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Can You Train With Urinary Incontinence? The Leak-Threshold Audit: The Door Where the Symptom Happens Mid-Rep — the Box Jump, the Double-Under, the Heavy Set — and the Internet Hands You Either the Pad-Up-and-Drop-Impact Script or the Just-Do-Kegels Script, Written for the Reader Who Leaks When She Trains and Wants to Know Whether the Training Caused It, Whether It Gets Worse Under Load, and Whether She Has to Stop — Where the Census Column Puts Leakage Inside Never-Pregnant Elite Sport at 28% (Gymnasts 67%) and Elite Endurance at 45.5% and CrossFit at 44.5% of 4,823, Where the Fear Column Meets the Athlete Physiology File (Exercising Women Carry Similar-or-Stronger Floors and Larger Levator Ani Muscles — the Athletes' 3× Prevalence Is a Threshold Story, Not a Damage Story) and the Umbrella's 4,649 Athletes Where Prevalence Did Not Track Sport, Impact Category or Modality but Weekly Volume at +6% Odds per Training Hour, Where the Honest Dose Column Lives in the Runner-vs-CrossFit Survey (SUI 37.0% vs 41.0%, p=0.141 — the Door Is Volume, Not Discipline) and ELSI's Moderate-Protective/Vigorous-Provocative Split (PR 0.66–0.73 vs 1.69–1.92, Sedentary ≥6 h PR 1.54–1.66), and Where the Treatment Column Is a Real Training File — the Knack Cutting Cough-Related Loss −98.2% in One Week Without a Strength Change, Skaug's Assessor-Blinded RCT in Functional-Fitness Exercisers at 64% vs 8% Improved (RR 7.96) With Symptoms Moving Before Strength Does, the Athlete Physio Meta at RR 0.81, and the Cochrane Backdrop at 56% vs 6% Cure

By RightRep AI Assistant · · 22 min read

Urinary incontinence is the file where the internet's two default scripts — pad up, drop the impact, accept the leak as the price of training and it's just kegels, squeeze when you remember — both fail the reader at the exact door she walked in through, because this reader's symptom is specific: she leaks mid-training — on the box jump, the double-under, the heavy set, the last kilometer — and what she needs to know is whether the training caused it, whether it is getting worse under load, and whether she has to stop. The pad-up-and-quit-impact script dies on the census: leakage is native to elite sport in women who have never been pregnant — 28% of Nygaard's 144 nulliparous college athletes leaked during their own sport, gymnasts at 67% [1] — and on the umbrella file where prevalence tracked weekly training volume at +6% odds per hour, not sport, impact category or modality [5]: "quit jumping" is not where the evidence points when gymnasts and CrossFitters and road runners all read inside the same band. The just-do-kegels script dies on the same file's honest legs: unstructured squeeze-counting is not the program the randomized column tested [9][11], the program that works in athletes is supervised, progressive and dosed [9][12], and the skill that buys the fastest effect — the pre-contraction before impact — is learned in days, not months [8]. So the fences come first. First: the red-flag column — new leakage with pain, blood or infection signs, sudden severe onset, or constant dribbling — is clinician territory before it is a programming question. Second: the postpartum reader takes the six-week clearance calendar first — the after-giving-birth door owns that return, and this file owns what leaks during it. Third: the man months past prostate surgery follows the urology calendar — the men's file lives on the incontinence benefit door, and post-surgical leakage is its column, not this one. Fourth: give the correct program eight to twelve honest weeks before any verdict on it [11]. With the fences standing, the evidence underneath is unusually kind to training: at this door, training is not the risk column — the floor it trains is the treatment column [9][11], the pre-brace is a learnable skill measurable inside a week [8], and the volume that crosses the threshold is a dose variable, not a verdict [5][6].

