Athletic Incontinence

Many of you are familiar with the term stress urinary incontinence (SUI).

This is the sudden, involuntary loss of urine from an increase in intra-abdominal pressure. Athletic or sports incontinence can be considered a subset of this, and often only occurs in a specific sport or with a specific skill. Up to 25% of elite female athletes experience leakage during their sport. Males - you are not exempt! One study of elite track and field athletes found that nearly 50% of females and 18% of males reported leakage during training or competition.

The pelvic floor is a group of muscles that run from pubic bone to tail bone and “sitz” bone to “sitz” bone. These muscles function to support our internal organs, aid in bowel and bladder control, and contribute to sexual function. Just like other muscles in the body, they contract and relax to the demands placed upon them. The pelvic floor should act somewhat like a trampoline and be flexible to lengthen downward and contract upward.  When this doesn’t happen, dysfunction can occur. 

Let’s now consider two female runners who are leaking.

The first has a great pelvic floor assessment and is able to contract, relax, and coordinate these muscles on exam. She transitions to running and leaks immediately! We will start to look more at form, cadence, and specific strength to determine where the system breakdown is occuring. The second runner has a very hypertonic (overactive) pelvic floor at assessment, with poor coordination and difficulty relaxing these muscles. She typically reports leaking ~ 3 miles into her runs.  While we will also take a look at her form at rest and after 3 miles to see if some fatigue related change occurs, her most likely culprit is pelvic floor fatigue from working too hard all the time!

If you are leaking with your activity, here are a few things to try:

1. Check your posture - stack your ribs over your hips
2. Perform a slight chin tuck (pull that chin back to create a double chin effect 🙂)
3. Land soft on your mid to forefoot with activity
4. BREATHE

Best, 
Dr. Jen

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