Run with More Security! How to Stop Peeing When Exercising.

How to Stop Peeing When Exercising! Yes, it is possible! Dealing with stress urinary incontinence was something I thought I just had to put up with. But luckily it's not, here is what I wish I knew sooner.

1 - Peeing your pants while running is common, but not normal. It’s not just a postpartum problem either. One study (1) showed 29% of female college track athletes experienced stress urinary incontinence with sport and I’ve had plenty of conversations with young female athletes who once wore leaking at the end of a hard cross country race as a badge of honor.

2 -Leaking urine is not the only pelvic floor symptom. It can present as hip pain, constipation, pelvic girdle pain, back pain…

3 - Holding a Kegel or doing more Kegels ain’t the way. Pelvic floor stuff is often whole-body stuff.

I care so much about all of this stuff because I’ve lived all of it.

I peed my pants while running, especially with hard efforts for YEARS!  The peeing was embarrassing but black shorts hid it well most of the time. You can’t see in this photo from 2019, but my pants are soaked in pee. This probably would have been a massive PR, if didn’t stop to walk on the downhills because it was so bad.

⁣

...buuuutttt....

It wasn’t just the pee. Stress incontinence is usually a whole-body problem!⁣ It’s a pressure/load management problem.

• I had terrible back pain.
• My shoulders and neck were constantly tense.
• I repeatedly sprained my ankle.

It took me 6 years before I finally admitted I had a problem and sought to fix it!⁣ If you are experiencing pelvic floor symptoms, including urinary incontinence, while running it could be that your pelvic floor is “weak”.

But it also could be that:

1. Your pelvic floor is tight and overworked because you are holding too much tension overall (stop sucking in your stomach and relax your jaw to start).
2. Extra pressure is pushing down on your pelvic floor because you're not “stacked” well above and/or your ribs don’t move well. Yes, your ribs are supposed to move!
3. You are struggling to handle the load somewhere else in the chain. Rotation, especially pronation at the feet and internal rotation at the hip are a huge part of it.
4. Or some combination of all of the above.

It's also important to note that natural pelvic floor activity is elevated above the standing baseline level throughout the whole duration of running. Just like any other muscle, it can get tired! Therefore, whatever you do, do not try to kegel while you are running! Purposefully keeping it engaged is just going to tire it out faster!

One study (2)  showed that women who experience stress urinary incontinence actually have a higher pelvic floor activity with running (the researchers were unsure of whether there was a biomechanical cause or a subconscious protection mechanism - if the latter is true thinking about is definitely not helping).

So what can you do:

1- Learn to breathe and relax. (More info Here)

2- Learn how your pelvic floor is connected and integrated with your movement.

3- Find your stack and get your ribs moving.

4- Practice that movement integration with intentional strength training (rotation, rotation, rotation!).

5- Get stronger overall to help your body handle the impact of running.

6- Go see a pelvic floor physical therapist to help you understand, feel, and connect with your parts.

Check out this blog post about running biomechanics and the pelvic floor for some more context around points 2 through 5. 

Psst. All of the above is included to some degree or another in all of my programs/courses.

Your Coach,
Alison

References:

1: Urinary incontinence in elite nulliparous athletes. Obstetrics and Gynecology, 01 Aug 1994, 84(2):183-187
2: Evaluation of pelvic floor muscle activity during running in continent and incontinent women: An exploratory study. Neurourology and Urodynamics. 2017; 36: 1570– 1576.