Medically, incontinence is the inability to regulate the body’s release of waste matter from the bladder or bowels; people who are incontinent aren’t able to fully control their urine or feces output. However, many laypeople use the term incontinence to refer only to urinary incontinence — the inability to control the flow of urine.
Per the Mayo Clinic, urinary incontinence affects around half of all adult females, with the prevalence rising with age. Certain lifestyle factors can increase the likelihood of experiencing incontinence, including running. Although incontinence while running can affect both genders, it’s especially common for females. Indeed, research indicates that approximately 40% of professional female runners or athletes experience incontinence. Moreover, a 2018 study looked at all female British athletes competing in the Commonwealth Games and found that 52% of participants experienced urinary incontinence, either in training or while competing.
Although urinary incontinence while running is common, especially for females, that doesn’t mean it’s normal to leak urine while running. Incontinent runners aren’t abnormal; rather, they don’t necessarily need to normalize incontinence and live with discomfort.
Various factors contribute to urine leakages while you’re running. Usually, runners leak urine because of a combination of increased pressure of the bladder and weakened pelvic floor muscles. In short, your bladder stores urine until it contracts to empty itself by forcing the urine out of your body via your urethra. Muscles, called the urethral sphincters, usually prevent urine from leaving the bladder until you’re ready. When you pee in a typical manner, you voluntarily relax these muscles and release the urine. Sometimes, however, people can lose control of this function and experience leaks ranging from a few drops to a full bladder’s worth of urine.
Causes of Incontinence When Running
There are several reasons you may feel like peeing when running or be unable to control urine leakages. The most common type of incontinence while running is called stress incontinence, which is the result of muscle weakness. Common reasons for muscle problems that lead to stress incontinence include:
Weak Pelvic Floor Muscles
The muscles in the pelvic floor span between the pubic bone and tailbone. The muscles support the bladder and bowel and, in females, the uterus as well. Essentially, they help stabilize and strengthen your body’s core, helping you perform functions such as urinating, defecating and having sexual intercourse.
If your pelvic floor muscles are weak, they don’t provide adequate support to certain organs. Importantly, lack of bladder support is a major cause of incontinence. The running motion puts greater pressure on the bladder, leaving weakened muscles more susceptible to failure, which in turn leads to leaks.
Hormonal Changes
Females typically experience many hormonal changes and fluctuations throughout their life. As well as during major life transitions, such as puberty, pregnancy, and menopause, hormone levels generally change during the month for women between puberty and menopause; your hormones naturally rise and fall throughout your menstrual cycle. Some women also suffer from hormone disorders, meaning that their hormone levels aren’t balanced as they should be. Hormone levels, in particular low levels of estrogen, can weaken the pelvic floor muscles.
High-Impact Exercise
High-impact exercises typically involve running or jumping. Examples include jogging, doing burpees, playing tennis, and performing squat jumps. Movements involve the feet leaving the ground, resulting in jolts or jerks to the body. These motions essentially bump and shake the bladder, which can cause stress and urine leakage.
Previous Childbirth or Surgeries
If you’ve given birth vaginally, it’s highly likely that your pelvic floor muscles aren’t as strong as they were before. However, women who give birth by caesarian section typically also experience weakened pelvic floor muscles to some degree; being pregnant can also cause stress, strain, and other damage to the muscles underneath the uterus. Surgeries in the pelvic region can also damage the muscles.
Age-Related Changes
A combination of factors often results in weaker pelvic floor muscles as you age. As you get older, you’re more likely to have given birth, gone through hormonal changes, and otherwise put your pelvic muscles under strain. Alongside weaker muscles, your bladder tends to hold less as you get older, meaning you probably need to urinate more frequently and are unable to hold your urine for as long when the urge strikes.
Types of Incontinence
There are four main types of incontinence, some more prevalent than others. Although each has different causes and triggers, the end result is the same: you leak urine to a greater or lesser extent. You can also experience several types of incontinence together.
Stress Incontinence
Stress incontinence is the most common type of urinary incontinence while running and at other times. It is typically triggered by movement, force, or activity, such as sneezing, laughing, coughing, or exercising. Most people don’t experience a feeling of needing to pee before leaking. In short, leakages typically occur because the muscles that usually hold the urine inside fail. With stress incontinence you may have just a few drops of leaked urine or your bladder may void completely. Approximately one-third of all females will experience stress incontinence at some point in their lives.
