Why Even Elite Athletes Leak: The Hidden Weakness in Strong Bodies

Dr. Sasha Speer, PT, DPT
Sep 11
3 min read

You can deadlift twice your body weight, crush a HIIT class, or run marathons—and still find yourself leaking when you sneeze, jump, or laugh.

Sound familiar?

You’re not alone.

Urinary leakage doesn’t just affect postpartum moms or older adults.

At Auria, we work with elite and high-performing athletes—people who train hard, eat clean, and live in strong, capable bodies—who are baffled (and often embarrassed) by pelvic floor symptoms.

Here’s the truth: leaking isn’t about weakness in the ways we’ve been taught to think. It’s about coordination.

The Myth of the "Strong Enough" Pelvic Floor

We often assume that athletic people are immune to pelvic floor dysfunction because they have strong cores, toned muscles, and good body awareness. But the pelvic floor doesn’t work in isolation.

Just like any other muscle group, it needs:

Proper timing
Balanced tension (not too tight, not too loose)
Integration with the rest of the core and breath system

When the pelvic floor isn’t coordinating well with the diaphragm, deep abdominals, and back muscles, it can’t manage pressure effectively—especially during high-intensity activities.

The result? Leaks, pressure, heaviness, or a feeling of instability.

Why Athletes Are Especially at Risk

Elite athletes often place high repetitive loads on their core and pelvic systems:

Lifting heavy weights
Jumping and landing
Rapid changes in direction
High-impact cardio or plyometrics

These demands create intra-abdominal pressure—and if the pelvic floor can’t meet that demand or time its contraction properly, leakage can occur.

Additionally:

Athletes often have overactive pelvic floors from constant bracing
They may unintentionally bear down (valsalva) during lifts
They might not have retrained their pelvic floor after injury, birth, or hormonal shifts

This isn’t a sign of failure—it’s a sign your system needs recalibration.

What Leaking Actually Tells Us

Leaking is never just “normal,” even if it’s common.

It’s your body saying:

“I’m working hard, but something’s out of sync.” “I need a little more support—or a little less tension.” “It’s time to revisit the basics of coordination and control.”

The pelvic floor isn’t just about strength. It’s about timing, breath, pressure regulation, and functional stability—especially under load.

How Pelvic Floor PT Can Help Athletes

At Auria, we specialize in assessing and retraining the pelvic floor in motion—not just lying down on a table. Your care is designed around your sport, your body, and your goals.