Treating Stress Incontinence: If you occasionally pee during your workout – or when you laugh, cough, dance or sneeze – you’re not alone!

The first time it happened was running the mile in high school, then again doing backflips on my trampoline at home, but I hit my limit when it began to happen when I jumped rope at CrossFit. I would barely make it more than 50 reps before feeling urine leaking out. Embarrassed, I’d high-tail it to the bathroom as soon as there was a break. “What do I do?” I thought. “Should I just leave? What if it happens again?” I would power through, but spent the rest of the class worrying that everyone else knew why I bolted to the bathroom.

If you occasionally pee when you workout – or when you laugh, cough, dance or sneeze – you’re not alone.  Stress incontinence is common, especially among women, but is largely underreported, due to the embarrassing nature and social stigma attached.

Stress incontinence is common, especially among women, but it is largely underreported, due to the embarrassing nature and social stigma attached. It is especially common in older women: A study published in 2015 by the University of California Davis showed that of the 3,000 women studied, 68% of the age 42 to 64 group experienced the effects of stress incontinence at least once a month.

Common Causes of Stress Incontinence

1. Weakening of the tendons and ligaments around the urethra. Once it isn’t supported sufficiently, the urethra isn’t as readily able to close off urine as it comes through the bladder, leading to the leaking.

2. Weakening of the the urethral sphincter. A weakened urethral sphincter can interfere with full closure or allow the sphincter to pop open under pressure. This can be brought about by a variety of factors, including pregnancy, vaginal childbirth, cesarean sections, and obesity.

3. Athletic hernias or muscle tears around the pelvic floor. If you are a gymnast, dancer, cyclist, or other athlete who notices urinary incontinence, you may be suffering from a nerve entrapment or irritation due to a pelvic muscle tear.

Hernias and muscle tears cause irritation to nerves. In the groin or pelvic region these injuries can block messages to the urethra, keeping it from properly functioning and tightening.

Athletic hernias are very common in female athletes. They often go undiagnosed, and are rarely connected to urinary incontinence in the diagnostic process. Seeking medical treatment promptly is advised if you have pelvic floor pain in addition to incontinence.

Treating Stress Incontinence

The good news is that you can fix this mid-workout leaking without surgery or medications.

1. Kegels. Your first place to start is with pelvic floor exercises like Kegel exercises. You can do them at home, anywhere. Try squeezing like you’re trying to stop urine from coming out, as if you were in a long line for a bathroom. Simply mimic that “up and in” contraction and hold for three seconds, then release. Repeat for 10 to 15 reps, then add more the next day.

2. Skip the Tea and Coffee before your workout. Sure, you want to get energized for your workout, but the caffeine in tea and coffee can stimulate urination, leading to more chances for leakage. You can limit your pee by limiting caffeine intake before and during your workout — and always go to the bathroom right before you start.

3. O-Shot® Medical Procedure.

The O-Shot® is a natural, nonsurgical procedure, performed by a doctor, nurse practitioner or physician’s assistant, that uses your own body’s growth factors to re-strengthen the urethral sphincter. It is proven to eliminate urinary incontinence in 9 out of 10 women, and comes with the side benefit of increased orgasms as well, through enhanced clitoral and g-spot stimulation. It’s called the ‘lunch break’ procedure, because it can be painless and you can return to life with zero down time.

4. Pelvic Floor Therapy. In many cases, it’s hard to know if you’re doing kegels right, and many women don’t have the muscle signaling to do kegels on their own. A physical therapist who specializes in pelvic floor work can help you get on the right track, helping you know your body and which muscles to reactivate, especially after childbirth or athletic injury.

5. Ultrasound Diagnosis and Treatment. If you were a gymnast, dancer, or female athlete who sometimes leaks urine, and may also experience groin pain or pain during intercourse, you are highly likely to have an athletic hernia, and there are a select group of musculoskeletal ultrasound experts who can diagnose and treat your issue. Seek out a specialist through MSKUS.com to find out more about regenerating the muscle and healing the nerve that is causing the pain and incontinence.

6. Inserts: Tampons & Pessaries. There is a temporary vaginal insert — called a high-impact pessary — that can work to provide support to the urethra during times of incontinence, like during a workout. You put the pessary in before your workout, and take it out when you’re done.

A thick tampon can act like a pessary and put enough pressure on the urethra to keep liquid from leaking out. Poise makes Impressa Bladder supports that look (and act) similar to tampons if you’d rather use those instead of your tampon stock.

7. Sanitary pads or panty liners. Pads and panty liners work to soak up any excess liquid that leaks out of your body, whether that be during your period or during a workout. Like tampons, the size — and absorbance level — differs among pads and panty liners, so experiment until you find one for you. You can also opt for bladder control pads by brands like Poise. These are much larger than regular pads and cover a bigger area, ensuring nothing seeps onto your leggings.

8. Urine-wicking underwear. Bladder control underwear doesn’t have to feel like a diaper. Brands like Icon make pee-proof underwear designed to keep you odor-free and dry, thanks to its moisture-wicking material that can hold up to six tablespoons of liquid (!). Better yet: They come in a variety of cuts and colors, keeping you comfortable and coordinated during you workout. And confident, of course!

If you are tired of living with the issue and just want to take care of it, where do you turn? Seeking a physical therapist who offers pelvic floor therapy? Want more info on the O-Shot®? Are you a dancer or a gymnast with pelvic pain and urinary leakage?

I said yes to ALL of those questions, and actually did everything suggested. From my medical colleagues, I went to physical therapy, got the Oshot, and did the ultrasound exam and injections, and no longer pee when I work out!

When I started Joy Wellness Partners in San Diego, CA in 2016, I incorporated the solutions that helped me and other women I knew, knowing so many girls could benefit if the solutions were available to them. Joy Wellness Partners and Enliven Aesthetics has a medical team with expertise in urinary incontinence solutions.

Call us at 858-609-0866 or email us at info@joywellnesspartners.com to speak to our patient care coordinators today about scheduling a full continence assessment.

References:

O-Shot® Official Home Page (Research, Video, Providers, & Provider Training) https://oshot.info/

Bardsley, A. An overview of urinary incontinence. Br J Nurs. 2016 Oct 13;25(18):S14-S21.https://www.ncbi.nlm.nih.gov/pubmed/27734727

Pelvic physical therapy: Another potential treatment option. Harvard Women’s Health Watch. 2018 Jun. https://www.health.harvard.edu/womens-health/pelvic-physical-therapy-another-potential-treatment-option

Impressa helps stop leaks before they happen. 2020 Jan. Proctor & Gamble.
https://www.poise.com/en-us/products/impressa/introduction