Involuntary peeing while doing sports is a common issue among women – of all ages. While aging and motherhood do increase the risk of developing it (further), the truth is healthy younger women quite often struggle with the very same situation: peeing when not wanting to, especially during physical exertion.

Even studies confirm that women engaging in high intensity sports often experience stress urinary incontinence. Among sports studied, gymnastics and trampoline had the highest rate, followed by swimming and judo.

In my opinion, any kind of sports, (runnig, CrossFit, weightlifting, powerlifting, gymnastics, athletics…) along with coughing and sneezing can causes involuntary urine leakage better known as the stress urinary incontinence.

The urinary tract and muscles to blame

When I am lifting heavy I usually don`t focus on controlling my urethral sphincters – two muscles that control the retention and release of urine from the bladder. I rather hope the bladder, an organ that collects the urine excreted by the kidney, will do its job properly. Its function is to store between 500-1000 millilitres of urine.

anatomy-1
Credit: pelvic-healthcare.com

Peeing usually happens voluntarily while sitting on a toilet. Unless a certain stress, like physical exertion at sports, creates a pressure that affects the muscles (urethral sphincters) to the point a small amount of urine leaks from the bladder through urethra on to our panties.

Urethra is a 4.8-5.1 centimetres long tube that connects the bladder with urinary meatus – the opening where urine exits our body.

We don`t have to go into details, but keep in mind, those structures have muscles and muscles can be re-trained.

Why involuntary peeing happens?

Doing sports safely goes along with engaging your core muscles – all muscles around your pelvis, abdominals, lower back and the spine. Activating those muscles stabilizes the spine, keeps your body balanced and helps you perform sports better: produces a force which makes you stronger, faster and more powerful.

But activating those muscles also has a tricky side.

Remember that deep breath you take before squatting down to keep your core strong? Those same now activated muscles that keep your spine stabilized during physical activity also put a certain amount of pressure on the urinary structures. Which means, when you squeeze your core muscles, those muscles also put a pressure on the bladder, causing the urethral sphincter – two muscles that control the retention – to open and leak a small amount of urine.

Also think of the time before your monthly period. The swollen muscles and bloated tummy make you feel you have to pee all the time.

Many women have weak pelvic floor muscles

Most women neglect crucial pelvic stability exercises. I see many women doing complex “big lifts” exercises but none of them takes time to do planks, bridges and dead bugs.

Your body won`t function if you don`t train it. Pelvic floor muscles can`t handle the pressure to hold the urine if they are not trained and maintained to do so. Especially if you are a woman that lifts big, jumps high, sprints fast or runs for miles.

How to prevent stress urinary incontinence?

While making your body functionally strong is the best investment to do, you also have to know there will always moments when a sudden, unexpected pressure, especially when focusing on setting a new deadlift PR or running your best time, will make you pee a bit.

First thought on how to solve the stress urinary incontinence were probably the notorious Kegel exercises – laying down in bed squeezing everything we have down there.

Honestly, I am not a fan.


To get more details on this issue I messaged my friend, a personal trainer specialized for training during and after pregnancy, Nuša Gnezda from Noshee Fit.

In Nuša`s opinion Kegels alone are not enough.

Solution: Practice Kegels while doing core strength exercises

Before starting with heavy lifting or a CrossFit workout, warm up properly. Take some time to train pelvic and deep trunk muscles.

Nuša suggests performing general core strength and stability exercises together with Kegels. To be exact: while you are doing for example glute bridges also focus on squeezing the pelvic floor muscles around urethra, vagina and anus.

Be consistent. Pick 3-4 exercises and train them 3-times a week as activation before the main workout. Perform all exercises slowly and controlled.

For her clients, Nuša usually picks the following exercises:

1. Glute brige (also with leg deviation)

Weighted_Glute_Bridge
Credit: workoutlabs.com

VIDEO: How to do Glute bridges

2. Dead bug

Dead_Bug-2
Credit: workoutlabs.com

VIDEO: How to do dead bugs 

3. Clamshell

rear-butt-workout-Side-Leg-Raises
Credit: durablehealth.net

VIDEO: How to do clamshells

4. Pallof press

unknown
Credit: fitrole.files.wordpress.com

VIDEO: How to do Pallof press

5. Glute march

Top-10-Bridge-Exercises-8
Credit: cdn2.stylecraze.com

VIDEO: How to do glute march

Solution 2: Make your body stronger with basic strength exercises

I am no stranger to bladder and kidney health issues: years of chronic infections. While I went through therapies with pills, medicines and all kinds of treatmenst, most effective strategy was sports. Building my body strong eventually strengthened my immune system to the point all other issues were solved easier.

It`s fun to do MetCons, max lifts and 10k runs everyday, but old-school bodybuilding has its meaning as well. Hypertrophy style of lifting, sets of 8-10 reps, will make your body additionally resilient. Also, your strength will go up.

Solution 3: Work on being healthy, but don`t obsess  

Keep your immune system working flawlessly. Healthy is not looking good, healthy is functioning good. Regular physical activity, balanced nutrition, sufficient sleep and most importantly effective stress management are essential. Before eliminating all food products that internet told you to ditch, look around your work and home environment: what are the stressors that make you feel worried? Ditch those first.

Solution 4: Lower the triples Cs – Caffeine, Coke and Cocktails

Caffeine, bubbles and alcohol will do no favour to stress urinary incontinence. But still, hydrate well. Dehydration will affect the bladder, making you feel you have to pee all the time. I love all three of the above, but green tea, smoothies and saving money by not drinking, works better.

Solution 5: Relax

When I was 9 and my health problems with kidneys and bladder did not get better, our family doctor told my mom to relax and stop checking up on me. This was the day my recovery began.

If the involuntary peeing happens often pay your doctor a visit. Told them you are doing sports. If they can`t help, ask Nuša at NoosheeFit or drop an email her as I`ll pass the message.

Otherwise wear the moisture-wicking underwear and change your panties right after sports to avoid any possible infections.


Sources:

www.nusagnezda.com

www.ncbi.nlm.nih.gov/pubmed/26369504

www.ncbi.nlm.nih.gov/pubmed/26348380