Urge Incontinence
Urge incontinence is where you get a sudden and uncontrollable urge to pee. It may also be referred to as an overactive bladder. It’s caused by your bladder contracting abnormally, which may stem from nerve damage or bladder irritation. If you have urge incontinence it can be impossible for you to delay urinating as soon as you get the urge. This can result in people wetting themselves. When you’re running outdoors, it’s unlikely you’ll always have a bathroom nearby.
Functional Incontinence
Functional incontinence occurs if you’re unable to adequately prepare yourself to urinate when you need to. For example, you may have mobility problems that prevent you from reaching the bathroom in time or reduced dexterity that can make it difficult to undo buttons or zips. Functional incontinence is caused by problems unrelated to the genitourinary system. This type of incontinence is more likely to affect older adults, people with disabilities, and people with cognitive impairments rather than runners.
Reflex Incontinence
Reflex incontinence is caused by involuntary muscle spasms that result in inappropriate urination. It’s usually caused by nerve damage that disrupts the signals between the bladder and the brain. Reflex incontinence is similar to urge incontinence, but without the strong and sudden feeling of needing to pee beforehand. With reflex incontinence you generally don’t have any warning before it happens and you may partially or fully empty your bladder at any time.
Mixed Incontinence
Mixed incontinence is where you experience more than one type of incontinence. For example, you may have bladder irritation that leads to urge incontinence alongside a weak pelvic floor, which can cause stress incontinence.
How to Manage Incontinence When Running
Whether you lose a few drops of urine or pee yourself completely, incontinence can put you off doing activities you love. Incontinence can be a major contributing factor for women stopping exercising, particularly as they get older. It doesn’t have to be that way, though; there are several ways you can reduce the chance of you experiencing incontinence while running as well as ways to mitigate the effects of any leakages.
1. Strengthening Exercises
If you experience stress incontinence, pelvic floor exercises, such as Kegels and toe taps, can help to strengthen your muscles. Stronger muscles often lead to less leaks.
2. Using the Bathroom
As simple as it sounds, making sure you always empty your bladder before going out for a run can reduce episodes of incontinence. Always visit the bathroom right before setting off for a run, whether or not you feel like you need to urinate.
3. Modifying Routines
Sometimes, changing the way you perform your exercise routines can prevent incontinence. For example, try switching high-impact warm-up activities for those that put less stress on your muscles before going out to run.
4. Wearing Dark Clothes
Wearing darker clothes won’t prevent incontinence, but it can prevent people from noticing if you tend to leak just a few droplets. Changing light-colored bottom garments for darker items can give you more confidence when running.
5. Wearing Absorbent Pads
Wearing an absorbent pad is an ideal way to feel comfortable and confident while running if you’re prone to urine leaks. Not only do you protect your clothes and prevent others from noticing leaks, but you remain fresh and dry as you run. Nexwear pads are discreet and designed to hold liquid, keeping you more comfortable.
6. Avoiding Triggers
Certain drinks can irritate your bladder, such as caffeine and alcohol. Some foods, including spicy dishes and acidic fruits, can also cause bladder sensitivity. Reducing your intake, especially before a long run, can help to prevent leaks.
7. Seeking Medical Advice
If incontinence is making your life difficult, don’t be afraid to speak with a medical professional. Your doctor can help you find the cause of your problems and may be able to recommend ways to improve issues. For example, sometimes, it’s possible to retrain your bladder with therapy. This is more useful if you experience urge incontinence. Medications, lifestyle changes, and surgeries may be other avenues to explore with your physician.
Prevention Strategies
Various measures may help lessen the incidence and severity of incontinence episodes. Prevention strategies may include:
- Maintaining a healthy weight
- Staying hydrated
- Regular elimination
- Adequate sleep
- Reducing alcohol and caffeine intake
- Avoiding food and drink triggers
- Stopping smoking
- Doing regular pelvic floor exercises
- Good personal hygiene
- Taking a break
- Improve breathing
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