Interview with Dr. Katie Thomas at Sports Performance Physical Therapy - San Diego, California
If you've ever experienced bladder leakage while jumping rope, running, lifting, or completing a high-impact workout, you're not alone.
Urinary leakage during exercise is something many athletes experience, yet it's a topic that isn't talked about nearly enough. For some athletes, it happens during double unders or other high-impact movements. For others, it doesn't appear until later in a workout, when fatigue begins to set in. The important thing to understand is that bladder leakage doesn't necessarily mean you need to stop jumping rope or avoid high-impact exercise altogether. It may mean that your pelvic floor and the muscles around it need more strength, mobility, endurance, or better coordination. We spoke with
Dr. Katie from Sports Performance Physical Therapy in San Diego, CA, to learn more about why urinary leakage can happen during training and what athletes can do to improve their pelvic floor function.
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Why Do I Leak Urine When Jumping Rope?
Jumping rope is a series of repeated challenges to your body. Whenever you jump and land, your muscles have to work together to absorb force and stabilize your body and prepare you for the next repetition. That becomes especially demanding when you're performing hundreds of single unders or double unders during a workout.
Dr. Katie specializes in working with athletes, particularly those involved in endurance sports and barbell training, and urinary leakage during competition and high-impact training is an issue she frequently encounters. One common misconception is that urinary leakage automatically means you have a weak pelvic floor. That's not always the case.
Athletes experiencing bladder leakage may have muscles that are too weak, too tight, or a combination of both.
That means the solution isn't necessarily doing more pelvic floor contractions or simply trying to "strengthen your pelvic floor." For some athletes, the challenge may involve strength. For others, mobility and excessive tension may be part of the problem. And for many, it can involve how effectively the entire system works together.
What Does Your Pelvic Floor Have to Do With Jumping Rope?
Think of your pelvic floor as a hammock of muscles supporting the contents of your pelvis. But your pelvic floor doesn't work alone. It's part of a much larger system known as the lumbopelvic complex, which extends roughly from your rib cage through your hips and thighs.
That includes your: Core Glutes Adductors Hip musculature, abdominals Pelvic floor: These areas must work together to create stability and help manage the forces and pressure generated during exercise.
When you're jumping rope, you're repeatedly asking this system to stabilize your body through takeoff and landing. One jump may not seem particularly demanding. But multiply that by 50, 100, 200, or more repetitions during a conditioning workout, and the demand becomes very different.
To any woman or girl who wants to pursue a career in CrossFit or really in anything, here are a few words of wisdom that I’d like to share from not only my own personal experiences but things I've learned from listening to other people sharing their stories with me.
Why Does Bladder Leakage Get Worse During a Workout?
A common complaint Dr. Katie hears from athletes is "I'm fine at the beginning of my workout, but toward the end of the workout or metcon, I start leaking. "That makes fatigue an important part of the conversation.
Your pelvic floor, core, glutes, hips, and surrounding musculature aren't only required to perform—they need enough endurance to continue functioning effectively as your workout progresses. As fatigue increases, maintaining the same level of muscular control can become more difficult.
For a jump rope athlete, that might mean the first round of double unders feels great, but leakage begins during rounds three, four, or five. Rather than focusing exclusively on the pelvic floor,
Dr. Katie recommends looking at the entire lumbopelvic complex and working on both strength and mobility.
Here are three exercises that can help. 3 Pelvic floor exercises for strength, mobility, and control of incontinence.
Exercise #1: Resistance Band Hip Flexor March First up is a band resisted hip flexor march. This exercise works on core stability, hip strength, glute activation, and overall control.
Exercise #1: Resistance Band Hip Flexor March First up is a band resisted hip flexor march.
This exercise works on core stability, hip strength, glute activation, and overall control.
How to loop a small resistance band around both feet. Grab a light to medium resistance band.
Place your hands on a bench or box or other elevated surface in a high plank position.
