Is Leaking Ever OK?

Is peeing during exercise normal?

You hear this all the time, and I use it a lot; the hashtag #commonnotnormal . It’s in reference to peeing during exercise. If you asked a class of moms, most of them say they have or continue to pee or leak during certain exercises. This is also supported by studies that state up to 5-72% with a common factor of 30% of women will have some form of stress incontinence in their lifetime.  

72%

That’s a big number!  It is not only embarrassing sometimes, but it can affect our quality of life.  How many times have you  thought twice about going somewhere because you knew you would either have to pee or you may leak while doing it?  That’s not OK and we help women every day.

BUT  —---IS it ever ok? 

I say—--I need to think about it.  And before every pelvic health therapist burns me at the stake, I want to put some clarification and context into this.  Have you done an exercise so much that you hit your fatigue point and couldn’t do another rep?   I’m betting yes.  Who hasn’t done a plank and put their butt in the air,  done a bicep curl where you used momentum and maybe your legs to help out, or ran so hard or so long you had shaky legs or had to lean on something after to support yourself ?   I sure have. Think about childcare—Have you ever been so tired of carrying or holding your baby in front of you that you had to put them on your hip, not because it was more comfortable, but because they were too heavy for that long?  Of course!!!

These are examples of exhausting your muscles to the point of failure or at the very least fatigue, and your body compensated.  Should you keep going with that workout or task? No–your body is giving clear signs to stop. 

Same with your pelvic floor muscles.  They can take a lot; and I really mean a lot. Gravity works on them every day; add on BABIES and BIRTHDAYS  and that’s a lot of load for your pelvic floor in just everyday life with standing, walking, lifting, breathing—basically everything!

Now do things like jumping, running , lifting heavier loads, jumping rope, mountain climbers, and squatting. These exercises add on to that load exponentially with body weight, increased respiratory rate, angles, and positions that  accentuate the need for pelvic floor activation.  If your body isn’t trained or ready for this load, it can be a recipe for fatigue and failure of your muscles, which can show itself in the symptom of leaking. 

So, am I saying it’s ok to leak?–not quite.  But depending  on WHEN  you are leaking, we can have a better explanation of why.

If you start your routine and are leaking on activities like mobility or simple activation exercises in the beginning or shortly after starting your workout, then we need to go back to basics, evaluate your pelvic floor, teach and then apply better strategies . This is where I would want to really hone in on education and focus on the WHY of your issue. 

If you don’t have symptoms of leaking with your current workout and  start a new program that has more cardio, load or jumping and you leak,  then we need to assess if your pelvic floor is ready for this change. We evaluate your strength, mechanics and pressure distribution.  Is it something we can change by changing a strategy?  

Are you leaking at the very end of the workout when you are doing a harder exercise like jumping rope or running?  We need to look at why the leaking is happening—-Did you just reach max capacity endurance wise because you are at the very end of a hard workout and you are tired and unable to control your pressure? 

All this information matters because I’m concerned less about someone who is at the end of their workout and is reaching their load threshold for pelvic floor vs a woman who starts leaking right away or as she tries to advance her workout. I’m not saying one is better than the other, leaking is leaking, but if we know the circumstances around your leaking, we can tailor the best solution for you.

Want to know what strategy is right for you? Find a PT who can assess your needs and apply them to your goals for a workout. 

Kellie is a PT specializing in orthopedic and pelvic floor PT, and is the co-founder of FitPartum. 

Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women [published correction appears in Nat Rev Dis Primers. 2017 Nov 16;3:17097]. Nat Rev Dis Primers. 2017;3:17042. Published 2017 Jul 6. doi:10.1038/nrdp.2017.42