'It's not normal, but it's common': PA-C Lisa Zwiers on urinary leakage in athletes

Urinary leakage is a challenge that many athletes face—often during or after exercise. Lisa Zwiers, PA-C, with AdventHealth Medical Group Urology at Denver, shares what people need to know about this common issue, why it happens, and when it’s time to seek professional help.

“Urinary incontinence is surprisingly common in athletes,” says Zwiers. “It varies by sport and sex, but female athletes, particularly long-distance runners, are more likely to experience it.”

Zwiers, who is also a CrossFit enthusiast, sees firsthand how this issue affects performance and confidence. “At my gym, there’s always a mad dash to the restroom when we jump rope. It’s a shared experience, but one we don’t talk about enough.”

Why it happens

The root cause? Often, it’s pelvic floor weakness. “The tendency to leak with exercise increases as we age, and menopause is a contributing factor,” Zwiers explains. “It becomes more challenging to keep the core and pelvic floor strong, but it’s absolutely possible.”

She emphasizes that while leaking may be common, it’s never “normal.” “It’s a sign that something in the system isn’t functioning optimally—and we can address that.”

What to do about it

Zwiers recommends starting with an office visit to properly diagnose the type and severity of incontinence. “A pelvic exam helps me determine whether a patient can start with a home exercise program or needs the guidance of a pelvic floor physical therapist.”

She often advises patients to focus on strengthening the legs, abdomen, and glutes—muscle groups that support the pelvic floor. “Movements like squats, glute bridges, and planks are great. And sometimes, a gym trainer can be a cost-effective alternative to PT if the patient doesn’t need specialized direction.”

For those who do need more support, pelvic floor PT can offer tools like biofeedback. “Many people don’t know how to properly engage the pelvic floor. Biofeedback helps train the neural pathways so patients can identify and activate the right muscles.”

Reclaiming confidence

Zwiers notes that leaking can influence everything from what athletes wear to how they move. “Instead of focusing on the workout, they’re worried about their bladder. That’s not how it should be.”

Know that you’re not alone and resolution may be easier than you think.

To schedule an appointment, please visit: AdventHealth Medical Group Urology at Denver and Lone Tree | AdventHealth Medical Group