Don’t be hamstrung by incontinence: How to keep on running and defy bladder weakness

We understand that urinary incontinence can sometimes make you feel like you have to stop doing the things you love in life such as exercising. One form of exercise which often triggers a leak is running, but this shouldn’t stop you slipping into your favourite trainers and heading to your local park!

That’s why we teamed up with prolific journalist and author Rose George who has previously written about running with incontinence, and specialist pelvic floor physiotherapist Amanda Savage to discuss how you can keep on running and defy leakage.

With their help, we hope we can show you that there’s no need to fear a light jog or a vigorous sprint – whether you’re wearing a TENA Lady product or not

What are your top practical tips for how women with incontinence can prepare themselves before a run?

Rose George: I’d never suggest that women cut down on hydration, especially as so many of us are under hydrated already, so I suppose the only option is to make sure you get to a toilet as close to the start of your run or race when you can.

That’s not easy when toilet provision for women is routinely under par. Women should have two or three times as many toilets as men to account for the fact it takes us longer.

Amanda Savage: Do some prep exercises before you even leave the house. Wake up all the muscles that are going to be needed to keep the impact of running down, and your bladder supported.

Focus on the gluts (bridge with leg changes), the lower abdominals (such as Pilates knee folds and double table top), with great attention to preventing bulging of the abdomen… and especially warm up with pelvic floor squeezes.

The pelvis is a compact space. If the bowel is full it will feel uncomfortable when you run and could put pressure on the bladder causing unexpected leakage. Leave time in your routine to have the option to empty your bladder and bowel before you go out.

You need privacy and TIME for a good poo. Take a book to read – it helps switch off your thinking brain and lets you relax.

If you’re caught short in the middle of a run without any form of specific protection against incontinence – what would you recommend doing?

RG: Finding a bush and not worrying about it. If you’re running into a city, find a pub. You’re unlikely to find an open public toilet as so many have been closed.

AS: You will feel mortified and embarrassed but remind yourself that it will feel worse than it looks. There is solidarity and support amongst women for problems like this, so don't be afraid to share your plight with your running friends.

Slow right down to a walk to prevent further leakage. If you feel self-conscious about a wet patch, take a top layer off and wrap it around your waist. A pro's tip, if it is hot, pour a bottle of water over your head – once you are wet in other places it won't be so obvious.

What clothes would you suggest running in for women who have incontinence?

RG: Black shorts or a skirt.

AS: Your shoes are your first line of defence against the high impact of running. Each step sends a jolt of high pressure, four times your body weight, through your ankles, knees, pelvis, spine... and bladder!

When running, that can be 800+ steps per mile! Check your trainers for wear and tear, and upgrade them if they are old, before looking for a shop that will watch you run in them and give you advice.

If you need orthotics make sure they fit well in the shoe, and re-lace shoes intermittently for better support.

If you feel that your bladder is 'bouncing' as you jog and is prone to leaking, try adding extra external support to your abdomen and pelvis. Start with very good pants! It's all about support.

The best pair to reduce joggle of the belly, pelvic floor, and your back. Maybe even wear two pairs?

What would you say to women who have just discovered they have incontinence while running who are trying to build their confidence up?

RG: There are options. First of all, go to a GP and get referred to an incontinence clinic. When I went, it was useful in that the nurse told me I was not a lost cause and could strengthen my pelvic floor.

I’ve often run in incontinence pants, which are fine, though I’m often worried that they are visible and bulky. But then again, I’m not embarrassed. That would be my biggest advice: don’t hide it.

I know I have been embarrassed in the past but if we talked about it more, things would get better.

AS: Often it is only when you try higher level exercise activities, like running, a more advanced class or upping your cardiovascular work at the gym, that you unmask an incontinence problem.

Bladder leakage is never normal. It is a sign that there is a lack of support for the bladder and poor closure of the bladder tube.

Though this is distressing, these are problems that can be greatly improved and often completely resolved. It is important to step back for a while and get proper help to sort out any muscle weakness, back or pelvic alignment issue and to check that the bladder and other organs are in good health.

You should not ignore the problem nor hide from it by using pads to put off seeking help. Be brave and talk to your GP or practice nurse to organise a referral to your local specialist physiotherapy team.

What other forms of exercise do you feel would work well for women combatting incontinence?

RG: I have a Kegel machine which works well when I remember to use it. I suppose Pilates would be good, but I haven’t done it for a while.

AS: While you are working on improving the pelvic support structures, avoid running and rather choose other fun, sweaty exercise styles that less ‘bounce’ in them.

Try power or Nordic walking (it can burn just as many calories as running), cycling, swimming, a low-impact cardio classes or using the cross-trainer at the gym.

Be cautious of rowing machines, unless you have excellent technique, as it is very easy to accidentally bear-down onto the pelvic floor with these.

Try to include some focused strength and conditioning in your week, such as body-balance, yoga, Pilates, Barre or Tai Chi. These mind-body activities will work you intensely with lots of emphasis on your core and pelvic floor.

There you have it – there’s no need to hide, just keep on running! If you would like more information on staving off bladder weakness, check out our pages about incontinence and how to deal with it.