Stress Incontinence & Exercise

Come on, Rabbit. Let’s you and me bounce, huh?

How many of us have bought trampolines for our children only to discover that playing Tigger and Rabbit on the new birthday present results in more than we bargained for…? It might surprise you to read that around 80% of professional trampolinists also have bladder problems or stress incontinence and many elite athletes also suffer from the same problem. One thing is for sure: you’re not alone. There aren’t many mums out there who are happy to bounce confidently with their children!

What is Stress Incontinence?
Stress incontinence is when you leak urine on any sort of physical exertion and is a common, although frequently hidden, problem particularly in younger women. Around a third of all exercising women say that they are incontinent during their workouts.

Stress Incontinence & Impact on Exercise
Many women say that they would be much more active if they could find a way to control their leaking. We are all encouraged to exercise for our health but 20% of women actually give up exercise completely because of their leakage. This means that bladder problems may be having a greater impact on our health than we realise.  Avoiding exercise can increase your risk of heart disease, strokes, high blood pressure, diabetes, cancer, obesity and osteoporosis. So, if you leak when you exercise but want to be more active, what can you do?

Many studies have shown that women who exercise regularly and are active actually report less urinary incontinence than women who don’t exercise. Giving up exercise altogether is therefore not the answer!

Pelvic Floor Exercises
The first thing to do is to find and train your pelvic floor muscles. Leaking during exercise is caused by weakness in your pelvic floor muscles or the tissues that support your bladder. By performing pelvic floor exercises (or Kegel exercises), you can give yourself more control over your bladder during exercise.

Pelvic Floor Regime
In the early stages of any pelvic floor regime it is advisable to avoid any exercise that involves repetitive bouncing as this is much more likely to make you leak and can weaken your pelvic floor muscles further. This includes running, aerobics, tennis, dancing, gymnastics, ballet or hockey. Over-doing abdominal exercises can cause leaking too and jumping with both feet off the floor at the same time is also a big no-no for women with bladder problems. However, low impact exercise can actually make your leaking improve and won’t interfere with your Kegels or any pelvic floor muscle programme.  Focus on activities such as swimming, cycling or very light weight training.

As your pelvic floor improves then you can begin to add in walking, the cross trainer, stepper and light exercise classes. Weight training (as long as you are not lifting heavy weights) has also been shown to reduce the incidence and severity of leaking. So rather than giving up exercise, just begin with something that is low impact and gradually build up over time as your muscles and your fitness improve. Ensure you wear pads designed for urine leakage rather than periods as you are building up the strength in your pelvic floor. They are far more absorbent and can help to control any odour too, giving you the confidence to focus on your exercise regime.

When to Seek Medical Advice for Stress Incontinence
If you can’t feel anything happening when you try to exercise your pelvic floor muscles or don’t seem to be getting anywhere, then that is the time to seek help. You can ask your GP to refer you to a Women’s Health Physiotherapist who can assess your muscles and show you how to perform them correctly. If your muscles are very weak you may need the help of incontinence products such as electrical stimulation or if you can’t feel anything when you tighten, biofeedback can help you to tune into your pelvic floor. Once you are able to do an effective contraction, Aquaflex cones can help to motivate you and are fantastic for progressing your pelvic floor and exercise regime onto higher impact activities.

If you wish to do running or aerobics or anything that involves high impact, your pelvic floor will need to be very strong. It is possible to achieve this but you need to be committed to a pelvic floor muscle programme over a number of months to get there.

By Alison Bourne MA (Cantab) BSc MCSP ACPWH

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