Sarah, a 42-year-old secondary school teacher from Southampton, had been turning up to Parkrun every Saturday morning for three years. She loved it — the camaraderie, the fresh air, the personal bests. But somewhere around the 2km mark, without fail, she'd feel that familiar damp patch spreading through her running leggings. She started wearing dark colours. She stopped lingering at the finish line. She was close to quitting altogether. Then she did one thing differently — she booked an appointment with a women's health physiotherapist — and within twelve weeks, she was crossing the finish line dry. Sarah's story is far more common than most British women realise, and if leaking during exercise has made you dread lacing up your trainers, this guide is written for you.
What Is Stress Incontinence, and Why Does Running Trigger It?
Stress urinary incontinence (SUI) is the involuntary leakage of urine that occurs when physical pressure — or "stress" — is placed on the bladder. Running is one of the most common triggers because every footstrike sends a shockwave upward through the body, creating a sudden spike in intra-abdominal pressure. If the pelvic floor muscles and urethral sphincter cannot respond quickly enough to counteract that pressure, urine escapes.
According to Bladder & Bowel UK, stress incontinence is the most prevalent form of urinary incontinence in women under 65. Studies suggest that up to one in three women who exercise regularly experience leakage during high-impact activity, yet the vast majority never seek help, often because they assume it is simply part of being female or getting older. It is neither inevitable nor untreatable.
The underlying mechanism almost always involves weakness or poor co-ordination of the pelvic floor — the sling of muscles, ligaments, and connective tissue that forms the base of the pelvis and supports the bladder, uterus, and bowel. When these muscles are not strong enough or fast enough to contract before impact, the urethra is left without adequate support.
Why Are Women Runners Particularly Vulnerable?
Several factors converge to make British women who run more susceptible to stress incontinence:
- Pregnancy and childbirth: Vaginal delivery — particularly following prolonged pushing, instrumental delivery (forceps or ventouse), or a large baby — can stretch and sometimes tear pelvic floor muscles and nerves. The damage may not become symptomatic until years later, especially once high-impact exercise resumes.
- Perimenopause and menopause: Falling oestrogen levels thin the urethral and vaginal tissues and reduce the elasticity of pelvic floor structures. Many women notice leakage for the first time in their forties or fifties, even if they have always exercised.
- High-impact sport history: Gymnastics, trampolining, and long-term distance running without proper pelvic floor conditioning can gradually wear down muscular support over years.
- Chronic cough or constipation: Both repeatedly strain the pelvic floor in ways that compound any existing weakness.
- Body mass index (BMI): Higher abdominal weight increases the baseline load on the pelvic floor, reducing its reserve capacity during exercise.
Importantly, leaking during a 5K Parkrun does not mean you have severe incontinence. Many women who leak only during running have a pelvic floor that functions adequately in daily life but simply cannot generate the rapid, forceful contraction needed to cope with repetitive impact.
The NHS Pathway: What to Expect When You Ask for Help
The NHS has a clear, evidence-based pathway for stress incontinence, and you are entitled to access it. The first step is to speak with your GP. Many women feel embarrassed raising the subject, but GPs routinely discuss continence issues — it is a clinical matter, not a personal failing.
At your appointment, your GP is likely to:
- Take a history, including how long the leakage has been occurring, what triggers it, and how much it affects your daily life.
- Carry out a urine dipstick test to rule out a urinary tract infection, which can worsen any underlying weakness.
- Discuss your obstetric history, menopausal status, and any relevant medication.
- Refer you to a women's health physiotherapist or a continence nurse specialist — the two key professionals who treat stress incontinence in primary and community care.
The Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) association — a specialist group within the Chartered Society of Physiotherapy — recommends that all women with stress incontinence receive a minimum of three months of supervised pelvic floor muscle training before any other treatment is considered. NICE guidance (CG171) mirrors this, confirming that supervised physiotherapy is the first-line treatment of choice.
If physiotherapy does not produce sufficient improvement, your GP or specialist may discuss further options including vaginal oestrogen (particularly useful for post-menopausal women), a continence pessary, duloxetine (a medication that supports urethral tone), or surgical options such as a mid-urethral sling. However, for the majority of women who run and leak, a well-supervised physiotherapy programme achieves significant or complete resolution.
If you are unsure whether your symptoms warrant a GP appointment, you can also contact NHS 111 for guidance, or visit the Bladder & Bowel UK helpline, which offers free, confidential advice from specialist nurses.
Self-Help Strategies That Make a Real Difference
Whilst you are waiting for a physiotherapy referral — or alongside it — there is a great deal you can do independently.
Master Pelvic Floor Muscle Training (PFMT)
Pelvic floor exercises are the cornerstone of treatment, but the technique matters. Many women either squeeze the wrong muscles or perform the exercises incorrectly for years without benefit. The NHS Squeezy app (available on the App Store and Google Play) was developed by NHS physiotherapists and provides guided exercise programmes with reminders — it is a genuinely useful tool.
The basic technique: sitting, standing, or lying down, draw up and inward the muscles you would use to stop the flow of urine. Hold for up to ten seconds, then fully release. Repeat ten times. Then perform ten fast, sharp squeezes — these quick-twitch fibres are exactly what you need during impact. Aim for three sets daily. Results take weeks of consistent practise, but the evidence base behind PFMT is robust.
Learn the "Knack" Technique
Research from the University of Michigan — widely referenced in POGP literature — introduced the concept of the "knack": deliberately contracting the pelvic floor a moment before and during a cough, sneeze, or — crucially — each footstrike when running. With practise, this becomes automatic. It is one of the most immediately practical strategies for managing leakage during running while you are building long-term strength.
