Lots of people are familiar with stress incontinence — when the internal pressure is too great for the support system of the bladder, leading to the leakage of urine.

But are you familiar with Sports Induced Incontinence?

This is a very unique diagnosis, where people only get incontinence during their specific sporting activity.

For example, I had a patient who was a mother of 2, and a marathon runner. She could jump, sneeze, and laugh with no issue. She could even run 15 miles without any issues, however, the second she got past 15 miles — leaks. And a lot of them.

She was really frustrated, because no practitioners would take her issues seriously. She could exercise, so what was the big deal that she couldn’t run more than 15 miles? But it was a big deal, her quality of life was greatly affected by this.

So we had to figure out why this was happening.

What the research finds, in regards to athletes that suffer from stress incontinence, is that they mostly likely have greater urethral mobility and delayed anticipatory postural musculature recruitment.

What does this mean?

The muscles around the urethra allow more movement with high or repetitive loads. And they are not as quick at reacting when they are called upon to work. So that means, that we need to incorporate training with athletes on force loads and anticipation like catching weighted balls, balance training, activities with eyes closed and not being able to anticipate balance perturbances.

As well, these individual’s will have short term muscle fatigue with intense exercise.

Meaning that once the muscle’s fatigue, they no longer give a maximal contraction in times of high load. Like running. So how do you improve this? For this particular patient, I had her try to run up to 15 miles prior to our appointment, so her pelvic floor would be more fatigued. Then we would do her pelvic floor strengthening exercises, as mentioned above. This started to slowly improve how much mileage she could go without leakage.

But what we found with this patient, in particular, that made the biggest difference was discovering she was an abdominal gripper. This means she had trained herself to pull her abdominal muscles in. All of the time.

Contracting the abdominals push a downward force on the pelvic floor — creating stiffness.

That leads to the pelvic floor not being able to maintain pressure with activity and increased ground reaction forces — so running with an abdominal contraction can cause stress incontinence. The pelvic floor needs to be able to move freely to contract and counter the high load of running. Hers was not!

So, as we started her abdominal down training — aka, learning to let go of her stomach — she was able to run further and further without incontinence. We incorporated breathing exercises, abdominal soft tissue work, abdominal stretches, and increased pelvic floor anticipatory firing activities. And she was finally able to run a full marathon without any leakage or need of incontinence pads.

When it comes down to it, there are few things that we know that are most likely associated with sports induced incontinence: increased urethral mobility, slower reaction skills of the pelvic floor, and sometimes more rigidity to the pelvic floor. But at the end of the day, we still have to do a thorough assessment and treat the individual. We all have learned habits that might be contributing to our pelvic floor issues.

If you only have incontinence during your runs, cross fit, or jumping activities — then you might have sports induced urinary incontinence.

Come in for an evaluation to learn the WHY.

Method Physical Therapy has the experience and knowledge to help, reach out today if you want to come in for an evaluation.