I absolutely freaked out the first time it happened.
I was in the midst of a truly brutal boot camp class when the instructor ordered us to start 30 seconds of jumping jacks. No sweat — I’ve done these millions of times.
Then, it happened: Small amounts of pee — for a lack of better phrasing — started leaking out, and I couldn’t do anything to stop it. I figured others would soon be able to see my mini-accident and instantly turned red. Luckily, no one did, but right after class I frantically typed “peeing during workouts” into the browser on my smartphone.
And I let out a huge sigh of relief.
It’s actually very common, according to everything I read on trusty Google. Everyone from casual weekend warriors to serious CrossFit competitors reported experiencing what’s known medically as stress incontinence, especially during workouts that included a lot of jumping.
“With stress incontinence, the sphincter pelvic muscles, which support the bladder and urethra, are weakened,” pelvic floor dysfunction specialist Gail O’Neill, P.T. tells SheKnows. “The sphincter is not able to prevent urine from flowing when pressure is placed on the abdomen, such as when you cough, laugh, lift something heavy, or during certain forms of exercise such as running and CrossFit.”
To remedy this, doctors commonly recommend that you regularly tighten your pelvic floor muscles — the ones that help you control the flow of urine — commonly known as Kegels.
However, I’ve found that doesn’t always work. I’m a Kegels fanatic and do Reformer Pilates at least four times a week, and I still deal with stress incontinence.
“Everyone wants a magic exercise: just do a plank, just do a Kegel, just do a squat,” adds physical therapist Julie Wiebe. “Creating balance in the system is a bit more complex than just clenching something.”
Think outside the Kegel
Stress incontinence can put a kink in your workouts, but Kegels aren’t necessarily the way to fix it — especially because the pelvic floor is only one piece of the puzzle. To solve the problem, we have to think about coordinating the work of the group of muscles that control continence, according to Wiebe.
“The system that controls leaks is the same system that creates a strong core: the diaphragm, the pelvic floor and your deep abdominal. So learning to coordinate the action of these three is critical to balancing the continence mechanism,” says Wiebe. “That means, how you breathe and how much you clench your abs or your pelvic floor are important.”
First, she recommends finding your true pelvic floor with this little trick.
www.youtube.com/embed/GZqrh7iniooThen, try a breathing trick known as a piston, which helps women coordinate the work of the muscles differently than a Kegel.
“Learning to let go of your abs and allow the diaphragm to come down for a big breath is a good first step to set up the recoiling action of a piston,” says Wiebe.
www.youtube.com/embed/mLFfZfm7O7c“Breaths should not be up — chests lifting, shoulders rising on inhale — this often occurs when women are holding their abs tight. See how your breath changes when you relax your abs.”
The breath should be lower, with movement of your rib cage below your breasts. This kind of breath will be more connected with your pelvic floor.
“See if you can feel your pelvic floor lower on this new inhale, and lift on exhale. When it lifts on the exhale, that is when you should challenge it on an exertion in fitness,” Wiebe adds. “So I teach my patients, ‘Blow before you go.’ Exhale, feel the pelvic lift, then continue the exhale as you exert or lift. Then let the pelvic floor lower again as you inhale between reps.”
Once you have found it, practice allowing to rise (on exhale) and lower (on inhale). “Using that leaning, ski jump idea while you’re running and maintaining a pistoning breath will help kick up the system and ease leaks,” Wiebe adds.
Other ways to fight stress incontinence
In addition to strengthening exercises, try these other tips to alleviate stress incontinence.
- Avoid sitting for long periods of time. “Sitting with poor posture weakens the pelvic floor muscles,” adds O’Neill. “Take breaks and walk around many times during the day.”
- No more “just in case” peeing. Most people, if they are leaking, think that going to the bathroom prior to exercising will reduce the leaking, according to O’Neill. “Although this may seem like a logical tactic, it is signaling the brain to tell the bladder to empty before it has achieved its necessary fullness,” she advises. “Your bladder will prematurely need to empty more not less.”
- Stay hydrated before and during your workouts. Some people think that if they drink less, they will need to pee less. The opposite is true, according to O’Neill. “Your urine becomes more concentrated,” she says. “This actually irritates the bladder, making it feel that it needs to be emptied more.”
A version of this article was originally published in July 2014.