Incontinence When Running? Here’s What You Need to Know

TEAM KNIX / YOUR BODY

Whether you’re an avid runner or an occasional fast-walker-come-jogger, there are certain things you expect to happen when you’re exerting: Sweat, fast breath, elevated heart rate, runner’s high… they’re all part of the expected package. Urinary incontinence when running? Not so much…

So what is happening if you experience involuntary peeing when running? Whether it’s sudden or persistent, rest assured there is an explanation for why female runners might experience involuntary urine leakage. Read on…

What Is Stress Incontinence?

Urinary incontinence happens when urine leaks outside your control and intention to pee. Stress urinary incontinence (SUI) is the most prevalent form of incontinence among women. It affects an estimated 15 million adult women in the U.S. This makes it the most common form of incontinence that women experience.

If you’ve ever peed a little when you’ve:

  • Laughed
  • Sneezed
  • Coughed
  • Exercised (including running)
  • Had sexual intercourse
  • Lifted something heavy or bent over

… those are symptoms of stress urinary incontinence.

Stress incontinence occurs when the body is exerting (or under physical stress) and other muscles or muscle groups (in particular the muscles of your pelvic floor) become compromised or less effective at doing their job, which includes holding in pee.

What Causes Stress Urinary Incontinence?

But why would the muscles of your pelvic floor “fail” while you’re running? After all running is a whole body experience and if you’re a regular runner, you’re presumably fit?!

Well, the muscles of your pelvic floor are just like any other muscle in your body. They can be weak because they’re not being exercised. Or they can be injured and so more susceptible to letting you down when the body is stressed—just the way a weak ankle might buckle when extra pressure is put on it.

For women, the major cause of damage to the pelvic floor muscles is pregnancy and childbirth. This can cause temporary stress incontinence, while the body is recovering from childbirth for example. But damage caused by childbirth can also cause more persistent stress incontinence. It all depends on the woman, her experience of childbirth, and how her body heals.

But those of us who haven't gone through childbirth don’t get off unscathed. Stress incontinence can also be caused by any surgery that impacts the abdominal muscles, bladder or pelvic floor, including hysterectomy.

Moreover, damage to muscles is just one dimension. If you have a weak pelvic floor due to lack of exercise or just general aging, you may also experience stress incontinence. This is why Kegel exercises are widely recommended for all women, especially as we grow older.

Unfortunately, the high impact exercises we often focus on (including running), while good for heart health and strength, don’t really strengthen these muscles.

Could Leaks When Running Be Caused By Another Form of Incontinence?

It’s worth noting that if you’re running extremely long distances or simply ‘need to go’ real bad, you may urinate. This is more about bladder fullness and a natural need to release. Both men and women who do extreme sports may experience this but not necessarily suffer ‘incontinence’ in the medical sense.

Although stress incontinence is most often the cause of involuntary peeing when running, there are other forms of incontinence (5 types, in fact!) and it usually requires a doctor to perform a diagnosis. Mixed incontinence is the second most common form of incontinence after stress incontinence, and it is a combination of stress and urge incontinence. So it is another candidate to explain the experience of involuntary peeing when running.

What Can You Do About Stress Incontinence?

We get it: Incontinence is not something you want to experience, especially when you’re working out and you feel like you’re taking good care of your body by trying to stay physically fit. But incontinence is an experience for many women and you’re not alone. 

Here are some things we recommend doing about it:

1. Talk to Your Doctor

50% of people with incontinence tend to just suck it up and not go to their doctor. This might be due to embarrassment or they may have a perception that this is just a reality for people of a certain age.

But we highly recommend you speak to your doctor. First, because they’re the only ones who can really diagnose what’s going on. Indeed, they might want to perform tests to rule out some other explanations. And, second, because they will have treatment options that you can’t offer yourself.

This isn’t to say that you can’t do anything yourself, but - really - don’t you want to know all your options and have the reassurance that you’re moving in the right direction?! 

2. Wear Leakproof Underwear When Running

One immediate change you can make that will give you back the freedom and confidence to run to your heart’s content is to invest in some leakproof underwear. Don’t worry: Leakproof underwear has come a long way from the disposable diaper-like kind.

Leakproof underwear comes with different absorbency levels, that can hold up to 8 tsp of pee. 

Super absorbent Knix leakproof underwear can hold up to 8 tsp of liquid (whether that’s sweat, blood or urine). Products like these can be a game changer for those experiencing female urinary incontinence, allowing them to remain active and social while exploring treatment options. 

And the best part? They’re like a second skin, so you can wear them with your regular running attire, including figure-hugging leggings and shorts.

3. Start Doing Kegel or Pelvic Floor Muscle Exercises

Kegel exercises or pelvic floor muscle exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. Good news: Kegel or pelvic floor exercises can be done any time, either sitting or lying down. You can even do them when you are eating, sitting at your desk or watching TV. So you don’t need to add another workout to your schedule

If you’re unsure how to do Kegel exercises, your doctor or physiotherapist can help you. But basically it’s like pretending you have to urinate and then holding it. You relax and tighten the muscles that control urine flow.

One way to learn the muscles you should activate is to pay attention when you pee: Start to pee and then stop. You should feel the muscles in your vagina, bladder, and anus get tight and move up. These are the pelvic floor muscles. 

Avoid Certain Beverages

While it’s important to stay hydrated, especially if you’re an athlete, there are certain beverages that can agitate the bladder.You may consider cutting back on caffeinated, carbonated beverages and/or alcohol.

Explore Other Medical Treatments with Your Healthcare Provider

Your healthcare provider will help you determine the extremity of your case and the appropriate treatment options to explore. They may start with something simple like bladder training and Kegel exercises.

Other options they may explore include devices like a vaginal pessary or urethral insert. And on the surgical end of the spectrum, the most common option is the sling procedure. This procedure entails the surgeon using the person's own tissue, synthetic material, or donor tissue to create a ‘sling’ or hammock that supports the urethra. 

The outlook for urinary incontinence will depend on many factors including your age, your medical and reproductive history and the severity of your incontinence.