You’d think that something that affects 1 in 4 women and makes running difficult would appear more often on the UKRunChat Twitter and Facebook feeds wouldn’t you? That topic is bladder weakness. Let’s face it, incontinence is an embarrassing and not very pleasant subject to discuss so it’s no big surprise that you don’t see #ipeewhenirun #ukrunchat on your feeds!

We do need to talk about it however as leaking urine when you run is REALLY common and a major barrier to women running, or even exercising at all. Because of the embarrassment factor, women don’t seek help and many think that it’s just a normal part of being a woman (especially after having children). This attitude needs to change. Yes, it’s common but it shouldn’t just be accepted because for the large majority of women it can be cured. So, if you’re one of those female runners wearing pads or sticking to black leggings then read on.

Aren’t there different types of urinary incontinence?

Yes. There’s urge incontinence when you have an overactive bladder, feel like you need to go to the loo a lot and leak urine if you don’t get there in time. Then there’s stress incontinence when urine leaks happen due to an increase in pressure inside your pelvis such as when you run, jump or cough. Many women have a mixture of both.

Are some women more likely than others to get stress incontinence?

Yes. The pelvic floor is the sling of muscles inside your pelvis that supports your bladder. If your pelvic floor is weak then it might not cope with sudden increases in pressure and urine leaks out as a result. Weak pelvic floors can happen after pregnancy (when the weight of a growing baby may weaken it), after childbirth, particularly if the baby was big or the labour was difficult. Being overweight increases the pressure on the pelvic floor and so does repeatedly straining with constipation and coughing. Our pelvic floor weakens with age too as oestrogen levels keep the tissues elastic and once we hit the menopause our oestrogen levels drop.

I’ve been squeezing my pelvic floor muscles but my incontinence isn’t getting any better. What am I doing wrong?

Strengthening the pelvic floor muscles is crucial so doing specific pelvic floor exercises (PFEs) is the right thing to do but it isn’t always as easy as it seems. Performing them correctly can be tricky. It also takes a long time to see any benefit. You need to do 12 to 16 weeks of good quality PFEs before you’ll notice a difference. There might also be other issues affecting you such as diastasis recti (a splitting of the abdominal muscles common after pregnancy) or weak glute muscles. If you haven’t been making progress with doing PFEs then I really recommend that you see a women’s health physio – your GP can refer you. They will carry out a full assessment, spot other underlying issues and teach you to perform PFEs effectively.

Wouldn’t it be easier to just get one of those electrical vaginal stimulation things?

There are lots of different devices you can buy in the chemist and online to help solve incontinence but be careful. Some of them are very expensive and won’t necessarily suit you. A women’s health physio can advise you which, if any of them, would benefit you. There are electrical stimulators that cause contractions of the pelvic floor muscles and there are also others that give ‘biofeedback’ and tell you how hard you are squeezing them yourself.

So, can I keep running while I’m trying to strengthen my pelvic floor?

The million-dollar question! To be honest, for some women it’s actually better to have a break from running while you get this issue sorted out or at least tackle it at a time when you’re not full on training for something. It depends how severe your weakness is and whether there are other issues alongside it. Sprinting and downhill running usually cause the most leaks and avoiding these for a few weeks while you’re undergoing treatment might be advised. Listen to your physio, if they advise a few weeks off then it’s wise to follow their advice as in the longer term your recovery will be quicker and more robust. Don’t forget though, exercising your pelvic floor is something you will need to do regularly for the rest of your life.

Please go and seek help if you’re affected by stress incontinence. Don’t be embarrassed, your GP will have heard it a million times and it’s what women’s health physios are trained to deal with.
For more detail on this topic and other exercise related women’s health issues you can buy my book, Sorted: The Active Woman’s Guide to Health. UKRunChat members can use the code UKRUNCHAT to get 20% off when buying direct from Bloomsbury.