Urinary incontinence is a common problem; its prevalence rises throughout the lifespan, especially after menopause. However, leakage of urine can be a significant problem among athletes at any age; one study found an incidence of about 40% among elite female college athletes; this statistic rises for high-impact sports. Running is an immensely popular high-impact fitness activity enjoyed by people of all ages. Unfortunately, many people, especially women, experience leakage while running. Can anything be done to prevent this?
Fortunately, yes. The first thing to consider is water intake. Many women restrict their water intake prior to and during runs in an effort to curb leakage; this is ill-advised, and will not help. Restricting fluid will lead to dehydration, which can actually irritate the bladder further, causing increased urge and leakage. The best way to hydrate is to drink small amounts throughout the day and throughout your run in order to decrease the load on your bladder.
Second, consider your breathing. The pelvic floor is part of your deep core, a muscle system bounded on top by your diaphragm, in front by your transversus abdominis, and in back by your multifidi. These muscles work in a coordinated fashion to manage intra-abdominal pressure, which increases significantly when you perform any high-impact activity, such as running. If you are breathing shallowly, as many of us do when we run, you are likely not involving your diaphragm, which also means that your pelvic floor is not activating the way it should. Try this: place your hands around your lower ribcage and take a deep breath. If your diaphragm is working optimally, your ribcage will expand to either side as well as to the front and back, and your belly will expand slightly. Your chest and upper ribs should not move as much. Learning to running while diaphragmatically breathing can significantly improve the activation of your pelvic floor and reduce leakage.
Third, consider your strength. Your legs, hips, and core need a significant amount of strength to withstand the repetitive pounding of running. At a minimum, you should be able to perform single-leg squats, calf raises and lunges with no loss of balance to have a strong enough base for running.
Finally, consider your posture. Ideally, you should be stacked; your head stacked over your ribcage stacked over your pelvis. Arms should be tucked at your sides; winging them out wastes energy. Your stride should be short, and you should land quietly, toward the middle of your foot.
Give these tips a try and see if they decrease your leakage while running. Pelvic floor physical therapists are trained to assess the performance of your pelvic floor and its ability to coordinate with your core, as well as look for the interrelationship of posture and overall alignment. GIve us a call to see if we can assist you!
Bo, K., & Borgen, J. S. (2001). Prevalence of stress and urge urinary incontinence in elite athletes and controls. Medicine and Science in Sports and Exercise, 33(11), 1797-1802. doi:10.1097/00005768-200111000-00001
Casey, E. K., & Temme, K. (2017). Pelvic floor muscle function and urinary incontinence in the female athlete. The Physician and Sportsmedicine, 45(4), 399-407. doi:10.1080/00913847.2017.1372677