Runners: Lose the Leak!


Waylaid from exercise by having to stop to pee too often?



Don’t bother going out to run for fear that you will wet on yourself?



Have you had to give up the thing that you love because you leak when you run?


You are totally not alone.  Research shows that 1 in 3 women leak a little with activity.  Healthy, young and active women leak.  And it doesn’t have to be this way!  You can lose the leak.  Read on and get back to running with confidence.

Despite the TV commercials encouraging you to address your issue with  medications or to use a pretty pad, there is much more you can do than to settle for dry mouth or diapers for the rest of your life.  Your first step is to understand what is happening.  The next step is to take action to get back to what you enjoy.

Incontinence, the involuntary loss of urine, happens to over 25 million women in the United States alone. Many of these women are under 30 years old and have never had children.  A study on young girls and incontinence finds 20% of otherwise healthy young girls are giving up on exercise because they pee a little when they run.1,2 Or jump. Or laugh.  This is not OK and it’s frustrating for the person, and for the pelvic health therapists who KNOW that we can make a difference in your lives.

Who leaks? Not just old or pregnant people!  One study asked 291 elite women athletes and dancers about if they leak and 51.9% said yes.1 And not just during training or competition.  Another study found that 20% of young women stop exercising because of leakage.2 Interestingly, a study of healthy fitness instructors also found 26% experience urinary incontinence.3

So what can be done?  The first thing that needs to be established, is what type of incontinence do you have?  The treatment for stress incontinence is different and urinary urgency or urge incontinence.  Some people have both!!  Now what??  Kegels may help (if you’re doing them right), but they might not!  A skilled Women’s Health Physical Therapist can help you learn what you need to do.  You may not need any exercises at all!!


  1. Thyssen et al. Urinary incontinence in Elite Female Athletes and Dancers. Int Urogynecol J (2002) 13:15-17.
  2. Nygaard I et al.  Exercise and Incontinence. Obstet Gynecol 1990; 75:848-851.
  3. Bo K, Bratland-Sanda S, Sundgot-Borgen J. Urinary incontinence among group fitness instructors including yoga and Pilates teachers. Neurourol Urodyn 2011;30:370-373.


The Magic Move

The other day Sandy and I were talking about the odd desire that physical therapists (at least in America) tend to want a protocol, including what exercises, are need to help a patient.  Sandy told me a great story of a very good occupational therapist she used to work with, who gave an inservice on his new shoulder protocol.  It was a handout of all the standard rotator cuff exercises, with one exercise scribbled out.  Which exercise doesn't matter for this story.

The patient was very compliant, but said that he didn't really care for most of the exercises, except for one that seemed to really help a lot.  When the therapist asked which one helped the most, the patient pointed to the one that was scribbled out.  He actually felt better moving his shoulder in a 'scribble' pattern.  It was amazing, he found his magic move! And it was not even in the protocol.

While the promise of simple instructions that can be applied to any person with a particular diagnosis is very seductive, I have observed 2 things.  First, most patients don't follow the protocol, usually because it is either 'too boring' or 'too long'.  The second reason is that we are not all the same.  We value different things, we enjoy different things, and we have different levels of motivation.

Admit it.  We all want that magic move.  The one thing that will make us feel better, the one thing that will 'fix' whatever is causing us pain, discomfort or loss of function.  If I find that move, I'm quitting my job, and doing a world tour and maybe some infomercials...

Until then,  we'll be here at Entropy, ready to help anyone who wants to find a program that works for them.

Alphabet Soup - What do all of those letters mean??

The medical profession is filled up with a variety of different letters:  PT, DPT, MD, DO, DC, WCS, certified, board certified....  All of those letters might instill a sense of confidence.  Or just confuse you.

I am as guilty as anyone for 'collecting' letters.  Sandy Hilton actually tells me I need a QR code for all of them (she is exaggerating just to irk me).  Some people collect letters as a symbol of accomplishment, some to make themselves more marketable.  Regardless of the letters after anyone's name, we have to remember those letters do not make that person a great clinician.

These letters can help a patient find a practitioner who specializes in something specific.  People 'earn' letters by completing advanced degrees, undergoing a written or practical test, or completing other advanced training.  But other times those letters may just translate into someone who has jumped through appropriate hoops and paid the necessary fees.

The whole purpose of this post is to just encourage patients, consumers and practitioners to consider what those letters mean.  Look them up, or ask the person who has the letters what they mean.  But then ask them what they had to do to get them.  Decide if those letters impress you as much after you know what they mean.


Thanks for listening :-)

Sarah J. Haag, PT, DPT, MS, WCS, Cert. MDT


PT=Physical Therapist (licensed physical therapist)

DPT= Doctor of Physical Therapy (professional degree, 2 or 3 additional years of schooling)

MS = Master of Science (in women's health, back to school again!)

WCS = Women's Health Certified Specialist (Board Certified Specialist in Women's Health Physical Therapy through the American Board of Physical Therapy Specialties)

Cert. MDT = Certified in the Mechanical Diagnosis and Therapy through the McKenzie Institute


Why Entropy??

We get several different reactions when we say that we just opened a clinic, and it's called, 'Entropy Physiotherapy & Wellness'. The first bit that seems to baffle people is 'Entropy'. Some people look confused. One guy grinned a little, but then couldn't remember why he would know what entropy is.

Entropy is the third law of thermodynamics. (Thanks, Mr. Kruse, my physics teacher at Bradley-Bourbonnais Community High School, for making this make sense). Entropy simply put is the tendency of the world to get messy. It is natural for us to seek the state which requires the least amount of energy to maintain, which also tends to be the most 'disordered'. Think of sitting up straight vs. slouching. One takes a bit of effort, but looks lovely and orderly. The slouching you do not even need to be conscious to do (no energy, lots of disorder).

All of that being said, Entropy is what happens to most of us when we have that crick, hitch, ouch, or even that incapacitating sciatica. It wasn't a traumatic event. But it also didn't really even hit us out of the blue (even if it feels like it did). As a very wise man once said (Morten!!), most of our pains took years of careful preparation.

So why Entropy? Mostly because we're falling apart in one way or another. Thankfully, entropy is a reversible process.

Once we have adequately explained entropy, the next question is: What's Physiotherapy?

Other than sounding just a bit more sophisticated than 'PT' or 'physical therapy', it is what every other country calls the profession that specializes in physical rehabilitation. And we just like it.