The short answer: yes — a leak is a threshold event, and the threshold trains

Strip the file to its spine. The census reads leakage into the middle of elite, never-pregnant sport: 28% of nulliparous college athletes leaked during their sport, jumping sports at the top — gymnastics 67%, basketball 66%, tennis 50% — and golf at 0% [1]; 45.5% of 112 elite endurance athletes, 76% of them nulliparous [2]; 44.5% across the CrossFit meta-analysis' 4,823 practitioners, stress-type in 81.2% of cases, jumps the named provoker [3]. The fear column inverts on contact with physiology: exercising women show similar or stronger pelvic-floor muscles and larger levator ani muscles than non-exercisers — athletes' roughly threefold prevalence is a threshold story, not a damage story [6]. The dose column runs on volume, not discipline: the 2026 umbrella — 14 reviews, 32 primary studies, 120 cohorts, 4,649 athletes — found prevalence did not differ significantly by sport, impact category or modality, tracking instead +6% odds per additional weekly training hour (p = 0.011) [5]; 1,379 women put road runners at 37.0% SUI against CrossFitters at 41.0%, p = 0.141 — statistically indistinguishable [4]. The skill column is the fastest result in this whole library: one week of a well-timed pre-contraction — the Knack — cut cough-related urine loss −98.2% on medium cough (P = .009) and −73.3% on deep cough (P = .003), without any measurable strength change [8]. The treatment column is a real training file: Skaug's assessor-blinded RCT in functional-fitness exercisers ran 16 weeks of pelvic-floor training against control — symptoms improved in 64% vs 8% (RR 7.96, 95% CI 2.03–31.19), ICIQ-UI-SF between-group −1.4 points (−2.6 to −0.2) [9]; the athlete physiotherapy meta-analysis prices the same column at RR 0.81 (0.78–0.84) [10]; the general-population Cochrane backdrop sits at 56% vs 6% cure for stress leaks (RR 8.38) [11]. That is the audit in one paragraph: this reader does not need to stop training — she needs the threshold raised, and the threshold is raised by a program [9][11], a skill [8] and an honestly-managed weekly volume [5].

What the condition actually is: a pressure contest, not a broken part

The mechanics in a paragraph: continence under load is a contest between the pressure pushing down — intra-abdominal pressure spiking on cough, jump, landing, heavy brace — and the structure holding closed: the pelvic-floor muscles, the external urethral sphincter, and the connective tissue suspending the bladder neck [6][8]. Stress urinary incontinence is the contest lost for an instant: pressure spikes faster than the floor closes, and a few milliliters escape. That is why the symptom is so specifically provoke-shaped — box jumps, double-unders, sneezes, max-effort sets — and why the file's three types matter for training: stress leakage answers to floor strength and timing (the treatment and skill columns below), urge leakage answers to the bladder-brain layer (the benefit door's behavioral file), and mixed layers both [11]. The threshold model is the frame that keeps every number in this audit honest: a leak does not mean the floor is damaged — exercisers' floors read stronger than sedentary ones [6] — it means that dose of pressure crossed that day's threshold. Thresholds move hour to hour (fatigue, fullness, cycle phase) and they move year to year, in the direction of the training: that is the entire treatment mechanism, measured as higher resting bladder-neck position, narrower levator hiatus and thicker sphincter after progressive floor training — hypertrophy anatomy, like any muscle under load [11]. The reader who leaks a little on her last set is not a contraindication walking into the gym; she is a muscle group short of a program.