Before you start the movement: Activate your lower abs. Squeeze your butt. Stay strong in the plank. Avoid allowing your hips to pike upward.
Don't allow your lower back and hips to sag toward the floor. Once you're stable, drive one knee forward using the hip flexor while maintaining tension against the resistance band.
The movement will look similar to a mountain climber, but speed isn't the goal. It’s not that. It’s stability and timing and control. Switch sides while holding your plank position.
Suggested Starting PointDo: 2-3 rounds of 15 seconds per side.
Once you're comfortable performing the movement from an elevated surface, you can progress by moving your hands to the floor. Remember: the floor variation is more difficult, so build your control first.
Exercise #2: Adductor Rockbacks
The second exercise focuses more heavily on mobility.
Your adductors are the muscles along your inner thighs, and these muscles attach near the pelvis. If they get too tight, tension can develop in the pelvic region. The adductor rockback is a great way to lengthen the inner-thigh muscles and increase mobility around the hips and pelvis.
How To Do It: Start on one knee with the other leg extended out to the side. Put your hands down on the floor in front of you. Slowly push your hips back toward your heel until you feel a comfortable stretch in the inner thigh.
Hold for about 5-10 seconds.
Breathe normally and allow yourself to relax into the position rather than forcing a deeper stretch. Return to your starting position and repeat.
Be sure to perform the exercise on both sides.
Adductor rockbacks can also be incorporated into your dynamic warm-up before jumping rope, running, lifting, or performing a conditioning workout.
Exercise #3: Pallof Press (Split Stance)
This exercise is designed to test your ability to maintain the core and pelvis without rotation.
You can do this with resistance bands or some other equipment that is attached to something that doesn’t move.
How to do it Start in a split stance, as you might catch a split jerk.
Get enough tension in the band so you feel it pulling you toward the anchor.
Square your hips forward and keep your torso upright.
Brace your core and maintain control through your pelvis.
From there, press the band directly away from your chest.
The band will attempt to rotate your body toward the anchor.
Don't let it.
Resist that rotational force and maintain your position as you press the band away and bring it back toward your chest.
Perform the exercise with both legs in front, not just your dominant side.
And it’s not like you should just take leakage as a necessary part of training.
The first thing is understanding that there can be multiple issues. You might need to work on: Role of the pelvic floor Core strength, Glute strength, Strength of the hips, Adductor flexibility Muscular Endurance
Managing pressure and breathing Jump Rope Skills Above all, each athlete is unique. If you’re leaking urine regularly during exercise, look for a trained healthcare provider or physical therapist, especially one who works in pelvic health and athletic performance.
They can see what is happening in your specific case rather than applying a one-size-fits-all solution.
Create a Better Base for Jump Rope
The jump rope is a very effective conditioning tool. But, just like any athletic movement, you have to prepare your body for the demands you are putting on it. Strengthening your core, hips, glutes and surrounding musculature as well as improving mobility and pelvic floor function can build a better foundation for training.
Meanwhile, working on your jump rope mechanics will make you a more effective jumper. Begin with controlled movements. Focus on quality, not speed.
Gradually build up your stamina. If you experience bladder leakage, don’t be afraid to talk about it or get the opinion of an expert.
Train smarter. Move better. Jump better.
About Dr. Kaitlin Thomas, PT, DPT
She attended San Diego Mesa College and California State University, Chico, where she earned her bachelor's degree in Exercise Physiology. She competed on the Cross Country and Track & Field teams at both schools, specializing in middle- and long-distance events.
Dr. Katie earned her Doctorate of Physical Therapy from Franklin Pierce University in Goodyear, Arizona, and has completed additional coursework in women's health and chronic pain.
This article is intended for educational purposes only and should not be considered medical advice or used to diagnose or treat a medical condition. If you experience urinary leakage, pelvic pain or other pelvic floor symptoms, talk to a qualified health care provider or pelvic health physical therapist.