Incontinence in the Female Athlete: What You Need to Know
Accidental leakage affects up to 80% of female athletes depending on sport — yet it's rarely talked about. Here's why it happens, who's most at risk, and what you can do about it.
Involuntary leakage — or incontinence — has long been overlooked in women's health, despite affecting between 10–55% of women aged 15–60. For female athletes, the risk is even higher: the physical demands of sport place an increased load on the pelvic floor, and around 30% of regularly exercising women experience leakage during at least one type of exercise.
What Is Incontinence?
Incontinence is defined as any involuntary leakage of urine. There are three main types relevant to athletes:
How Common Is It in Sport?
The vast majority of sportswomen who experience incontinence deal with stress incontinence specifically. While athletes in some sports — such as soccer and cycling — are more prone to urgency incontinence, leakage during impact and high-load activities is far more prevalent across the board. Those most at risk include trampolinists, gymnasts, hockey players, ballet dancers, and any athlete whose sport involves significant jumping or landing.
Why Does Leakage Happen?
Stress incontinence occurs when there is a sudden increase in intra-abdominal pressure — which is precisely what happens during laughing, jumping, heavy lifting, or bracing your core. When we brace, that force pushes downward onto the pelvic floor, a sling-like structure that supports the bladder. If the pelvic floor isn't strong enough to counteract that downward load, the bladder is compressed and urine leaks out.
In sport and exercise, we are constantly running, jumping, pushing, and pulling — all of which amplify the downward pressure on the bladder and pelvic floor. The greater the intensity and impact, the greater the demand on these structures.
How Is Incontinence Treated?
The good news is that effective treatment options are widely available — for professional athletes and recreational exercisers alike. For almost all types of incontinence, the first line of treatment is pelvic floor strengthening, guided by a Physiotherapist or Women's Health practitioner.
Activating the pelvic floor requires deliberate practice. It should feel like a gentle "tighten and lift" sensation around the vagina — similar to the sensation of stopping the flow of urine or holding onto wind. Once you've mastered the basic activation, your practitioner will progress you toward holding contractions for longer, coordinating activation with movement, and eventually training under load — matching the demands of your specific sport.
Depending on the type and severity, your GP may also recommend medications, supplements, or assistive devices to manage symptoms while you build pelvic floor strength.
Don't put up with it
Incontinence during exercise is common — but it is not normal, and it is not something you simply have to accept. The stigma around the topic means many women suffer in silence for years before seeking help, when in most cases the condition responds very well to targeted physiotherapy.
If you are experiencing any involuntary leakage — whether during exercise, sport, sneezing, or daily activities — it is worth getting properly assessed by a practitioner with experience in Women's Health.
Ready to address it?
Our Exercise Physiology team at 4D Health and Performance has experience in Women's Health and pelvic floor rehabilitation. A proper assessment is the first step — no referral required at our Sydney CBD and Norwest clinics.
Book an Exercise Physiology Assessment →References
- Teixeira RV, Colla C, Sbruzzi G, Mallmann A, Paiva LL. Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis. Int Urogynecol J. 2018;29(12):1717–1725.
- Nygaard I, DeLancey JO, Arnsdorf L, Murphy E. Exercise and incontinence. Obstet Gynecol. 1990;75(5):848–851.
- Townsend MK, Danforth KN, Rosner B, et al. Physical activity and incident urinary incontinence in middle-aged women. J Urol. 2008;179(3):1012–1017.
- Goldstick O, Constantini N. Urinary incontinence in physically active women and female athletes. Br J Sports Med. 2014;48(4):296–298.