The census column: leakage is native to elite, never-pregnant sport

How big is this door inside training populations, really? Bigger than the silence around it admits. Nygaard's classic surveyed 144 elite nulliparous college athletes — average age 19.9, none ever pregnant — and 28% leaked during their sport: gymnastics 67%, basketball 66%, tennis 50%, field hockey 42%, track 29%, swimming 10%, volleyball 9%, softball 6%, golf 0%; two-thirds of the leakers did so more than rarely, and 40% first noticed it in high school [1]. The endurance file agrees at altitude: 112 elite endurance athletes — 57 cross-country skiers, 55 runners, 76% nulliparous — reported SUI at 45.5%, with no significant difference between skiers and runners [2]. The CrossFit meta-analysis stacked 13 cross-sectional studies: 4,823 women aged 18–71, overall prevalence 44.5%, severity mostly mild (55.3%) or moderate (40.7%), stress-type in 81.2% of the cases, jumps the commonly-named provoker, and age, BMI and parity — not training history — the associated factors, with practitioners reading higher than non-practitioner controls [3]. Read as one column: roughly a third to nearly half of women inside serious training leak during it, most of them stress-type, most of them mildly, and the women who never got pregnant are in the same band as everyone else [1][2][3]. The difference between the athlete who leaks and the one who does not is not a different sport or a damaged floor — which is exactly what the next column tests.

The fear column: does training cause it? A threshold story, not a damage story

This is the section that separates this door from the way the internet tells it. The fear says training — especially lifting and jumping — wrecks the pelvic floor. The physiology file says the opposite about the floor itself: in Bø and Nygaard's Sports Medicine review of the whole question — is physical activity good or bad for the female pelvic floor? — exercising women show similar or stronger pelvic-floor muscle strength than non-exercisers and larger levator ani muscles, without obstructed-labor penalties, while mild-to-moderate activity decreases incontinence risk and only strenuous acutely provokes it [6]. The athletes' roughly threefold prevalence against controls [6] is not a list of ruined floors — it is a selection-and-exposure effect: sport repeatedly tests the continence threshold with pressure spikes sedentary life never generates, so sport is where a sub-clinical threshold deficit becomes visible as a symptom [6][8]. The umbrella file settles the "which training ruins it" version directly: across 14 systematic reviews, 32 primary studies, 120 cohorts and 4,649 athletes, prevalence did not differ significantly by sport discipline, impact category or modality — professionals only trending higher — while each additional weekly training hour ran +6% odds (p = 0.011) [5]. And the head-to-head nobody expects: 1,379 women — 521 runners, 858 CrossFitters — reported SUI at 37.0% vs 41.0% (p = 0.141), statistically indistinguishable, while runners actually carried more prolapse symptoms (12.7% vs 7.8%, p = 0.003) and more anal incontinence (34.0% vs 27.7%, p = 0.014) [4]. Translation for the field: there is no guilty exercise and no innocent one — there is a continence threshold, a weekly volume that pressures it, and a floor that either closes against the pressure or hasn't been trained to yet [4][5][6]. Which is why the treatment is never "quit the sport"; it is "raise the threshold under it" [9][10].

The honest dose column: volume is the variable, and it cuts both ways

The honest legs of this file matter as much as the headline, because this reader has already noticed the pattern her n=1 keeps reporting: worse on high-volume weeks, better after deloads. The population-scale version of her ledger exists. The weekly-volume curve: +6% odds per additional training hour per week, across 4,649 athletes — the dose-response this door actually runs on [5]. The intensity split in the general population: Brazil's ELSI aging cohort — 4,020 women aged 50+ — found moderate physical activity protective (PR 0.66–0.73) while vigorous activity ran provocative (PR 1.69–1.92), and sedentary time ≥6 hours a day its own leak risk (PR 1.54–1.66); women with sufficient activity and low sedentary time cut prevalence by 33–35% (PR 0.65–0.67) [7]. The apparent contradiction with the athlete file dissolves on mechanism: general moderate training protects the floor the way it protects everything — less load carried, better tissue conditioning — while unconditioned ballistic volume crosses the threshold; the conditioned floor is precisely what the treatment column builds [6][7][9]. So the dose rule for this reader prints honestly: the program is not the problem — the program is the solution being under-dosed on one side (floor training) while over-dosed on the other (impact volume the floor hasn't been prepared for) [5][7]. The practical shape of re-balancing: ramp impact and max-effort brace volume on the ordinary beginner ladder every rehab door in this library uses, exhale on the effort instead of bearing down (the breath-holding door owns the pressure mechanics), and let the floor-training column catch up before the impact column climbs again [5][8][9].

The skill column: the Knack — a week-old skill worth −98.2%

The fastest result in this entire file belongs to a skill, not a strengthening cycle, and it is the bridge between "leaking today" and "trained floor in twelve weeks." Miller, Ashton-Miller and DeLancey randomized 27 women with mild stress leaks (mean age 68) to learn the Knack — a single well-timed pelvic-floor contraction starting just before a cough — or to a wait-list [8]. One week later, the medium cough leaked 98.2% less (P = .009) and the deep cough 73.3% less (P = .003) [8]. Two details make this the most gym-portable number in women's health: the effect appeared without any measurable strength gain — timing, not force, closed the door [8] — and it was learned in a week [8]. Pre-brace before impact is exactly the skill version of what the whole treatment column builds passively: the conditioned floor closes ahead of the pressure spike instead of after it [8][11]. In training terms it installs everywhere: contract-and-hold before the unrack, before the jump, before the sprint, before the sneeze you feel coming — the same cuing architecture as bracing under a heavy set, one floor lower. It is not the whole program — mild cases were the study population, and the effect sizes shrink as severity grows [8] — but it is the day-one intervention that keeps her in the session while the twelve-week program does its slower work underneath [8][11].

The treatment column: train the floor, keep the program

The treatment question this reader actually asks — can I fix this without quitting the gym? — has a randomized answer conducted inside the gym population. Skaug's BJSM trial took 47 functional-fitness exercisers — CrossFit-style training, mean age 33.5 — and randomized them to 16 weeks of pelvic-floor muscle training or control, assessor-blinded: the training group's symptom score (ICIQ-UI-SF) fell between-group −1.4 points (95% CI −2.6 to −0.2), and 64% reported symptom improvement against 8% of controls — RR 7.96 (95% CI 2.03–31.19) [9]. The trial's honest internals are as instructive as its headline: adherence ran 70%, and the symptom change arrived without significant between-group differences in measured pelvic-floor strength [9] — coordination and timing moving before the dynamometer notices, the Knack mechanism at program scale [8][9]. The athlete file underneath agrees: the meta-analysis of physiotherapy in high-performance female athletes priced the intervention at RR 0.81 (95% CI 0.78–0.84) for continence versus controls [10]. And the general-population backdrop is the strongest conservative-treatment file in this library's whole health wing: the Cochrane pooled 31 trials and 1,817 women — 56% vs 6% cure for stress leaks (RR 8.38, 95% CI 3.68–19.07), the review's only high-quality-evidence verdict, 74% vs 11% cured-or-improved [11]. Delivery details decide real-world outcomes: in the exercise-induced-leakage review, supervised programs beat unsupervised ones in athletes — pad-test improvements appearing only in the supervised arms [12] — which is the same supervision edge the general Cochrane carries [11]. Dose it like a program, not a ritual: three sets of ten quality contractions daily, progressed in hold time and speed over eight to twelve weeks, with a pelvic-health physiotherapist correcting the technique once at the start [11][12] — a rep scheme argument, structured exactly like any progressive overload cycle for any other muscle.

The technique column: run softer, not less — and the honest aids file

Two more columns complete the audit for the specific reader who leaks in running shoes. The biomechanics file — 32 Brazilian runners with and without SUI — found no group differences in pelvic-floor, trunk or lower-limb strength, but a different movement signature entirely: the SUI runners absorbed less energy at the ankle (p = 0.019, d = 0.54), compensated with more at the hip (p < 0.001, d = 0.85), and transmitted more shock up the leg — tibia-to-femur attenuation reduced (p = 0.038, d = 0.80) — at similar ground-reaction forces [13]. Translation: leaking runners are not weak runners; they are stiff-ankle, hip-heavy runners, and impact-management is a coachable skill — cadence up, quieter landings, ankle stiffness addressed — sitting beside the floor program rather than replacing it [13]. The aids file, reviewed honestly: in the exercise-induced-UI literature, tampons may reduce training-session leakage more than pessaries for CrossFit and aerobic exercisers, and a vaginal sponge cut pad-weight gain during aerobics — temporary mechanical scaffolding for the session while the floor trains underneath [12]. Price it exactly as the review does: an aid for the provoking session, not a treatment [12]; the pessary-versus-training question at prolapse severity belongs to the prolapse door, where the device column is stronger [12]. Together these columns close the loop this door opened with: the leak is a threshold event; the threshold rises from below (floor program [9][11]), sharpens in front of the load (the Knack [8]), and gets fed less pressure per step (technique [13]) — three levers, none of which is "stop training."

The program in gym terms: what trains, what ramps, what stops

Trains always: the whole library, plus one muscle group added. Whole-body progressive strength two-to-three times a week on the ordinary floor (the machines-vs-free-weights question answers to preference and tolerance here, not to leakage severity) — and the pelvic floor trained deliberately: supervised if possible, three-by-ten daily, progressed in hold and speed across eight-to-twelve weeks [11][12], stacked with the skill: pre-brace before every impact and every heavy set [8]. The incontinence benefit door owns the full dose logic; this door owns its place inside a training week.

Ramps impact volume like a beginner, whatever your training age says: the dose column prices weekly volume, not training itself [5][7] — jump volume, sprint volume and max-brace volume climb the ordinary ladder while the floor program runs underneath; exhale-on-effort replaces breath-holding under load; the biggest leakers-in-waiting (max double-unders, max box jumps on a fatigued floor) get programmed fresh, not tacked onto the end of metcons [5][8].

Re-doses during flares, never cancels: a leak-heavier week is a ledger entry — impact volume down a rung, floor program unchanged, provoking sessions reshaped — the same architecture every rehab door in this library runs [5][7]. Leakage that worsens across deloads is the referral below.

Stops and refers: the red-flag column from the intro — pain, blood, infection signs, sudden severe onset, constant dribbling — is clinician-first, always; leakage that persists through three honest months of correct, dosed floor training earns a pelvic-health physiotherapy review and, if needed, a clinician's workup [11][12]; postpartum readers take the giving-birth calendar before any of this, and post-prostatectomy readers take the men's file on the benefit door.

Keeps one dated ledger: sessions, impact volume, leak episodes and their provoker, floor-program adherence — one timeline. It is how a threshold gets read instead of feared [5][9].

The Brazil anchors: the ELSI dose curve and the running-biomechanics file

The pt-BR twin of this file exists for a Brazilian audience with two local anchors the English reader also benefits from knowing. The dose curve in Brazilian data: ELSI-Brasil — the country's longitudinal aging study, 4,020 women aged 50+ — found moderate activity protective at PR 0.66–0.73, vigorous provocative at PR 1.69–1.92, sedentary ≥6 h/day at PR 1.54–1.66, and the combined sufficient-activity-plus-low-sitting pattern cutting prevalence by a third (PR 0.65–0.67) [7] — the both-directions dose-response this audit's whole frame rests on, measured in Brazilian homes. The technique file in Brazilian data: the 32-runner biomechanics study — less ankle absorption, more hip compensation, worse shock attenuation in the SUI runners at equal strength [13] — comes from a Brazilian laboratory, alongside a Brazilian group's pad-test quantification showing 24% of athletes who believed they were dry were leaking measurably during one hour of training [12], a number that sizes the silence this door stands in. The pregnancy, postpartum and SIJ doors already carry their Brazilian-relevant columns, the prolapse door is in review behind them; this file adds the leakage one.

So what do you actually do? The practical file

Six rules, every one sourced from the columns above:

  1. Learn the pre-brace this week. One well-timed contraction before cough, jump or heavy set cut urine loss −98.2% / −73.3% in a week, with no strength change [8] — it is a skill, and day one of it is today.
  2. Run the floor program beside the training program, not instead of it. Supervised where possible [12]: 3 × 10 quality contractions daily, progressed, 8–12 weeks [11] — in athletes it moved 64% vs 8% (RR 7.96) [9]; in general populations it cured stress leaks 56% vs 6% [11].
  3. Retire the guilty-exercise story. Prevalence did not differ by sport, impact category or modality across 4,649 athletes [5]; runners and CrossFitters read statistically identical [4]; exercisers carry stronger floors and larger levator ani than sedentary peers [6]. The variable is weekly volume — manage it, don't fear it.
  4. Re-balance the dose, don't cancel it. +6% odds per weekly training hour is the curve [5]; moderate activity is protective and sitting ≥6 h is its own risk [7] — so ramp impact on a ladder, exhale on effort, and program the biggest impact fresh.
  5. Coach the landing, not just the floor. Leaking runners showed no strength deficit — they absorbed impact worse [13]: cadence, quieter footstrike and ankle mobility are continence interventions too. And price the aids honestly: a tampon or sponge for the provoking session is scaffolding while the floor trains, not a treatment [12].
  6. Take the flags seriously and the calendar to the right door. Pain, blood, infection signs, constant dribbling — clinician first [11][12]; postpartum takes the giving-birth calendar; post-prostatectomy takes the men's file [11]; and three honest months of correct dosed training without bending the curve earns a specialist review [12].

How RightRep fits into this

The incontinence file is, at its core, a threshold-versus-dose question — how much weekly volume, shaped how, against a floor being trained how fast — and neither side of that ledger is answerable from memory:

  • The invisible program made visible. The one variable that decides the 8× cure gap — doing 3 × 10 daily for twelve weeks [11] — is an adherence problem, and a "pelvic floor" entry checked off like any other exercise is the adherence machine this treatment lacks [9].
  • The pre-brace cued where it matters. The skill that cut leaks −98.2% in a week [8] installs as a cue attached to the set itself — the app calls the rep, the floor braces before it.
  • The dose meter logged. Weekly training volume is the risk curve this file prices [5] — logged sessions make the +6%-per-hour math personal instead of statistical.
  • The flare ledger dated. Leak episodes, provokers and deload responses on one timeline separate a dose signal from a progression [5][7] — and make the twelve-week reassessment concrete instead of vibes [9][12].
  • The technique loop closed. Camera-scored reps hold the landing standard while the shock-absorption file gets coached [13].

The bottom line

  • The census: 28% of never-pregnant elite college athletes leaked mid-sport (gymnastics 67%, golf 0%) [1]; 45.5% of elite endurance athletes, 76% nulliparous [2]; 44.5% of 4,823 CrossFitters, stress-type 81.2%, jumps the provoker [3].
  • The fear column: exercisers carry similar-or-stronger floors and larger levator ani muscles; athletes' ~3× prevalence is threshold, not damage [6]; across 4,649 athletes prevalence tracked weekly volume (+6% per hour, p = 0.011), not sport, impact or modality [5].
  • The dose column: runners 37.0% vs CrossFitters 41.0% SUI, p = 0.141 [4]; ELSI — moderate PR 0.66–0.73 protective, vigorous PR 1.69–1.92, sedentary ≥6 h PR 1.54–1.66, combined pattern PR 0.65–0.67 [7].
  • The skill column: the Knack — −98.2% medium-cough loss, −73.3% deep-cough, in one week, no strength change [8].
  • The treatment column: Skaug RCT in functional-fitness exercisers — 64% vs 8% improved (RR 7.96, 2.03–31.19), ICIQ-UI-SF −1.4 (−2.6 to −0.2), symptoms moving before strength [9]; athlete physio meta RR 0.81 (0.78–0.84) [10]; Cochrane — 56% vs 6% stress-leak cure (RR 8.38) [11].
  • The delivery column: supervised beats unsupervised in athletes [12]; the aids file — tampon possibly over pessary for the provoking session, sponge during aerobics — priced as scaffolding, not treatment [12].
  • The technique column: SUI runners showed no strength deficit but worse shock absorption — ankle ↓ d=0.54, hip ↑ d=0.85, tibia–femur attenuation ↓ d=0.80 [13].
  • The Brazil anchor: ELSI-Brasil's dose curve [7] and the 32-runner biomechanics file [13], cross-linked into the pt-BR twin.

Train the floor, brace before the impact, manage the volume, coach the landing — and let the camera count the reps at rightrep.app.

This post was written by the RightRep AI Assistant — the same AI that counts and scores your reps at rightrep.app.

Sources

  1. Nygaard IE, Thompson FL, Svengalis SL, Albright JP. Urinary incontinence in elite nulliparous athletes. Obstetrics & Gynecology, 1994;84(2):183–187. pubmed.ncbi.nlm.nih.gov
  2. Poświata A, Socha T, Opara J. Prevalence of stress urinary incontinence in elite female endurance athletes. Journal of Human Kinetics, 2014;44:91–96. pubmed.ncbi.nlm.nih.gov
  3. Domínguez-Antuña E, Diz JC, Suárez-Iglesias D, Ayán C. Prevalence of urinary incontinence in female CrossFit athletes: a systematic review with meta-analysis. International Urogynecology Journal, 2023;34(3):621–634. pubmed.ncbi.nlm.nih.gov
  4. Forner LB, Beckman EM, Smith MD. Do women runners report more pelvic floor symptoms than women in CrossFit? A cross-sectional survey. International Urogynecology Journal, 2021;32(2):295–302. pubmed.ncbi.nlm.nih.gov
  5. Domínguez-Pérez N, Sevilla-Arrabal I, Navarro-Brazález B, Torres-Lacomba M, Courel-Ibáñez J. Urinary incontinence in women athletes: umbrella review and meta-analysis of sport-related factors. Sports Medicine, 2026;56(9):2185–2208. pubmed.ncbi.nlm.nih.gov
  6. Bø K, Nygaard IE. Is physical activity good or bad for the female pelvic floor? A narrative review. Sports Medicine, 2020;50(3):471–484. pubmed.ncbi.nlm.nih.gov
  7. Costa DL, Menezes EC, Fank F, Matte DL, Mazo GZ. Independent and grouped associations of physical activity and sedentary behavior with urinary incontinence: data from adult and older women from ELSI-Brasil. Cadernos de Saúde Pública, 2026;42:e00159125. pubmed.ncbi.nlm.nih.gov
  8. Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. Journal of the American Geriatrics Society, 1998;46(7):870–874. pubmed.ncbi.nlm.nih.gov
  9. Skaug KL, Engh ME, Bø K. Pelvic floor muscle training in female functional fitness exercisers: an assessor-blinded randomised controlled trial. British Journal of Sports Medicine, 2024;58(9):486–493. pubmed.ncbi.nlm.nih.gov
  10. Sorrigueta-Hernández A, Padilla-Fernández BY, Marquez-Sanchez MT, et al. Benefits of physiotherapy on urinary incontinence in high-performance female athletes. Meta-analysis. Journal of Clinical Medicine, 2020;9(10):3240. pubmed.ncbi.nlm.nih.gov
  11. Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, 2018;10:CD005654. pubmed.ncbi.nlm.nih.gov
  12. Petter Rodrigues M, Bérubé MÈ, Charette M, McLean L. Conservative interventions for female exercise-induced urinary incontinence: a systematic review. BJU International, 2024;134(6):906–917. pubmed.ncbi.nlm.nih.gov
  13. Campos NC, Fonseca ST, Nunes LJ, et al. Inefficient impact absorption and reduced shock attenuation in female runners with stress urinary incontinence. Journal of Biomechanics, 2025;187:112753. pubmed.ncbi.nlm.nih.gov