by Dr. McKenzie Redd, PT, DPT at CPR Physical Therapy + Performance

If you leak during workouts, it’s rarely just about weakness.

More often, it’s about pressure management — how your core system and pelvic floor are handling load.

And I know… you’ve probably been told:

“Oh, you leak? Just do Kegels.”

But let’s talk about why that’s not always the right strategy.

When you cough, laugh, jump, sneeze, run, or lift heavy, you create increased intra-abdominal pressure. That’s normal. You need pressure to move well and generate force.

But if that pressure isn’t managed well, the pelvic floor often becomes the pressure relief valve.

Think about squeezing a balloon. If the pressure has nowhere to go, it pushes downward. The same thing can happen in your body.

And that’s when leaking shows up.

The Core Is a Pressure System

Your core is not just your abs.

Think of it as a pressure canister:

• The diaphragm on top
• The pelvic floor on the bottom
• The abdominal wall in the front
• The spinal muscles and connective tissue in the back

When you inhale, the diaphragm descends. The pelvic floor lengthens in response. The abdominal wall expands. Pressure distributes evenly.

When you exhale, the system recoils.

That expansion and compression cycle is what allows you to move efficiently, stabilize your spine, and produce force.

If one part of that system isn’t doing its job — leakage can happen.

Habit #1: Gripping Your Abs 24/7

One of the most common patterns we see?

Constant abdominal gripping.

A lot of women have been coached to:

• “Brace harder.”
• “Squeeze.”
• “Pull your belly button in.”
• “Stay tight.”

So they walk around gripping their abs all day. They brace before every movement. They never fully relax.

The problem? Constant tension increases baseline pressure.

If you’re squeezing your abs like a vice grip, that pressure has to go somewhere — and often it pushes downward toward the bladder.

Instead, think about this:

• Relax when you’re not lifting.
• Brace only when needed.
• Keep breathing.
• Avoid holding your breath unnecessarily.

Coordination > constant tension.

Habit #2: Bearing Down Instead of Bracing

There’s a big difference between bracing and bearing down.

Bracing is 360-degree expansion of the ribcage and abdomen with controlled tension.

Bearing down is pushing pressure downward toward the pelvic floor.

If you do core work and only feel engagement above your belly button while your lower abdomen bulges or “pooches,” you’re likely bearing down.

That increases downward pressure and increases the likelihood of leakage.

A good brace should feel like expansion around your entire trunk — not force pushing toward the pelvic floor. If you notice a “lower belly pooch” or a lot of tension in your upper abs when you are squeezing your core… you might be bearing down.

Habit #3: Breath Holding Without Strategy

Breath holding (Valsalva) isn’t automatically bad. High-level lifters use it strategically.

But here’s the issue: if you’re holding your breath without pelvic floor coordination — especially during high reps or conditioning work — pressure spikes fast.

If the pelvic floor doesn’t reflexively respond at the right time, leakage happens at the peak of force production.

Common moments:

• The bottom of a heavy squat
• The pull of a deadlift
• Landing from a jump
• Repeated impact while running

This is often a timing issue as much as a strength issue.

A simple starting point?
 Try exhaling through the hardest part of the movement.

If you leak coming out of the bottom of a squat, try a controlled exhale as you stand.

Small changes in breath strategy can make a big difference.

Why Kegels Alone Don’t Fix This

Kegels are voluntary contractions of the pelvic floor.

They’re not useless — but they’re not the whole answer.

They don’t address:

• Breath mechanics
• Ribcage positioning
• Abdominal wall strategy
• Hip strength
• Impact mechanics
• Timing under load

You don’t leak because you can’t squeeze hard in isolation.

The pelvic floor works as part of a larger system.

Research has even shown that women who leak don’t always have weaker pelvic floor strength compared to those who don’t leak — but they often have weaker hip strength.

That matters.

You can have a strong Kegel on the table — and still leak during a box jump if your hips, glutes, and core aren’t managing force well.

Doing 50 Kegels on your couch doesn’t teach your pelvic floor how to respond during a 185-pound clean.

It doesn’t improve landing mechanics.
 It doesn’t retrain your brace.
 It doesn’t build impact tolerance.

And if your pelvic floor is already overactive? More Kegels can actually make things worse.

What Actually Helps

Instead of defaulting to “squeeze more,” we look at the full system:

• Can you expand your ribcage 360 degrees?
• Can your pelvic floor lengthen — not just contract?
• Are your ribs stacked over your pelvis?
• Can you brace without bearing down?
• Can you manage pressure repeatedly under fatigue?
• Do your hips and glutes contribute effectively?

Then we retrain in positions that look like your sport:

• Loaded carries
• Squats
• Step-downs
• Running drills
• Jump progressions

Because leaking during workouts is a dynamic problem.

It requires a dynamic solution.

Leaking Is a Symptom — Not a Life Sentence

It’s common in high-performing women.

Especially those who:

• Lift heavy
• Train intensely
• Have had pregnancies
• Push through discomfort

But common does not mean normal.

When intra-abdominal pressure is managed well, the diaphragm, abdominal wall, spine, and pelvic floor work together — expanding and recoiling in sync.

When that system is efficient:
 You don’t cross your legs before a jump.
 You don’t pick leggings based on “just in case.”
 You don’t avoid certain movements.

You just exercise like you want to… without having to worry about your pelvic floor or core. That’s exactly how it should be.