Bladder leakage during exercise
If running, jumping, HIIT, dance fitness, or tennis makes you leak, you’re far from alone. Leaking during exercise is one of the most common pelvic floor problems, and one of the most fixable. Stopping exercise is never the answer. The goal is to get your pelvic floor strong enough for your workouts.
Why it happens
Exercise-related leaking is almost always stress incontinence: your pelvic floor can’t fully resist the spikes in abdominal pressure that come with impact and exertion. The activities that cause the most trouble:
- Running and jogging: repetitive impact
- Jumping (box jumps, jump rope, double-unders): high-force impact
- HIIT and CrossFit: a combination of impact and exertion
- Aerobics and dance fitness: jumping and bouncing movements
- Tennis and pickleball: sudden directional changes with impact
“Exercise-related leaking is a mismatch between the demands of the activity and the capacity of the pelvic floor. The fix is increasing the pelvic floor’s capacity — not decreasing the demand.”
Signs you should get help
- Any leaking during exercise, even if it’s “just a few drops”
- Wearing pads, dark clothing, or extra layers during workouts
- Avoiding certain exercises or movements
- Cutting back on intensity or skipping workouts because of leaking
Treatment options
- Sport-specific pelvic floor training: learning to activate your pelvic floor during dynamic movements
- Breathing coordination: exhaling on exertion to engage the pelvic floor at the right moment
- Graduated return: building back to high-impact activities as pelvic floor strength improves
- Pessary: a support device that can be worn during exercise
- Specialist evaluation: if therapy isn’t enough, a urogynecologist can discuss additional options
We have pelvic floor physical therapists in our office, and we work closely with dozens more throughout northeast Wisconsin and Michigan’s Upper Peninsula. Between physical therapy and our other treatment options, we can almost always get you back to exercising without leakage.
Next step
Don’t let leakage take exercise away from you. Whether you start with pelvic floor therapy or come in for an evaluation, we can work out a plan to get you back to full activity.
References
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Nygaard IE, Heit M. Stress urinary incontinence. Obstet Gynecol. 2004. doi:10.1097/01.AOG.0000137874.84862.94
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American Urogynecologic Society (AUGS), Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). Joint position statement on midurethral slings for stress urinary incontinence. Female Pelvic Med Reconstr Surg. 2021. doi:10.1097/SPV.0000000000001096
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ACOG Committee on Practice Bulletins—Gynecology, American Urogynecologic Society, Kenton KS, et al. Urinary incontinence in women (ACOG Practice Bulletin No. 155). Obstet Gynecol. 2015. doi:10.1097/AOG.0000000000001148
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Wu JM. Stress incontinence in women. N Engl J Med. 2021. doi:10.1056/NEJMcp1914037
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Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019. doi:10.1097/GCO.0000000000000584
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Lukacz ES, Santiago-Lastra Y, Albo ME, et al. Urinary incontinence in women: a review. JAMA. 2017. doi:10.1001/jama.2017.12137
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Ashton-Miller JA, Howard D, DeLancey JOL. The functional anatomy of the female pelvic floor and stress continence control system. Scand J Urol Nephrol Suppl. 2001.