Feeling like you need to pee when you’re walking is something a lot of people experience, but it’s not normal – particularly if you often have to cut your walk short because you can’t wait to go.

This type of incontinence is called stress incontinence, where you experience an urgent need to pee (and possibly leaks, too) when your bladder is under pressure. If you have stress incontinence, laughing or coughing can trigger the sensation of needing to wee, as can walking – the impact of striking the floor can cause urine leakage.

Approximately 9 million people in the UK are living with some form of stress incontinence. It’s a condition that doesn’t always have a straightforward fix, and it can have a huge impact on your quality of life and mental wellbeing. But it is treatable.

We asked the experts what causes someone to experience stress incontinence, and how to fix it.

“The urge to pee can come at any point during the day once the bladder is filled to a certain level,” explains Clare Bourne, leading pelvic health physiotherapist and author of Strong Foundations. “Stretch receptors in the bladder wall send messages to our brain to make us aware of the presence of urine in the bladder. This first awareness comes before the bladder is full and gives us time to get to a toilet as needed.”

If you feel an urgent need to pee, and you don’t feel able to wait the five or 10 minutes needed to locate a loo, then this is an indication of an overactive bladder, according to Bourne. “Equally, these symptoms can be related to weaker pelvic floor muscles and urethral sphincters.”

Anyone can develop stress incontinence; however, women and those assigned female at birth are most likely to experience it, due to risk factors including pregnancy and childbirth.

There are a few common causes of stress incontinence, Bourne says, including:

Pregnancy

“Growing a baby puts more pressure on your bladder, which can mean it can’t hold as much urine and makes you feel the need to pass more frequently.”

Childbirth

“After birth, especially after vaginal birth, the pelvic floor muscles are recovering from a large stretch and sometimes a tear as well. Pelvic floor muscle weakness can mean we can’t hold for as long, and women can often report different forms of incontinence after birth.”

UTI (and similar) infections

“If someone has an acute urine infection this will often cause symptoms of needing to pee more frequently and urgently, and requires antibiotics.”

Bladder pain syndrome

“Some women will experience bladder pain syndrome, which causes painful and sudden urges to pee, as well as needing to go more frequently. Women often report pain as the bladder fills with urine.”

Perimenopause and menopause

“Women, during perimenopause or post-menopause, can notice new bladder symptoms such as urgency and frequency of needing to pee as well. This can be related to hormonal changes that occur during this time, mainly the decline in oestrogen levels.”

Often, stress incontinence and feeling like you need to pee when walking can be linked back to pelvic floor dysfunction.

“The pelvic floor is a muscular hammock slung between the pelvic bones – the hammock’s trees,” explains Megan Vickers, postpartum physio specialising in pelvic floor and birth recovery at Postpartum Plan. “If we move the trees, and when we walk the pelvis bones move reciprocally and constantly, then we are moving the pelvic floor and this can affect the organs within it – especially the bladder.

“If the pelvic hammock is stretched and weakened from pregnancy, childbirth, trauma or hormonally (it’s more lax post-menopause) then its ability to support the bladder will be reduced and this will be most noticeable when standing and walking. Occasionally, increased urgency during weight-bearing activities can signal a pelvic organ prolapse, where the pelvic organs are sitting lower than they should be.”

If you’re experiencing any kind of incontinence or you feel an urge to pee more than eight to 10 times during a 24-hour period (depending on your fluid intake), then it’s important to get checked out by your GP, Vickers says. “It can be as simple as prescriptive pelvic floor exercises to remedy these symptoms, but often it is more than that and we need to look at resolving pelvic dysfunction, improving core strength and strengthening posture too.”

First and foremost your GP will rule out urinary infections and screen for any more serious conditions. “If this comes back clear then conservative management is often recommended first,” says Bourne. This might include:

• Pelvic floor muscle rehabilitation – looking at optimising muscle function in different positions. This won’t just be focused on strengthening the muscles.
• Discussing bladder irritants and how to reduce these, including fizzy drinks and artificial sweeteners.
• Ensuring that you’re not struggling with constipation.
• Bladder retraining.
• Devices that might support you with your rehabilitation or to manage symptoms in the short term.

“If conservative management isn’t working then often more tests will be requested and, where appropriate, medication is used.”

Bourne recommends starting with diaphragmatic breathing to help the pelvic floor muscles to be flexible. “Breathing into the lower rib cage, allowing them to expand and the tummy to soften, before exhaling fully. Repeat this five times.

“Then, work on engaging the pelvic floor. Think about squeezing around the anus and holding in wind. This should be felt internally without external movement of the body or squeezing the legs or bottom muscles. Once you have squeezed, allow the muscles to fully relax. Try this for 10 reps.”

She recommends combining this with the following breathwork:

1. Breathe in, allow the pelvic floor to relax
2. Breathe out, and contract the pelvic floor
3. Breathe in and fully relax

Image: Getty