It’s not exactly a secret, but it is an unspoken truth that a lot of women spring a leak during workouts. Even though there are accessible treatments for athletic incontinence, one study showed that just 4.6% of women sought out and actually received treatment for their drips. Why? Because a) shame + the concept of oversharing and b) pervasive societal messaging that tells women a little leak is NBD, especially if it happens during workouts 👎👎
Whether you’re a career athlete, a professional couch cushion, or somewhere in between, hear this loud and clear: leaking during physical activities shouldn’t be a given. If you have six-pack abs and run a four minute mile (bravo, by the way!) but you leak along the way, I’m the couch cushion here to tell you it’s possible to run dry. To learn more, I rang Lindsey Vestal, our resident pelvic health expert, and Julie Wiebe, a body literacy crusader and physical therapist who integrates pelvic health and sports medicine. First things first:
Why is athletic incontinence so common?
Understanding why workout-related drips and floods are so prevalent requires two personal epiphanies:
- Our definition of strength is all wrong. Leaking during workouts is a form of stress incontinence, which is your bod’s way of cluing you in on some internal imbalances. Julie says a lot of athletes overlook the clue, or go about addressing it in the wrong way. Focusing only on strengthening your pelvic floor as a solution to leaking is the same as thinking building up just your biceps makes your entire body fit (kegels, anyone?). A strong pelvic floor is part of a bodily system that, when functioning optimally, has full range of motion, elasticity, and buoyancy to roll with the movements and breaths your body is experiencing every minute of every day. For me, the confusion about pelvic fitness isn’t unlike that super buff human in yoga class (you know who you are) who reaches for their toes but can barely bend over. It’s surprising to see, but it also makes you realize that you’ve conflated one kind of strength with another, equally important form of fitness.
- We are way too obsessed with abs. These days we’re culturally obsessed with six-packs, but Julie explains that a fitness industry that constantly tells us to crunch our stomachs or clench our abs ends up putting extra pressure on our floors (not to mention our body image). When you hold your breath and squeeze your abs during an exertion, you’re almost guaranteeing that your pelvic floor will be overwhelmed by intra abdominal pressure from your diaphragm, which means prime leak time. Combine our ab-session with the reality that athletes and New Years resolution exercisers alike are usually pushing their bods to reach their next personal best, and you’ve got a recipe for tons of pelvic floor pressure with a large side of leaks.
Ok, but why should I care?
It’s easy to dismiss a drip when you’re in peak physical shape (or working toward it) because, as Lindsey says, you might not have external motivators pushing you to change your bod *internally*. You’ve already got buns of steel, so what’s the big deal about a little leak? It’s true that unresolved leaks don’t always spiral into something bigger, but leaking can become more severe over time, and more complicated as you age. It’s also a symptom associated with a few other not-so-fun-or-glamorous sensorial experiences, like:
If you’re leaking during workouts, it’s probably time to incorporate some modifications and a different kind of fitness into your routine.
So what should I do to address my bladder leaks?
- Find a pelvic floor therapist or physical therapist who will work with you! There’s a myth out there that physical therapists (pelvic floor PTs included) make a living telling athletes they can’t keep doing what they love. If you find a doc who immediately tells you your pole-vaulting career needs to be put aside for the rest of your days, Julie says it can be helpful to try opening the conversation up to monitoring and modifying behaviors, instead of non-negotiable restrictions. A skilled, comprehensive PT will complete a full evaluation and work with you to alter movements and behaviors wherever possible so you can keep deadlifting, sprinting, or crab walking to your heart’s content. You can start your search for a PT near you here.
- Stop holding your breath during exercises. If you don’t have access to a PT in the immediate future, working on your breath is a huge first step in taking pressure off your pelvic floor. Instead of holding your breath and clenching your stomach when you pick up a heavy box, practice beginning an exhale before you start the exertion, and continuing it through the exertion. Julie explains that this “blow before you go” technique not only takes pressure off your pelvic floor, it also preps it to support you during anything from picking up your toddler (or, in my case, 50-pound lap dog), to pilates class, to cartwheels with your kids or grandkids.
- Hydrate smarter. During workouts you’re usually either guzzling water during breaks (guilty 🙋), or you’re just going without. Lindsey explains that both approaches to hydration have downsides. When you chug large amounts of water, your bladder can’t actually absorb everything it’s being inundated with, so you can end up peeing or leaking away all that potential hydration. On the flip side, if you aren’t getting enough H2O, your bladder starts spasming and sending dehydration signals to your bod, which can also trigger leaks. Giving yourself adequate breaks to hydrate (and making sure you’re drinking water instead of bladder irritants like coffee or carbonated drinks) will help your bladder function better.
When you reframe how you think about internal strength and pay attention to your body's cues about pressure, you can make sure sweat is the only puddle left on your mat.
*~Have you experienced leaks during exercise? Share your story in the comments!~*