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  • Writer's pictureNashville PT

Do you always have to "go" before or during a workout?

Updated: Jan 25, 2021

Female athletes (such as gymnasts, trampolinists, weightlifters, and runners) or people who play high impact sports (such as basketball, netball or running) or participate in high intensity training such as HIIT and bootcamp are at increased risk of developing pelvic floor problems. A collection of studies has demonstrated that approximately one-third of female nulliparous (never given birth) athletes experience urinary incontinence during their athletic activities. This in part is because of the constant and excessive downward pressure that these sports place on their pelvic floor. Most likely, few if any of these athletes have learned about the pelvic floor muscles and have not trained them correctly.

Most athletes have greater abdominal pressure with activity that needs to be counter-acted by the pelvic floor muscles. Therefore, the pelvic floor muscles need to be stronger and have more endurance in athletes, and work in a coordinated effort with the other core muscles surrounding the pelvis. Often, the pelvic floor and related hip muscles may be too tight or have increased tension. This actually causes weakness in the muscles. Therefore, the pelvic floor muscles must first be released or lengthened before they can be strengthened. This may be the reason that initial attempts at doing Kegel exercises at home without correct instruction are not helpful.

Incontinence (‘peeing yourself’) when doing high impact exercise may be common but is not normal. It is important to train your pelvic floor muscles coordinated with the correct breathing pattern. The pelvic floor muscles need to contract automatically and efficiently. If initially trained in a controlled setting, with the assistance of an expert pelvic floor physical therapist, and progressed to sport specific activity, an athlete should be able to train her muscles to be able to support her bladder to avoid leakage during activity.

If you are peeing yourself during your exercise routine, then consultation with pelvic physical therapist to determine if you have pelvic floor muscle dysfunction is the first step. The treatment is a conservative approach to educate you on correct way to contract your muscles. Just a few visits are typically needed to not only eliminate your leakage, but also to help you progress further with your exercise program as a strong core is key to success to building strength throughout your entire body.

Sandy is certified in pelvic floor physical therapy and practices out of our Franklin office and West Nashville office. She is currently accepting new patients and would love to see you for any and all of your pelvic floor needs. You can reach her by email at

If you want to learn more about your pelvic floor CLICK HERE for a free e-book all about your pelvic floor!


Kari Bo, et al: Evidence Based Physical Therapy for the Pelvic Floor (2007) Elsevier.

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