Bladder Leakage During Exercise: What’s Happening?

Bladder leakage during exercise is more common than you might think, and it’s not just athletes who experience it. For many, activities like running, jumping, or lifting can lead to involuntary urine leakage, which can feel embarrassing or frustrating.

But there’s good news: understanding what’s behind these leaks and learning ways to manage them can make all the difference, helping you stay active with confidence.

What is Stress Urinary Incontinence?

Stress urinary incontinence (SUI) is the term used to describe those unexpected urine leaks that occur during activities that put pressure on the bladder. It’s more than just a “sporty” issue—everyday actions like sneezing, laughing, coughing, or lifting anything heavy can also trigger it.

These leaks happen because the bladder and surrounding structures experience increased abdominal pressure, which temporarily overwhelms the strength of the muscles that control urine flow.

SUI is commonly linked to weakened pelvic floor muscles, but it’s a condition that can affect people of all ages and fitness levels.

Factors like aging, childbirth, obesity, and certain surgeries (such as prostate or gynecological surgeries) can weaken the pelvic floor over time, making it harder for these muscles to hold urine effectively. Even long-term activities that involve repetitive lifting or strain can contribute to stress on the pelvic floor muscles, increasing the likelihood of leaks.

Understanding SUI as a manageable condition is key—it’s common, and with the right strategies and support, it’s entirely possible to strengthen these muscles and improve bladder control.

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How Common is Urinary Leakage?

Very common!

Many people believe that only older adults and women who have given birth experience urine leakage. Contrary to popular belief, research has found that 33% of elite athletes experience urine leakage, regardless of their gender.

A 2017 research study identified that volleyball players have the highest occurrence of urine leakage. However, you don't have to be an elite level athlete to experience leakage. This is common in gymnasts, runners, indoor soccer players, cross-country skiers and basketball players.

While this type of leakage is common, some people may also experience symptoms of an overactive bladder, with sudden urges to urinate, even outside of physical activities.

Why the Pelvic Floor Muscles Matter

The pelvic floor muscles support essential functions within the body. Acting as a supportive sling, these muscles hold up the bladder and other pelvic organs, including the uterus and rectum, which are crucial for maintaining bladder control and overall core stability.

When these muscles weaken, it can lead to challenges in managing bladder control, especially during activities that put extra pressure on the abdomen.

But when the pelvic floor muscles lose strength or get damaged, they might not be able to keep everything in check during activities that increase pressure in the abdomen.

Tips to Manage Bladder Leakage During Exercise

Here are some practical, simple adjustments that can help you manage stress incontinence:

Strengthen with Pelvic Floor Exercises: Kegel exercises can help build strength in the pelvic floor muscles, boosting your bladder control. To try it, imagine you’re stopping the flow of urine, contracting and releasing those muscles in intervals. Practicing this regularly can make a noticeable impact.
Change Up Your Routine: If high-impact workouts are causing problems, try switching to lower-impact activities like swimming, cycling, or yoga. These exercises put less stress on the pelvic floor while still providing a great workout.
Maintain a Healthy Weight: If extra weight is part of the picture, even a small weight loss can reduce the pressure on your pelvic muscles and bladder, helping reduce leaks.
Train Your Bladder: Setting a regular schedule for bathroom breaks and gradually extending the time between can help retrain the bladder, reducing those “urgent” feelings that can lead to leaks.
Rethink Diet Choices: Limiting caffeine, alcohol, and spicy foods can help prevent bladder irritation. And drinking smaller amounts of water more frequently (instead of all at once) can help prevent sudden urges.

Is it Possible to Exercise Regularly with SUI?

Absolutely, it’s possible to exercise regularly with stress urinary incontinence (SUI)! Many people with SUI stay active and enjoy their workouts by making a few adjustments to their routine and focusing on strengthening the pelvic floor.

Low-impact activities like walking, swimming, cycling, and yoga are excellent options, as they put less pressure on the pelvic floor and have a much lower chance of causing you to leak urine than high-impact exercises like running or jumping.

With consistent pelvic floor exercises (like Kegels) to build strength and stability, many people find they’re able to handle a wider range of activities with confidence.

Additionally, practicing good form and making adjustments as needed, like avoiding overly intense core movements that can strain the pelvic floor and lead to leaking urine, can be helpful.

Consulting with a pelvic health physical therapist can also provide personalized strategies to help manage SUI effectively while keeping you on track with your fitness goals.

How Physical Therapy Can Help

Research has consistently found that physical therapy for pelvic floor muscles is the number one most effective treatment for urinary leakage. Pelvic floor physical therapists can help you learn more about the anatomy of your pelvis and how to properly strengthen your pelvic floor muscles.

They can also help you train your pelvic floor muscles specific to your sport, and share strategies to withstand the pressure that occurs during high-impact activities. So if you're unsure what your next steps should be, we recommend contacting a Physical therapist who specializes in pelvic floor therapy.

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Summing up:

Bladder leakage during exercise is an issue many people face, but with the right strategies, you don’t have to let it hold you back.

By working to strengthen the pelvic floor and making a few tweaks to your routine, you can regain control and enjoy your workouts with confidence.

Remember, you’re not alone in this—taking proactive steps is the best way forward to keep doing what you love without worry.

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Author: Dr. Crystal Okenkpu, PT, DPT, CLT

Crystal Okenkpu Crystal graduated from the University of Houston with a B.S degree in Kinesiology Exercise Science. She received her Doctor of Physical Therapy degree from Mary Baldwin University – Murphy Deming College of Health Sciences. She is currently a Women’s Health Resident focusing on pelvic health and is passionate about female athletes with pelvic floor dysfunction and women experiencing pelvic region dysfunction postpartum. Originally from Houston Texas, Crystal enjoys anything artsy, outdoorsy, running on trails, traveling, exploring new restaurants, playing sports, and going to greenhouses/plant nurseries.