Urinary leakage (or ‘urinary incontinence’) isn’t something women usually discuss openly, but the truth is, it’s not uncommon and it’s certainly nothing to feel any embarrassment about. At different stages of life, women might experience incontinence for various reasons. Vhi’s Senior Musculoskeletal & Pelvic Health Physiotherapist, Dawn Cantwell, explains the role that the pelvic floor muscles play, and the types of exercise that can help reduce incontinence. 

What is urinary incontinence and what causes it? 

Urinary incontinence is a loss of bladder control that can lead to involuntary leakage. This can understandably be distressing, but it’s not at all uncommon and can absolutely be worked on. A woman’s pelvic floor is made up of muscles that support and hold her pelvic organs in place, such as the uterus, vagina, bowel and bladder. The pelvic floor muscles play a major role in controlling your bladder and bowel so that you can hold in urine and stool until you’ve reached a toilet. Then, these muscles need to facilitate the emptying of your bladder and bowel when you get to the toilet.

If you have some kind of dysfunction in your pelvic floor muscles, urinary leakage can become an issue. Dysfunction can include:

• the muscles might be too tight (common in athletes)
• they may be weak due to childbirth or a change in hormones during menopause
• if you have issues causing excessive strain on the muscles, such as persistent coughing, constipation or extra body weight.  

Understanding the link with exercise

Let’s consider what happens when we take part in high impact exercises, including running. When we run, the force of our foot hitting the ground moves from our feet up through the body and then comes back down and is absorbed by the pelvic floor muscles (imagine a trampoline). If there’s a disruption to this shock absorption, we can see why it could cause bladder issues:

• If your pelvic floor muscles are ‘lazy’ (not activating when they should), they might not respond quickly enough to close off your bladder when faced with this extra downward pressure. This can lead to leakage. 
• If your pelvic floor muscles are weak, they might not be strong enough to keep the bladder closed when faced with this extra load, leading to leakage. 
• If your pelvic floor muscles are too tight or they don’t relax well, their shock absorption capacity might be compromised, leading to them tiring prematurely, leading to leakage. 

These issues can all sound intimidating, but there are lots of ways you can improve your pelvic floor health! If you experience leakage, or frequent and intense urges to urinate, visit your healthcare provider and they’ll work with you to create a treatment plan. 

What exercises can help reduce urinary leakage?

Working on your pelvic floor strength isn’t going to be enough on its own. You’ll need to focus on strengthening and conditioning other parts of your body too. Here are some useful exercises to try: 

• Pelvic floor strength training: Kegal exercises (repeatedly squeezing and relaxing the pelvic floor muscles) are a good start, but if you visit a pelvic health specialist for an assessment, they will look at the strength, endurance, tone, movement capacity and relaxation capacity of your pelvic floor. This allows them to figure out what kind of treatment and exercise programme will work best for you.
• Glutes: Our glutes are at the back of the pelvis. They’re the biggest muscle in the body and help to take some load and pressure off our backs, so it’s vital that we strengthen them. Things like squats, lunges and glute bridges are effective.
• Core: Strengthening your core helps to support the front of your pelvis. 
• Trunk (the chest, abdomen, and back) mobility: We need to be rotating from our trunk and our shoulders when we do exercise like running, to reduce and safely distribute stress on our muscles. In tandem with these exercises, be sure to also do stretches for your spine. 
• Calves: Calf raises can be done together, single leg at a time, or even sitting down, if it best suits your mobility or strength. 
• Functional strength and balance: Movements that test and improve your balance, like single-leg squats and plyometrics are great. Plyometrics are exercises that require you to stretch and contract your muscles over and over, such as skipping, jump squats, burpees and lateral hops (jumping with both feet from side to side). 

Hill running (on the incline rather than the decline) is great to target all the muscle groups I’ve mentioned above. During a hill run you’ll engage your glutes, quads, calves, core and abdomen, making it a super effective aspect of your training. Plus, if you take part or plan to take part in races like the Vhi Women’s Marathon, hill runs make race day that little bit easier!

If you regularly exercise, have a look at my blog, ‘How to protect your pelvic health when exercising.’

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately.