By Dr. Katie Spruell, PT, DPT, CSCS, PCES | Amplify Physio | Maryville, TN
You’re at the gym. You’re on a run. You’re jumping on the trampoline with your kids. And then — it happens. A little leak. Maybe enough to notice, maybe enough to change your clothes. Either way, enough to make you wonder if this is just your life now.
It’s not. And it’s far more common than you think.
Leaking with jumping, running, coughing, or sneezing is called stress urinary incontinence (SUI), and it has nothing to do with emotional stress. It’s a physical response — your pelvic floor not generating enough pressure fast enough to keep up with the demand being placed on it. And it is treatable.
Here’s what’s actually happening, and what you can do about it.
What’s Actually Causing the Leak
Your pelvic floor is a group of muscles that sits at the base of your pelvis like a hammock. One of its jobs is to keep you continent — which means it has to close off the urethra (aka your pee spout!) tightly enough to hold urine in, even when pressure builds up inside your belly.
Every time you jump, run, cough, sneeze, or lift something heavy, your intra-abdominal pressure increase — and it does so quickly. Research shows that fast, involuntary pelvic floor muscle contractions are required within milliseconds of impact — during running, jumping, and trampolining — to maintain continence. When your pelvic floor can’t respond quickly enough, or isn’t strong enough to match that spike in pressure, leaking happens. nih
Activities that involve jumping tend to induce the most urinary leakage, with peak ground reaction forces during high-impact activities ranging up to 14 to 22 times body weight. That’s a significant demand — and it explains why a pelvic floor that handles daily life just fine can still struggle during a run or while jumping. nih
This Isn’t Just a “Mom Problem”
One of the biggest myths about leaking is that it only happens to women who have had children. That’s not true.
A systematic review found a prevalence of urinary incontinence among female athletes of about 25.9% across different sports, with stress urinary incontinence being the most common type. We’re talking about young, fit, active women — many of them have never been pregnant before. nih
Research found that all women who do high-impact exercise are susceptible to stress urinary incontinence — and that leaking occurs regardless of the number of pregnancies a woman has had. MDPI
So if you’ve been dismissing your symptoms because you think you’re too young, too fit, or haven’t had kids — please don’t. Your experience is real, it has a cause, and it has a solution.
Curious if pelvic floor PT could help you? Book a free 15-minute discovery call — no referral needed, no commitment, just a conversation.
Why “Just Do Kegels” Isn’t Always the Answer
When women mention leaking to their doctor, the most common response is: do your Kegels. And while pelvic floor muscle training is absolutely part of the picture, a Kegel alone is often not enough — and for some women, it can actually make things worse.
Here’s why: leaking during impact isn’t always a weakness problem. Oftentimes, it’s a coordination and pressure management problem. Your pelvic floor needs to contract reflexively and rapidly — not just when you consciously squeeze. If the timing is off, or if the muscle is actually too tight and can’t generate force efficiently, squeezing harder won’t fix it.
This is exactly why a thorough pelvic floor assessment matters. What’s driving your leaking? Is it strength? Timing? Coordination? Pressure or Load management? The answer determines the treatment — and it’s rarely one-size-fits-all.
The Real Fix: Building Capacity for the Demand
Think of it this way: if running is the goal, your pelvic floor needs to be trained to handle running. That doesn’t mean you start by running through your symptoms. It means you build from where you are and progress intentionally.
In practice, that might look like:
- Starting with walking — low impact, manageable load, symptom-free
- Adding incline or pace as your pelvic floor adapts
- Introducing impact gradually — small hops, skips, short jog intervals
- Layering in strength training to build the foundation that supports everything above it
The same goes for jumping, HIIT, sports, or playing with your kids. You find the version of that activity that doesn’t provoke symptoms — and that becomes your entry point. Then you add volume. Then load. Then intensity. You earn each level, and your pelvic floor earns it with you.
This is the same principle we cover in depth in our post on exercising with pelvic organ prolapse — because whether you’re dealing with prolapse, leaking, or both, the approach is the same: meet your body where it is and build from there.
When to Stop Pushing Through
Leaking during exercise is common — but it is not normal, and it is not something you should ignore, accept or just push through. Continuing to push through symptoms without addressing them can reinforce poor movement patterns and make the underlying issue harder to treat over time.
Signs it’s time to see a pelvic floor PT:
- You’re leaking on most runs or workouts
- You’ve started avoiding activities because of it
- You’re wearing a pad “just in case” during exercise
- You’ve tried Kegels for weeks and nothing has changed
- The leaking is getting worse, not better
No matter how long you have been dealing with these symptoms – week, months, years or decades- there is always hope! It’s never too late to get started!
Pelvic Floor Physical Therapy in Maryville, TN and Surrounding Areas
If you’re dealing with leaking during exercise and you’re in Maryville, Alcoa, Louisville, Knoxville, or anywhere in Blount County, we can help. At Amplify, we do a thorough evaluation to understand exactly what’s driving your symptoms — and we build a plan that gets you back to the activities you love without planning your route around bathroom stops.
You shouldn’t have to choose between staying active and staying dry.
Schedule Your Free Discovery Call →
Prefer to talk first? Call or text us at 865-233-3533.
Dr. Katie Spruell is a Doctor of Physical Therapy, Certified Strength and Conditioning Specialist, and Pelvic Health specialist serving Maryville, Alcoa, Louisville, Knoxville, and Blount County, TN. To schedule an appointment at Amplify, call 865-233-3533.