Review Your Fluid Intake
Counterintuitively, drinking too little can worsen incontinence by concentrating the urine and irritating the bladder lining. Bladder & Bowel UK recommends six to eight cups of fluid per day, predominantly water. Reducing or eliminating caffeine — a bladder irritant — can produce a noticeable improvement in urgency and leakage frequency within days.
Modify Your Running Technique
Overstriding — landing with the foot well ahead of the centre of mass — increases ground reaction force and worsens impact transmission. A women's health physiotherapist or running coach can assess your gait and suggest modifications. Shorter, faster strides typically reduce pelvic floor loading significantly.
Choose Your Running Surface Wisely
Grass and trail running absorbs more impact than tarmac or concrete. If you have the option, starting or returning to running on softer surfaces can reduce symptoms whilst your pelvic floor strength improves.
Build Back Gradually
If you have recently given birth, the POGP's "Returning to Running" guidelines (updated in 2023) advise against high-impact running before twelve weeks postnatally at the earliest, and only once a postnatal physiotherapy assessment has confirmed readiness. Returning too soon is one of the most common reasons why leakage during running develops or worsens.
Staying Active Without Worry: Orykas UK Washable Incontinence Knickers
Managing stress incontinence during the treatment process — or on days when symptoms are worse — should not mean abandoning your running kit or resorting to bulky disposable pads that shift uncomfortably mid-run. Orykas UK's washable incontinence knickers are designed specifically for active women who need reliable, discreet protection without compromising their lifestyle.
All Orykas UK products are made from OEKO-TEX Standard 100 certified bamboo fibre — a breathable, naturally antibacterial fabric that wicks moisture away from the skin and resists odour, making it particularly suited to exercise. Each pair is machine-washable at 40°C and, with proper care, lasts two to three years, making them considerably more economical and more environmentally responsible than disposable alternatives over time.
Three styles are available to suit different needs and preferences:
- Women's Washable Incontinence Pants for Heavy Leakage — the highest-absorbency option in the range, designed for women who experience significant leakage during running or other high-impact activity. The multi-layer bamboo-fibre core locks fluid away from the body, whilst the slim profile fits discreetly beneath running leggings.
- Women's High-Waisted Washable Incontinence Pants — the high waistband provides gentle abdominal support, which many women find comfortable during running, and the extended waistband helps the knickers stay securely in place during movement.
- Women's Lace-Waistband Washable Incontinence Pants — for women who do not wish to sacrifice femininity for practicality. The lace-trimmed waistband and elegant silhouette make these suitable for wearing beyond the gym, with the same reliable bamboo-fibre absorbent core.
If you live with a chronic condition that causes urinary incontinence, you may be eligible for VAT relief on incontinence products under the HMRC disability-products scheme — meaning you pay no VAT on qualifying purchases. Orykas UK can advise on eligibility at checkout. This is worth noting when comparing the long-term cost of washable knickers against disposable pads.
Related Orykas UK Advice
If you found this article useful, the following guides from the Orykas UK blog offer further practical information:
- Urinary incontinence in women: natural treatment, what really works
- Urinary Leaks in Women: Causes, Types, and When to See a Doctor
- How to stop urinary leaks in women: complete solutions
- Urinary protection for women: complete 2026 guide
Frequently Asked Questions
Is it normal to leak when running, or should I see my GP?
Leaking during running is common, but it is not something you should simply accept as normal. Bladder & Bowel UK emphasises that any degree of urinary leakage during exercise is a sign that the pelvic floor needs attention. A GP appointment is the right first step — your GP can assess the cause, rule out any underlying conditions, and refer you to a women's health physiotherapist. You do not need to be leaking large amounts or every time you run to deserve NHS support.
How long will pelvic floor exercises take to stop leakage during running?
Most women notice meaningful improvement within eight to twelve weeks of consistent, correctly performed pelvic floor muscle training — though this varies depending on the degree of weakness and how diligently the exercises are practised. NICE guidance recommends a minimum three-month supervised programme before evaluating whether additional treatment is needed. Many women see significant improvement within that window; some achieve complete resolution.
Can I continue running while I am treating stress incontinence?
In the vast majority of cases, yes — and your physiotherapist will encourage you to do so. Running itself does not worsen stress incontinence provided you are actively strengthening the pelvic floor alongside it. Using washable incontinence knickers during runs can help manage leakage whilst your pelvic floor strength builds, allowing you to continue exercising without anxiety or discomfort.
Will stress incontinence get worse if I ignore it?
It can. Without targeted pelvic floor training, the muscles continue to weaken — particularly as oestrogen levels decline through perimenopause and menopause. What begins as occasional leakage during running can progress to leakage during walking, coughing, or sneezing. Early intervention produces the best outcomes. The good news is that even women who have been symptomatic for many years can achieve substantial improvement with the right treatment.
Are Orykas UK washable incontinence knickers suitable for running?
Yes. All three styles in the Orykas UK range are designed to fit closely and securely under exercise clothing without bunching or shifting during movement. The OEKO-TEX certified bamboo fibre is breathable and moisture-wicking, making it more comfortable against the skin during exercise than the plastic-backed materials used in most disposable pads. The absorbent core manages leakage discreetly so you can focus on your run, not on what might be happening beneath your leggings.
Sources and further reading: NHS (nhs.uk/conditions/urinary-incontinence); NICE Guideline CG171 — Urinary incontinence in women; Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) — Returning to Running Postnatal Guidelines (2023); Bladder & Bowel UK (bladderandbowel.org). The information in this article is intended for general educational purposes and does not constitute medical advice. Always consult your GP or a qualified continence specialist for diagnosis and personalised treatment.
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