explains that although pelvic floor muscles can play a role, it's usually a flawed system versus a single muscle that’s the issue.3

The pelvic floor is one part of the muscle system that makes up your "deep core." Think of the pelvic floor as the bottom of a canister that provides stability and support for your internal organs. It also affects your ability to control your bladder and have a bowel movement. The top of the canister is your diaphragm, and around the sides are your abdominal muscles.

Ideally when you breathe in, the diaphragm and pelvic floor both relax downward, and your ribs and belly expand outward. This draws air into the lungs. When you breathe out, the diaphragm and pelvic floor naturally draw up and in, pushing air out of the lungs. 

This healthy range of motion is important because it helps absorb impact and manage pressure – two key things while you run or exercise. If you grip your abs or squeeze your pelvic floor to try to prevent leaking, you might make the problem worse.3

If you do have weakness in your pelvic floor, then Kegel exercises can help, but doing them correctly is vital. Learn more about the pelvic floor and Kegels here: What to Know About the Pelvic Floor

Perfect your running form

For runners, good alignment helps your core absorb impact and prevent leaks. For example, slightly leaning forward puts your deep core "canister" in the best alignment to do its job. Think about stacking your rib cage over your pelvis, something that comes naturally when running uphill.

More running tips from Dunfee:3

  1. Eyes at the horizon. Look about 20 feet ahead with your neck long, chin gently tucked.
  2. Don't overstride. Think about propelling yourself from your glutes rather than pulling through your hip flexors in the fronts of your thighs. You should land with your foot underneath you.
  3. No chicken wings. Swing arms forward and back rather than side to side.
  4. Land like a “whisper.” If you hear pounding, then see what you can do to soften your steps. Landing in the middle or front of your feet instead of your heels reduces the force by about half.

Strengthen your hips and glutes

According to Dunfee, the pelvic floor is a helper muscle, and it loves to take over and help stabilize the body when the hips or glute muscles aren't doing their job. The problem is that the pelvic floor will easily fatigue and stop working correctly – possibly leading to complications associated with pelvic floor dysfunction.

If weakness in these areas is a problem, then exercises such as squats, lunges, dead lifts, bridges, and hip thrusts can help. For runners, focus on single-leg exercises whenever you can because running is a single-leg dynamic activity.3

Work up slowly over time

After you get a feel for the correct breathing pattern and alignment, it can take time to build up your endurance. Rather than continuing to run no matter what, try alternating running and walking (walk when you notice you're not maintaining the correct form or breathing).

For a more intense workout that won't derail your progress, run up hills and walk down. Hills are great because they force the body into a position where the rib cage is over the pelvis and the bum untucks, which helps you maintain proper form.3 

Still struggling? Get help from a professional

If your bladder still leaks despite your best efforts, then Dunfee suggests getting a referral to a physical therapist. If your pelvic floor isn’t functioning the way it should, then overly tight muscles might be the culprit instead of weakness. A pelvic floor physical therapist has special 

training in pinpointing the cause of dysfunction and can tailor a program to help.

A word from Thorne

Explore our suite of products to support all phases of a woman’s life and be on the lookout in spring 2023 for exciting additions to these offerings.

References

  1. Stress incontinence. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727 [Accessed October 3, 2022] 
  2. Poświata A, Socha T, Opara J. Prevalence of stress urinary incontinence in elite female endurance athletes. J Hum Kinet 2014;44:91-96. 
  3. Dunfee HA. (expert opinion). Mayo Clinic, Rochester, Minn. [October 2022]