Health Library / Training
This content is for education only and is not medical advice. I'm a fitness coach, not a physician. Talk to your doctor before starting any medication, hormone, supplement, or new exercise program, especially if you have a medical condition or take prescriptions.
A woman told me she'd stopped jumping. Not stopped training — stopped jumping, specifically. No box jumps, no skipping, nothing with both feet off the floor. She'd been quietly editing her own program for two years and hadn't mentioned it to anyone, including her doctor.
She leaked when she jumped. And she'd decided that was just what happens now.
It isn't. This is one of the most common things in the over-45 world and one of the least discussed, so let's discuss it.
Your pelvic floor is a sling of muscle across the base of your pelvis. It holds your bladder, bowel and — in women — uterus in position, it's part of how you control continence, and it participates in stabilising your trunk every time you lift something.
It's muscle. Which means it can be weak, it can be tight, it can be poorly coordinated, and all three respond to training.
After menopause the tissue changes as estrogen falls, which is why this so often shows up in the same few years as everything else in this library. In men it turns up most often after prostate surgery, and men are even less likely to raise it.
Leaking with pressure — sneezing, coughing, laughing, jumping, a heavy lift. That's stress incontinence, and it's the one that quietly reshapes people's training.
Urgency — the sudden, non-negotiable need to go, sometimes with leaking on the way. Different mechanism, different management.
Heaviness or dragging, particularly by the end of the day or after lifting. That's worth getting looked at properly.
You've heard the answer: do Kegels.
Here's what that misses. A meaningful number of people with pelvic floor symptoms have a pelvic floor that's too tight, not too weak. It's already holding tension it can't release, and it's failing because a muscle that never lets go can't contract properly when you need it.
For those people, more squeezing makes it worse. They do Kegels faithfully for months, get worse, and conclude they're beyond help.
You cannot tell which one you are from an article. That's the whole reason this module ends where it does.
Pelvic floor muscle training works — it's first-line treatment and the evidence is genuinely good. The catch is that it has to be the right training, done correctly, for your pattern.
Most people do it wrong on the first attempt. They hold their breath, clench their glutes, squeeze their inner thighs, bear down instead of lifting. A practitioner who can assess what you're actually doing changes the outcome more than any cue I can write here.
Breathing is part of it. Your diaphragm and pelvic floor move together. People who brace by holding their breath and bearing down under every heavy lift are driving pressure downward, repeatedly, for years.
How you lift matters more than whether you lift. Exhaling through the hard part of a rep, not gripping your abdomen so aggressively that pressure has nowhere to go but down, and building load gradually all matter. Lifting is not the enemy here. Lifting badly, with a pelvic floor that can't manage the pressure, is.
A pelvic health physical therapist is the person for this. They exist, there are more of them than there used to be, and they assess directly rather than guessing. It's a normal appointment and they have this conversation all day.
See someone if you leak at all — any amount, any trigger. If you feel heaviness or a dragging sensation. If you have pain with intercourse. If you've had a baby, ever, even decades ago. If you've had prostate surgery.
And see a doctor rather than a therapist first if urinary changes came on suddenly, if there's blood, pain or fever, or if something feels acutely wrong — those point elsewhere.
Being over 50 is not a reason to accept leaking, and "everyone has this" is not the same as "nothing can be done." It's a treatable muscular problem that happens to be embarrassing, and the embarrassment is what keeps people from the treatment.
She's jumping again, by the way. It took about four months.
Last updated September 30, 2026