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Pee Leaks With A Tense Pelvic Floor

Updated: Jan 3, 2023

People who have a tight and non-relaxing pelvic floor can develop similar bladder issues to someone who has a weak pelvic floor.

I know, I know, this is a big head scratcher.

Our pelvic floor muscles need to be able to fully contract to keep stool and urine in our body, but they also need to be able to fully relax to allow urine and stool to exit the body.

Urgency and Urge Incontinence

The sudden onset of the need to pee is called urinary urgency. People who develop urgency sometimes also develop urinary frequency, which is the frequent need to pee.

These two conditions can compound to become urge incontinence, which is involuntary loss of urine followed by an urge to pee.

This condition is the result of bladder irritation. There are many reasons why the bladder can become irritated. That said, most of the causes for bladder irritation are linked to an up-regulated nervous system, especially in bladder pain syndromes.

Bladder irritation can develop from pelvic floor weakness, or an absence of tone from the pelvic floor signaling to the bladder that it is safe and supported.

But it can also develop from pelvic floor clenching and prolonged high pelvic floor tone, which irritates that bladder, decreases the ability to fully void, and is highly correlated to bladder pain syndromes.

Stress Incontinence

There are two types of stress incontinence. The first is incontinence with laughing, sneezing, coughing, and singing. Pee leaks with these activities speaks to a lack of pressure management in the core system, which is linked to the abdominal wall and diaphragm function (breathing).

The pelvic floor should contract and then elongate (or eccentric contraction) with a high pressure activity. A pelvic floor that is too tense will not be able to elongate, and may not be able to contract initially either. This will result in pee leaks.

The second type of stress incontinence is with jumping and running, or impact in general.

Pee leaks associated with these activities means the pelvic floor is unable to support the pelvis under the stress of the impact.

A tight pelvic floor cannot contract further to support the organs under stress, and pee leaks will result.


Pee leaks with a tense pelvic floor can mimic pee leaks that occur with a weak pelvic floor. There are a few signs outside of a pelvic exam that will signal pelvic floor tension, such a pain, but otherwise the best way to determine what is going on in the pelvic floor is a pelvic exam with a skilled practitioner.

A tight pelvic floor in a way IS a weak pelvic floor, because it is too tight to function properly. Everyone is a little bit different in terms of what they need to help resolve their pee leaks. It's important to get individualized and ongoing care to make sure you have find the underlying why of your issues and restore pelvic floor function!

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