Leaking on running is something maybe women accept as part of having babies. About 1 in 3 women will suffer from urinary incontinence. As women, we should not accept having to wear pads and black leggings every time we go for a run or jump as normal after having children. Find out the top 8 causes of incontinence so you can start planning how to resolve yours.

Understanding the reasons why leaking occurs is the first step to helping manage the symptoms of urinary incontinence. Some women may have one main contributing factor to their incontinence while others may have many factors. While you might think all incontinence is the same there are many factors influencing continence and addressing the ones that are related to your body will be key to finding a solution.

Some issues are simple to address on your own; while with many others, guidance from a women’s health physiotherapist is essential to get the best results.

So, let’s examine some of the top causes of incontinence:

1.    Weak pelvic floor muscles

If you do not exercise any part of your body regularly it gets weak and deconditioned. This is especially true for your pelvic floor after birth. That makes it less available to react to the impact running generates in the body; this in turn can cause leaking.

The NICE guidelines recommend that all women perform a set of 10 slow pelvic floor muscle contractions and 10 fast contractions, three times a day.

This sounds easy but you are probably one of the many women who are not sure if they are doing the pelvic floor muscles correctly. Some even do the opposite, bearing down on their pelvic floor when trying to do the pelvic floor exercises. An individual assessment with a women’s health physiotherapist can ensure you are doing your pelvic floor muscles correctly and help you work at the right level for where your body is at.

Developing strategies to ensure you are consistent with your pelvic floor muscle training is essential. This is where many women struggle. One minute it is Monday morning, and you are full of enthusiasm for pelvic floor exercises and the next thing it’s Friday evening and somehow you have not done a set!

Consistency is key when doing pelvic floor muscle training. Have a look at your day and see what activity do you do everyday (ie: brush your teeth, have a cup of tea), could you tag a set of pelvic floor exercises onto this habit?

2.    Overactive pelvic floor muscles

Most women have heard of pelvic floor muscle weakness, but did you know sometimes the pelvic floor muscles can be “switched on” all the time and overactive? This sounds like it is a good thing but when you are running your pelvic floor muscle needs to lengthen just before your heel strikes the ground and then contract to support your bladder as you push off. A muscle that is held tight all the time cannot lengthen and will not be available to prevent leaking on running. We want flexibility and strength, not rigidity.

Co-ordinating breathing with the movement of the pelvic floor is the starting point for this. If you are a member of The Bump Room Community, you will find a video on coordinating your breath and pelvic floor in the education section of phase 1. As you inhale your diaphragm descends and your pelvic floor will lengthen. This synergistic muscle action allows your system to respond more effectively to the demands of running.

A women’s health physiotherapist can also help you reconnect to your pelvic floor muscles and diaphragm again.

3.    Sucking in your tummy muscles

Let it go, et it go……….. A constantly drawn in, tight waist forces pressure down internally, overwhelming the pelvic floor. When you suck in your tummy muscles on running (or just in your daily activities), you increase the demands on your pelvic floor.

If you have attended a postnatal class with The Bump Room you will know that we don’t want the upper abdominal muscles to be doing all the work!

Learning to consciously release and soften your waist (after years of sucking it in) is perhaps the most difficult of all habits to change but can make a huge difference to your pelvic floor muscle performance. Breathing and coordination exercises will help you change this habit and reduce the pressure down on your pelvic floor muscles as you run.

It can take a lot of work and conscious effort but the benefits are huge.

4.    Hormones

For some women, their symptoms of urinary incontinence increase around the time of their period, and this can be due to hormonal shifts in their bodies. Working on your pelvic floor muscle strength consistently can help to minimise the effects of the hormonal cycle on your incontinence.

5.    Excess weight

Unfortunately, as women, we carry weight around our tummy. When we run any extra pounds create more force down on our pelvic floor muscles increasing the risk of leaking urine. Losing weight has been shown to reduce urinary incontinence.

Increasing your walking pace and distance is a great place to start with losing weight and improving your body’s capacity for running. Progress to walking uphill and build up your strength before returning to running.

6.    Constipation or Bloating

Constipation is a major contributing factor to pelvic floor muscle dysfunction. Chronic straining from constipation can lead to a weakening of the pelvic floor muscles. The rectum is very close to the bladder. When the rectum is overfull (due to constipation), it can press on the bladder, reducing the amount of urine the bladder can hold. This may cause you to leak urine or make you feel as if you need to pass urine right away or frequently.

Monitoring your fluid, fiber, exercise and adopting the correct toileting position will help. A footstool in the bathroom to ensure your knees are higher than your hips will allow your bowels to open easier.

In some cases, constipation can be caused by the pelvic floor muscles not relaxing properly. When we open our bowels the pelvic floor muscles need to lengthen to allow a bowel movement to occur. A tight/non-relaxing muscle can create an obstruction to opening your bowels. The footstool will help this, and working on breathing, diaphragm and pelvic floor coordination.

7.    Fatigue

For many women incontinence only occurs after a period running (eg: after 1km). Running generates forces of over 2.5 times your body weight. The repetitive forces overtime can cause incontinence, due to pelvic floor muscle fatigue or even decreased endurance of the leg muscles, which in turn will change your running technique (increasing ground reaction forces and pressure through your body). Your body could benefit from a specific whole body strengthening and endurance programme to increase your body and pelvic floor’s capacity for running.

The postnatal classes at The Bump Room have 2 distinct levels to progressively build your body back up to manage the load of running and impact exercise. An important point to remember is that sometimes your body is just too tired. Maybe you have not got enough sleep recently? This heavily impacts your pelvic floor muscle performance and even your whole body’s ability to cope with the increased demand of running. Never feel bad about resting. Looking after a newborn is demanding and sometimes rest is the best option for you right now.

8.    You have a post birth injury

Some women can experience a birth injury during childbirth. This could mean they may need support for the pelvic floor to maintain continence while running. There are many options available including the EVB support short and various types of pessaries but you would require an individual assessment with a women’s health physiotherapist will evaluate what support if any could benefit your body.

Common does not mean normal!! If you are experiencing symptoms of urinary incontinence, the best thing you can do to help yourself is book an appointment with a women’s health physiotherapist to assess which factors are contributing to your symptoms and create a plan to get you back to enjoying running again. Remember, it is never too late to work on improving your pelvic floor muscles.