Urine Leakage While Running: Why It Happens, What Causes It & How To Stop It
Urinary leakage while running is incredibly common, though it’s challenging to get accurate numbers of prevalence largely due to under-reporting and lack of discussion surrounding this symptom. Though there are limited studies assessing the prevalence of leakage amongst runners specifically, we have more data looking at leakage amongst the larger bucket of impact sports.
The evidence that we do have indicates that an average of 45% of adolescent females experience leakage during high impact sports, with another study finding that 16% of women over age 20 experience leakage with running. Interestingly enough, leakage prevalence is even higher amongst elite athletes who participate in impact sport with 51% of female, elite track and field athletes experiencing leakage.
Though leakage is common, it’s treatable. In today’s blog post we’ll cover causes and risk factors for leakage, why leakage happens with running and ways you can change your running form to reduce the amount you leak. And because I am who I am, we’ll also talk about how pelvic floor PT can help you stay dry during your runs.
Here’s the TL;DR: Leakage is common and in the absence of underlying medical conditions, it’s caused by some combination of weakness and poor coordination. Small changes to your running form can help and if that’s not enough, consider pelvic floor physical therapy.
What are risk factors for leakage?
Urinary leakage impacts a significant portion of women in the United States, with one study quoting a prevalence of 61%. Some risk factors for leakage include:
Pregnancy
Vaginal birth
Menopause
Prior gynecologic surgery
Certain medications
Chronic constipation
It’s important to note that leakage resulting from the majority of these life events or experiences is still treatable. Pelvic floor physical therapy can help - continue reading for more on this.
What causes urinary leakage?
The cause of urinary leakage differs based on the type of urinary leakage an individual is experiencing. There are three main types of leakage - stress incontinence, urge incontinence and mixed incontinence.
Stress incontinence is the kind of leakage that happens with coughing, sneezing, jumping and often running. This type of leakage is typically caused by a combination of weakness and coordination deficits. Stress incontinence occurs because of increased pressure in the abdomen which overpowers your ability to hold back urine.
Urge incontinence is the type of leakage that occurs when you get a strong, sudden urge to urinate. This often strikes out of the blue but can also be associated with certain environmental triggers, like sticking a key in the door when you come home or walking by your bathroom. The cause of urinary urgency can be an irritated bladder, tightness and irritation in the pelvic floor muscles, medication, diet and more.
Mixed incontinence is a combination of the two and is fairly common.
Why does leakage happen while running?
Leakage while running can present a few different ways. For some, leakage is worst at the beginning of a run. For others, it gets worse as they begin to fatigue. And for others, every step causes an uncomfortable bladder pressure.
The reason you’re leaking while running depends on a few factors including your history and how your leakage shows up, but for all people leakage while running is caused by some combination muscle weakness, lack of flexibility and poor coordination.
It’s important to note that it’s not always about the pelvic floor. Postpartum runners who experience stress urinary incontinence have been found to have greater hip weakness, shorter cadence and more ground contact time.
Changing your running form to reduce leakage
Let’s first define ground reaction force. Ground reaction force is the amount of force the ground exerts on your body every time you touch down to the ground. In the case of running, everytime you land, you experience about 3 times your bodyweight in ground reaction force traveling back up into your system.
Think about it - running is basically a repetitive single leg jump. That’s a ton of work for your entire system. Your ankle and knees need to be strong and steady enough to absorb that shock and what they don’t absorb travels up into your hips, pelvic floor and all the way up your spine.
Tweaking your running form can significantly alter the amount of force your body has to absorb with each step. Less force with each step is less stress for your pelvis and in many runners, these little tweaks can result in reduced leakage.
Here are two tweaks to your form that you can play with to reduce ground reaction force, improve efficiency in your system and thus minimize leakage:
Land with your foot under your center of gravity
Landing with your leg extended and heel in front of your body causes an increase in ground reaction force. If you can imagine the feeling in your body when you brake in your car, it’s uncomfy. When you land with your feet in front of you while running, ground reaction force increases and consequently so does stress on your pelvis. Landing with your body over the top of your foot reduces the force your joints and pelvic floor have to deal with as you run, reduces fatigue in the surrounding muscles and can reduce both leakage and other symptoms like knee pain, too.
Avoid sucking your belly in during your run
Like we previously discussed, your body needs to find ways to absorb the ground reaction force traveling up your limbs with each step as you run. Intentionally stiffening your abdominal wall limits your core’s ability to do that and thus increases the force exerted on both your pelvic floor, contributing to leakage.
Besides shock absorption, your abdominal muscles are postural which means they’re always working when you’re upright. They need to be able to engage more when you lift a heavy object and engage less when you lift something light. By keeping your core “tight” the entire time as you run, you’re going to limit it’s ability to function as it should, contributing to faster fatigue which also contributes to leakage.
How can pelvic floor PT help
Understanding the root cause of your leakage is key to effectively treating it, and every individual’s root cause is a little different. Working with a pelvic floor PT gives us the opportunity to find the why behind your symptoms in order to create a personalized plan that really works.
You do not have to keep leaking with running. We can help you get dry so you don’t have to worry while you’re out on the trails. Schedule your call today.
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.