Why do I Pee When I lift Something Heavy?
Have you ever lifted something heavy and experienced leakage? While common, this is NOT normal and CAN be fixed with the right diagnosis and exercises.
If you’ve ever wondered “Why do I pee when I lift something heavy?” read on! We will discuss why it happens, what factors can increase your risk for these symptoms and how to manage these symptoms if you do have them.
Urinary leakage, also known as urinary incontinence, during activities like lifting heavy objects is typically caused by a condition called stress urinary incontinence (SUI).
Stress incontinence occurs when physical pressure or stress is placed on the pelvic floor diaphragm/bladder neck, leading to leakage of urine. This can happen during activities such as lifting, sneezing, coughing, or exercising, which all increase intra-abdominal pressure.
Factors that put people at risk for stress urinary incontinence are:
Pregnancy and childbirth
Menopause
Nerve injuries to the pelvis or lower back
Obesity
Pelvic surgery
Chronic coughing
Diabetes
So why does this happen?
Pelvic Floor Muscle Weakness, lack of endurance, or coordination:
The pelvic floor muscles are responsible for supporting the bladder and urethra. When these muscles are weak, they may not provide enough support during activities that increase abdominal pressure, such as lifting. The increased pressure can overwhelm the bladder's ability to hold urine, leading to leakage.
Weakness can come from childbirth, aging, obesity, and or chronic coughing/sneezing.
Increased Intra-Abdominal Pressure:
When lifting heavy objects, the body increases intra-abdominal pressure to stabilize the torso. This pressure is transmitted to the bladder, and in a healthy system, the pelvic floor muscles and urethral sphincter work to prevent urine leakage.
However, if the pelvic floor has low endurance, strength, or lack of coordination with the change in pressure, this can lead to leakage.
Breath Holding:
People often hold their breath and or strain when they lift something very heavy. They perform a valsalva maneuver which increases the intra-abdominal pressure even more in order to help with trunk stability and core rigidity.
The inability of the pelvic floor muscles to counteract this pressure is a key factor in urinary incontinence. The valsalva maneuver exacerbates this dysfunction, leading to leakage, especially in individuals with weakened or uncoordinated pelvic floor muscles.
A study published in the International Urogynecology Journal (2012) discussed the relationship between increased intra-abdominal pressure and the onset of stress urinary incontinence (SUI).
It was shown that activities that raise intra-abdominal pressure, such as lifting or coughing (which are similar to the Valsalva maneuver), can lead to leakage of urine in individuals with weakened pelvic floor muscles or sphincter dysfunction.
The study found that an increase in intra-abdominal pressure caused by certain maneuvers could overcome the urethral closure pressure, leading to involuntary leakage of urine in susceptible individuals.
How to manage stress urinary incontinence:
The Knack technique is a simple but effective strategy for managing stress urinary incontinence (SUI).
The technique is specifically designed to help people with SUI by teaching them to contract their pelvic floor muscles before performing an activity that might trigger incontinence.
It is essentially a way to "prepare" the pelvic floor for increased intra-abdominal pressure, such as during a sneeze or a cough.
Perform the Preemptive Contraction (The "Knack"):
When you anticipate a situation where you might leak urine (e.g., before sneezing, coughing, or lifting), contract your pelvic floor muscles (as if you're stopping urination or holding in gas).
Hold the contraction before performing the action that might trigger incontinence (sneezing, coughing, or lifting) and during the actual cough, sneeze, jump, or blowing of your nose
The idea is to engage the pelvic floor muscles in advance of the physical stress to help support the bladder and urethra, allowing you to avoid leakage.
Practice Regularly:
Like any other muscle strengthening technique, the Knack works best when practiced regularly. This should help build the coordination needed to use the technique effectively in daily life.
Try to practice the Knack during activities that don't cause leakage to strengthen your pelvic floor muscles and reinforce the habit. For example, practice it while forcing several coughs.
Tip: If you're unsure whether you're isolating the pelvic floor muscles correctly, it may be helpful to work with a pelvic floor physical therapist to ensure you're using the right muscles. SUI could be a factor of more than just pelvic floor weakness. It is important to be thoroughly evaluated by a pelvic floor specialist in order to set a baseline and prevent any other types of leaking or pelvic floor dysfunction.
So if you’re wondering “Why do I pee when I lift something heavy?” it may be time to get your pelvic floor checked out.
How do I get help if I am peeing when I lift something heavy?
If you’re looking for personalized, one-on-one sessions to address your urinary leakage or pelvic floor concerns, we provide pelvic health physical therapy services to women in the Jacksonville Beach area.
If you’re looking for providers who will listen to you and help you get to the root cause of your pelvic concerns, we’ve got you. We’re here to help you if you’re experiencing pain, heaviness, leaking, or are pregnant/postpartum and want to continue safely working out/running/lifting during your pregnancy and get back to your sport after birth.
Get started today by booking a discovery call.
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