Does Excercise Make Stress Urinary Incontinence Worse or Better?

Women are often told to exercise more, but those who suffer from incontinence might wonder about this advice. Bladder leakage during exercise is not only discouraging, but it might also make you wonder, does exercise make stress urinary incontinence worse? Can exercise help with urinary incontinence in women?

This blog from the Pelvic Awareness Project will explore what you need to know about exercise and urinary incontinence, including the best types of exercise and how to handle those troublesome leaks.

Exercise and Bladder Leaks

There are different kinds of incontinence, and several causes of bladder leaks. Urinary incontinence can impact up to 60% of women during their lifetime.¹

Here are the main types of urinary incontinence:

1. Stress urinary incontinence or SUI: Leakage when there’s pressure on the bladder, like during exercise.
2. Urge incontinence: Leakage when you have a sudden and intense need to pee.
3. Overflow incontinence: Leakage because the bladder doesn’t completely empty.
4. Mixed incontinence: A combination of several conditions.

Stress urinary incontinence (SUI) is the most common among women. In one study, 61.8% of women had urinary incontinence, and of those, 37.5% had SUI.² This sudden and involuntary leakage of urine happens when you laugh, cough, sneeze, and yes, during exercise. 

That doesn’t mean you shouldn’t be active. In general, exercise is good for you, even with the occasional leak. If you’re bothered by incontinence, don’t stop being physically active. 

Don’t Let Bladder Leaks Stop You From Exercising

Bladder leakage during exercise is just one way that incontinence negatively impacts your quality of life. It’s not surprising that some studies report that up to 20% of women quit physical activities due to incontinence.³

Bladder leaks are not a laughing matter, and not something you should just accept as a natural part of aging, or of being a woman. If you have any type of incontinence problems, use the Pelvic Awareness Project’s Physician Finder to find a doctor near you with expertise in women’s health. 

A proper diagnosis of your incontinence issues, along with a treatment plan, can get you back to enjoying your lifestyle, including a regular exercise program.  

Does Exercise Make Bladder Leaks Worse?

The answer to whether physical activity makes SUI worse is not straightforward. There is some evidence that suggests an increase in rates of stress incontinence among physically active women, but the reasons aren’t clear.⁴ 

On the flipside, a sedentary lifestyle, such as sitting for long periods of time, makes incontinence worse. 

One study found that incontinence was “significantly associated” with sedentary behavior in older women. Researchers have found a clear link between prolonged sitting and urinary incontinence, suggesting that reducing sitting time could be a beneficial treatment for incontinence.⁵

Another study found that sitting for more than seven hours a day made incontinence worse, and for women in particular, it made SUI worse.⁶

Being active is better than being inactive, and exercise can help alleviate stress urinary incontinence. The difference could be in the exercise program you choose.

Best Exercises For Women with Stress Urinary Incontinence

One of the leading causes of SUI is a weakened pelvic floor. This important group of muscles and ligaments holds your pelvic organs in place, and also supports bodily functions like peeing and pooping. When the pelvic floor is weakened, the muscles responsible for holding in urine are impacted.

Exercises to strengthen the pelvic floor are among the most important for any woman. Kegels, as they’re commonly called, are also easy to add to your daily routine. 

To perform Kegels, follow these steps:

1. Contract the muscles you use to hold in pee.
2. Hold the contraction for three seconds. 
3. Then relax for three seconds. 
4. Perform 10 repetitions, gradually increasing to 15 repetitions per set.
5. Build up to three sets a day, once sitting, once standing, and once lying down.

Other exercises that can benefit SUI include yoga and pilates, both of which strengthen your core muscles, including your pelvic floor.6 Low-impact workouts like walking and swimming are also beneficial. 

Worst Exercises For Bladder Leaks

High-impact exercises, such as running and aerobics, as well as sit-ups, can put pressure on your pelvic floor muscles and increase the risk of leaks. Heavy lifting also strains your pelvic floor muscles. Be sure to tighten your pelvic floor when you do need to lift, but be careful with weight-lifting exercises.⁷

Other ways to help ease incontinence include losing excess weight and not smoking, since being overweight or having a chronic cough can both make SUI worse.⁷ 

How To Prevent Bladder Leaks During Workouts

You want to be active, but bladder leakage during exercise is holding you back. Here are some tips for exercise and urinary incontinence.³

1. Address Stress Incontinence Causes

Some solutions to bladder leaks during workouts are linked to stress incontinence causes. For instance, women who have pelvic organ prolapse sometimes suffer symptoms of incontinence. In this instance, a device known as a pessary can help relieve pressure on the bladder caused by the prolapse.

2. Use Protection

While it’s not ideal, wearing an incontinence pad can help give you the confidence to be active and enjoy the many benefits of physical activity. 

3. Plan Ahead

If you’re going to work out, cut back on fluids before you start, and empty your bladder just before you begin. Be careful not to limit overall fluid intake, however, as this can make incontinence worse and lead to constipation.⁷ 

4. Watch What You Eat

For some people, certain foods or drinks can irritate the bladder and make incontinence worse. Avoid those the day before or day of your activity. Examples include spicy foods, acidic foods, alcohol, and caffeine. 

Want to know more about staying active? Read this overview of managing incontinence during exercise. 

Exercise Can Help Stress Urinary Incontinence 

While some forms of physical activity can put strain on your pelvic floor muscles, and possibly cause bladder leaks, it’s important to stay active. 

Exercise is healthy for everyone, including women with incontinence. The best way to deal with leaks during exercise is to address the cause of your incontinence. With proper diagnosis, you can develop a plan with your doctor that will allow you to remain physically active while limiting or avoiding bladder leaks.

[accordion][accordion_item title="Click for References"]

1- https://www.ncbi.nlm.nih.gov/books/NBK539769/

2- https://pubmed.ncbi.nlm.nih.gov/35030139/

3- https://nafc.org/bhealth-blog/dont-quit-exercising-because-of-urinary-incontinence/

4- https://pmc.ncbi.nlm.nih.gov/articles/PMC6711374/

5- https://pubmed.ncbi.nlm.nih.gov/32017767

6- https://pmc.ncbi.nlm.nih.gov/articles/PMC10950664/

7 - https://www.nhs.uk/conditions/urinary-incontinence/10-ways-to-stop-leaks

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