Women on a trail run

Stress Incontinence and Female Athletes

Private: Elizabeth G. Matzkin, MD
Contributor Elizabeth G. Matzkin, MD
Contributor Joy Shine, MSPT, CLT

As a part of your training routine, you may be focused on strengthening a variety of muscle groups in your legs, arms, or abdomen. But there’s an important area you may be missing. Did you know that nearly one in three young women experiences stress urinary incontinence, or urine leakage, during exercise?

“During physical activity, especially high-impact sports like running and jumping, there is an increase in intra-abdominal, or belly, pressure,” explains Joy Shine, MSPT, CLT. “The pressure causes the bladder, bladder neck, and urethra to move downward, allowing the involuntary passage of urine.”

A Training Routine for Your Pelvic Floor Muscles

Pelvic floor muscles support pelvic organs and prevent urinary leakage. If these muscles are not coordinated well enough, however, they will not effectively do their job. The good news is that simple exercises can be done to help strengthen the pelvic floor muscles and prevent urinary leakage during exercise, as well as coughing, sneezing, laughing, or heavy lifting – other common causes of stress urinary incontinence.

  • Pelvic floor muscle exercises (commonly known as Kegel exercises) are performed by contracting the pelvic floor muscles, providing closure around the anus, vagina, and urethra. During a pelvic floor muscle contraction, a squeeze and upward lifting sensation can be felt around the vagina and anus when contracting these muscles correctly. Performing three sets of 8-12 slow-velocity repetitions, two to four times a day, are advised for pelvic floor muscle strength training.
  • “The Knack” is a pre-contraction and hold of the pelvic floor muscles before and during activities that increase intra-abdominal (belly) pressure.

The beauty of these exercises is that they can be done anywhere and at any time

“It’s important, however, to make sure that you are doing these exercises correctly and regularly for maximum effectiveness” says Joy.

Seeking Treatment for Urinary Incontinence

Talk with your doctor if you are experiencing symptoms of stress urinary incontinence. In some cases, your primary care physician may recommend that you work with a pelvic floor physical therapist who can guide you in the proper contraction of your pelvic floor muscles and give you tips for properly engaging your pelvic floor muscles. If these exercises don’t provide enough control over symptoms, a urogynecologist can provide additional treatment options

Private: Elizabeth G. Matzkin, MD
Elizabeth G. Matzkin, MD

Elizabeth G. Matzkin, MD, is Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital, Team Physician for Stonehill College Athletics, and Assistant Professor of Orthopaedic Surgery at Harvard Medical School.

Joy Shine, MSPT, CLT

Joy Shine, MSPT, CLT, is a senior women's health physical therapist in the Department of Rehabilitation at Brigham and Women's Hospital. She also works with the Women's Sports Medicine Program.

Before you go,

Staying active through regular exercise and playing sports offers many physical and mental health benefits. Get tips on how to optimize your workouts and keep your body safe from injury. Read more exercise and sports articles.