min read

Why Do I Leak With Activity? SUI and Pelvic Health Therapy Solutions

Learn about stress urinary incontinence (SUI) and effective pelvic health therapy treatment methods.
Written by
Lauren Potter
Published on
Mar 5, 2024

Why do I Leak With Activity?

Stress Urinary Incontinence and Treatment Protocol

Do you ever leak a little when you don’t want to?

  • At the bottom of a heavy squat?
  • Towards the end of tumbling practice?
  • At the end of a workout that has a lot of box jumps or double-unders?
  • Towards the end of a long run?

Are you terrified to sneeze in public because you might leak?

Do you avoid jumping on the trampoline with the kids?

Leaking urine with jumping, coughing, sneezing, and running is called stress urinary incontinence (SUI). SUI is involuntarily leaking urine in response to increased intra-abdominal pressure.  

SUI looks different for everyone, and there are several things that can contribute to this.  In this article, we will explore some of those reasons and how physical therapy can help you.

How can a physical therapist help reduce urinary incontinence?

(1) Assess Pelvic Floor Muscle Strength

A physical therapist who has undergone specialized training to treat the pelvic floor can perform an internal assessment of your pelvic floor muscles (PFM). Not everyone needs an internal examination, and it is not required in order to participate in pelvic floor physical therapy, but an internal examination can give your physical therapist valuable information regarding your ability to contract your PFM, PFM strength and endurance, and if you have PFM tightness.

If your PFM are weak and/or tight, then the PFM may not be able to contract properly to resist the increases in intra-abdominal pressure that occur with coughing, sneezing, shouting, and jumping, and this can lead to unwanted leaking.  

We can train the PFM in isolation, but we can also strengthen them with a co-contraction from the surrounding musculature which gives us great results!  

(2) Assess Hip Strength

The hips and the PFM sit near each other inside the pelvis. If your hips are weak or have poor muscular endurance, then you may have difficulty contracting your PFM.

Studies have shown that strengthening the hips can strengthen the pelvic floor and lead to a significant reduction in symptoms of urinary incontinence!

(3) Teach You How to Activate Your Muscles in Response to Load

It goes a step further than just strengthening what is weak… We must teach our muscles how to respond to increases in external load as well.  If you leak at the bottom of a heavy squat, then we must train your muscles how to function in that range!  We cannot expect our muscles to properly contract when squatting to depth with load if we do not train them how to do it.

This is where functional fitness is so important! If we only strengthen our muscles in one plane of motion or with isolated exercises (e.g., bicep curls, clamshells, knee extensions, etc.), then we may not have adequate strength to allow our bodies to move for everyday activities.

Functional fitness is an excellent way to teach our muscles to contract through various ranges of motions and in response to different external loads. Functional fitness carries over into everyday life as well!  Functional fitness can help you develop the strength and coordination to pick up the kids, carry groceries, move furniture, place items on the top shelf, and so much more!

What if I Only Leak at the End of my Workout?

If you are leaking towards the end of your workout, you may have decreased muscular endurance. Our pelvic floor muscles can fatigue just like any other muscle group. If you only notice leaking towards the end of a set of double-unders, you may have decreased muscular endurance in your PFM or hips!

Isn’t leaking common?  

While stress urinary incontinence may be common, this does not mean that it is normal. If you are experiencing urinary incontinence and have brushed it off as “normal” because so many other women are also experiencing it, please know that it’s abnormal and physical therapy can help! Reducing SUI can significantly improve your quality of life!

A physical therapist can help identify muscle weakness, decreased endurance, or muscle imbalances that are contributing to stress urinary incontinence.

What Should I Do if I Leak Urine When I Don’t Want to?

Reach out to a pelvic health physical therapist! Stress urinary incontinence responds very well to physical therapy. Your physical therapist will complete an in-depth examination.  This may include assessing pelvic floor muscle function internally, assessing hip strength, looking at how you breathe, assessing your ability to create an abdominal contraction, looking at how you move functionally, discussing bladder irritants or lifestyle factors, and so much more.  

Which path will you choose? Will you choose to continue leaking, or will you choose to improve your quality of life by decreasing episodes of SUI and getting stronger with physical therapy?

What can I do next?

If you are looking for a physical therapist who will help to decrease urinary incontinence and improve your function and quality of life with a strength and conditioning approach and live in the Birmingham, Alabama area, schedule an appointment with Vulcan Performance today. Dr. Lauren Potter specializes in treating pelvic health physical therapy and has received training through the Herman and Wallace Pelvic Floor Rehabilitation Institute to treat the pelvic floor.

Interested in learning more about pelvic therapy services at Vulcan? Click here to read more!

$(“a”).each(function() { var url = ($(this).attr(‘href’)) if(url.includes(‘nofollow’)){ $(this).attr( “rel”, “nofollow” ); }else{ $(this).attr(‘’) } $(this).attr( “href”,$(this).attr( “href”).replace(‘#nofollow’,’’)) $(this).attr( “href”,$(this).attr( “href”).replace(‘#dofollow’,’’)) });