Let’s Talk About Leaking and Incontinence

Today we’re diving into a topic that so many women struggle with, but rarely talk about: leaking and incontinence. If you’ve ever “peed a little” when you sneeze, laugh, run, or lift something heavy — you are not alone. And while it’s common, it’s not something you just have to live with.

What’s Normal When It Comes to Pee?

Before we talk about what’s not working quite right, let’s establish what’s normal:

✅ You pee 5–8 times per day (if you’re under 65, you usually don’t wake at night to go; over 65, once per night is typical).

✅ You can hold it if you need to.

✅ You don’t have pain, burning, or infections.

✅ You don’t worry about your bladder.

✅ When you go, you have a steady stream that lasts at least 7–8 seconds.

That’s what healthy bladder function looks like.

Why Women Experience Leaking More Than Men

It really comes down to anatomy. In men, the urethra (the tube urine travels through) is much longer. In women, it’s a much shorter distance. So when abdominal pressure increases (think coughing, sneezing, jumping, or lifting), it’s easier for urine to escape.

What Is Incontinence?

Incontinence is simply leaking pee when you don’t want to. It shows up in a few different ways:

• Urge Incontinence → That sudden, “I need to go NOW” feeling. Sometimes you even plan your day around bathroom locations. This often happens when the bladder muscles and receptors send the “full” signal too early, even when your bladder isn’t full.

• Stress Incontinence → Leaking when pressure spikes in your abdomen (sneezing, laughing, coughing, running, jumping, lifting).

• Athletic Incontinence → Leaking only during exercise (running, CrossFit, lifting, jumping) but not in daily life.

• Mixed Incontinence → A combination of urgency and stress leaking.

  
  

And yes — this isn’t just a “mom problem.” Research shows nearly 50% of adolescent female athletes report stress incontinence, even without kids.

When Does Leaking Happen?

Most often during:

• Coughing, sneezing, laughing, vomiting

• Running or jumping (impact activities)

• Lifting heavy weights (especially deadlifts)

• Using a lifting belt incorrectly

  
  

Why It Happens

Leaking isn’t always about “weak” pelvic floor muscles. Sometimes it’s the opposite — muscles are too tight and fatigued. Other times it’s coordination: the pelvic floor isn’t engaging at the right time to meet the pressure demand.

How Common Is It?

📊 41% of pregnant women experience stress incontinence.

📊 After vaginal delivery, women are 2–4x more likely to leak compared to C-section births.

📊 Almost 45% of women leak with high-intensity exercise like CrossFit.

There’s also a strong link between incontinence and mental health — anxiety and depression can reduce activity levels, which means less pelvic floor strength and resilience.

What You Can Do

✨ The Knack Technique: If you know a sneeze is coming, pre-engage your pelvic floor just before it happens. This helps it handle that quick burst of pressure.

✨ Position Matters: Stand tall — not slouched, not arched. Ribs stacked over pelvis is the most efficient alignment for your diaphragm, core, and pelvic floor to work together.

✨ Breathing, Not Bracing: Don’t suck in your stomach or bear down. Think “corset”—wrap your core and lift pelvic floor as you exhale during exertion.

✨ Soft Landings: When jumping or running, land lightly to reduce impact forces.

✨ Strengthen & Relax: Pelvic floor muscles need both. Constantly “doing kegels” without rest can actually backfire. A strong body overall = a strong pelvic floor.

The Gold Standard for Treatment

The research is clear: pelvic floor muscle training with a pelvic floor physical therapist is the most effective treatment for incontinence.

It’s not just about stopping leaks — it’s about retraining your body to automatically respond to life’s demands, whether that’s sneezing, running, or lifting.

And here’s something exciting: preventive pelvic floor training during pregnancy can reduce stress incontinence in late pregnancy by 62%. That means you don’t have to wait for symptoms to show up — you can train now and avoid issues later.

Final Takeaway

Leaking might be common, but it is not normal — and you don’t have to just live with it. With the right strategies and support, your bladder and pelvic floor can work for you, not against you.

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