What is exercise incontinence? It is the leakage of urine or loss of bladder control during exercise or exertion. It occurs when abdominal exertion exceeds what the bladder sphincter can resist. This can be a case of pelvic floor muscle fatigue, changes in connective tissue, or inadequate abdominal pressure transmission. For some women exercise is the only time that they have urinary leakage.

Exercise incontinence is not uncommon. Up to one-third of women who exercise have urinary leakage during their sport or exercise. That is an incredible percentage. It is unfortunate that this is not addressed for female athletes at all levels.

Female athletes in general have well-developed abdominal muscles. When abdominal muscles contract, they create pressures greater than what the urethra and pelvic floor muscles can counter. This can occur with a cough, sneeze, laugh, or a lift. It may occur when the woman jumps, jogs, does a sit-up, or pushes off the pool wall while swimming. According to a study including elite college athletes none of whom had had the stress of pregnancy and childbirth on their pelvic floor, the most common sports where urinary leakage occurred were gymnastics (67%), basketball (66%), tennis (50%), field hockey (42%), track (20%), and swimming (10%). It is amazing to consider that two-thirds of the athletes participating in gymnastics and basketball have to contend with bladder control symptoms. Of this group, less than 5% had ever discussed their urine loss problem with a coach, trainer, nurse, physician, or family member. They expressed embarrassment, anxiety and fear over their symptoms. 42% reported that they leaked urine during regular non-sport activities of daily life.

Few women have had training in the development of the muscles in the pelvic floor. These muscles provide support for the bladder and urethra to prevent the leakage of urine. Many can benefit from pelvic floor re-education. Pelvic floor re-education requires an exercise protocol that includes muscle specificity and overload just like any other strength training program. Individuals are not shy about seeking help when instruction in a strength training program is needed for their quadriceps though pelvic floor instruction is somehow embarrassing and “taboo”. Many women are not able to identify the correct muscle for contraction, thus they see no results and comment “I tried those exercises and they didn’t work.” With specific instruction and for some the use of biofeedback effective training can make a significant change in the quality of your exercise or competition experience.

Laura Cooper, DPT and Brittany Jones, DPT have specific training in treating exercise incontinence as well as many other women’s health issues including pelvic pain and pre/post partum issues.