Runners are comfortable talking about most awkward mishaps on the run but there’s one topic you don’t hear too often and that’s leaking whilst running. And yet, research has established that as many as 30% of female runners experience this at some point which is similar to the current prevalence in the general population. Well, no topic is off-limits on the blog, so to shed more light on this area, physiotherapist Arifa is back on Physio’s Corner to share some common causes of involuntary urine leakage and more importantly FIVE practical ways to deal with it.

There are countless women suffering from involuntary urine leakage whilst running (stress incontinence) and unfortunately most women don’t feel comfortable talking about it or seeking help. Involuntary urine leakage is best defined as an uncontrollable and unintentional leakage of urine. This can create a huge barrier to running and doing other activities that promote a happy and healthy lifestyle. There are several factors that contribute to involuntary urine leakage and if we are to delve deeper, it is important for us to understand a bit more of our anatomy.

Function And Importance of Pelvic Floor Muscles

The pelvic floor muscles are located at the bottom of the pelvis and are attached to the pubic bone and across to the sitz bones and the back of the tailbone.

They play a key role in preventing unwanted leakage and their ability to relax and lengthen as well as contract and lift is vital in correct functioning of this group of muscles. These muscles also play a vital role in supporting the organs and form part of the core. Certain events like pregnancy and delivery can have an impact on pelvic floor dysfunction. Unfortunately, there is a misconception that pelvic floor dysfunction is a normal consequence of pregnancy and childbirth but it’s important to realise that although it is common, it is not normal. Other causes can be chronic constipation as well as being overweight. All these causes place a strain and tension on the pelvic floor muscles leading to various pelvic conditions. 

Running is a  high impact exercise that is associated with an increase in abdominal pressures and huge ground reaction forces when we hit the ground. Our bones, leg muscles and ligaments absorb these forces but some are transmitted to the pelvic floor. If the pelvic floor muscles are not able to withstand this load, this makes it harder for them to contract consistently which can lead to leakage. There are times when the pelvic floor muscles are too tight as well and this can result in the muscles’ inability to absorb forces, again leading to leakage.

Five Tips To Help With Leaking

1/ Strengthen Leg Muscles. Leg muscles and those around the pelvis play a vital role in absorbing some of the ground reaction forces. This means that the stronger these muscles are the better. So strengthening the calves, hamstrings, quadriceps and glutes can really help and should form a regular part of your routine. See my previous post for some specific exercises.

2/ Improve Core Breathing. The pelvic floor forms part of our deep core along with the diaphragm (breathing muscle), abdominals and back muscles. Together these muscles work like a canister – so when we inhale the diaphragm lowers along with the pelvic floor muscles and as we exhale the diaphragm and pelvic floor rise. This healthy range of motion is important in absorbing ground reaction forces. Constantly contracting your abdominals can make the leakage worse. Thus breathing is actually a vital part of managing pelvic floor dysfunction as it enables one to coordinate breath with pelvic floor. To practice this kind of breathing, you may find this video on core breath for better pelvic floor and abdominal function very useful.

3/ Improve Running Form. Keep in mind that running form can play a huge role. Over-striding and running heavy can create more forces to contend with, thus it may also be important for you to consciously think of running more lightly and landing close to your body. 

4/ Use Absorbent Pads. While strengthening your leg muscles and improving your breathing and running form, you may find it useful to wear absorbent pads whilst running to absorb any leakage. Of course, this should not be seen as a permanent fix but it may give you some added confidence to keep running as you work on solving the root causes.

5/ Consult A Specialist. It may be important for you to see a pelvic floor health therapist to assist with improving the efficiency of the pelvic floor muscles to contract and relax adequately. They will also be able to recommend specific exercises for you, given their assessment of how your muscles are working. In addition, you will benefit from additional knowledge and understanding of bladder and bowel function that will likely have a hugely positive impact.

Leaking or involuntary urine incontinence may not be spoken about too often, but with 30% of women runners affected by it, it is certainly a topic that needs more open conversations. Many women tend to suffer in silence and are often not even comfortable raising this topic with a health specialist. So if this is an issue that affects you, know that you are not alone. But also know that there are things you can do to help and that there are health professionals available should you need more interventions to keep you running more happily and confidently.

Thank you once again to Arifa for sharing her expertise and knowledge on this platform. If you’re keen to connect with her directly, please do so via email arifamod@gmail.com or mobile, +267 75399431.

Excited to be linking up with My First 5K and More, Running With Attitude, Run Laugh Eat Pie, Runs with Pugs, and Zenaida for FIT FIVE FRIDAY!