Urinary Incontinence Among Active Females Is Common, But Treatable
by Dr. Colleen McGinnis
Urinary incontinence (UI) is a real problem that women of all ages will likely face at some point in their lives. I’m 37 years old and I started strength training when I was in high school. I played soccer, ran, competed in triathlons, and lifted weights. I considered myself to be fairly fit when I was introduced to Crossfit in 2012, but soon realized that I hadn’t pushed my body that hard in any previous activity. I began performing Olympic lifts, double-unders, and box jumps all for the first time. It was then that I also experienced my first incidents of urinary incontinence. It was as you can imagine, embarrassing, alarming, and inconvenient to say the least. I began to avoid exercises that caused stress on my bladder or led to “leaks” and I would always bring an extra pair of leggings with me just in case. Being a Physical Therapist I understood what was happening to my body but not entirely ‘why’ and certainly not how common this condition was. It didn’t hit home until almost a year later while I was judging a Crossfit competition. I was counting the repetitions of a 24 year old female performing box jumps. Before she was able to complete her last jump she crumbled to the ground. My first thought was; ‘oh no, she’s hurt’. I bent down and asked if she was ok. We were being watched by hundreds of spectators. She looked up at me almost in tears and said she had completely peed herself. That was a turning point in my career.
“The mainstream advice is “do your kegels” which can help in some cases but other times is simply not enough”
Studies(1) have shown that 30% of women in the US experience urinary incontinence (UI). Despite this fact, it’s a topic not frequently discussed. The average woman will struggle with UI for 6 years before finally speaking with her health care provider. Women are increasingly discovering the health benefits of strength training, but high impact activities like Crossfit and running put a lot of stress on our bodies, and it’s common for this stress to lead to urinary incontinence. 30% of female runners also report having experienced UI while running. And then of course there’s childbirth. 92% of women experiencing UI after giving birth reported(2) they still battle with the condition 5 years on.
The good news is that UI can be treated, and proper treatment can be very effective and long lasting. The first step is understanding the cause. Misunderstanding the underlying cause of your incontinence can result in treatment that is ineffective or may even worsen your symptoms. The mainstream advice is “do your kegels” which can help in some cases but other times is ineffective and simply not enough. Kegels can actually worsen symptoms if you suffer from pelvic floor over-activity. It is important to assess the pelvic floor as well as have an orthopedic assessment performed by a qualified Physical Therapist to help determine the appropriate course of action.
Urinary incontinence could be a result of many different issues. Some of the more common ones are;
A weak pelvic floor.
An overactive pelvic floor.
An imbalanced inner core.
Pelvic floor dysfunction due to spinal or hip dysfunction. While the pelvic floor is important, it’s only part of the equation. Your spinal mobility, core muscles, hips, thighs, and glutes all play a part in maintaining normal pelvic floor function.
It is important to consult with a Physical Therapist who specializes in pelvic floor treatment if you are experiencing UI symptoms. Pelvic floor physical therapy is the recommended(3) first step in treatment for a wide range of pelvic floor disorders including incontinence. Treatment is available and effective, and can help improve pelvic floor coordination, strength, endurance, tone, and reduce over-activity.
Bottom line is; treat the leak ladies!
References in this article: (1) Abbitteboul Y, Leonard F, Mouly L, Rivière D, Oustric S. 2015 Urinary Incontence in non-professional female marathon runners. Prog Urol. Sep;25(11):636-41 (2) Viktrup L, Lose G 2000 Lower Urinary tract symptoms 5 years after the first delivery. Int Urogynecol J Pelvic Floor Dysfunction 11(6):336-40 (3) Dumoulin C, Hay-Smith J, Mac Haber-Seguin G. 2014 Pelvic floor muscle training verses no treatment or inactive treatments for urinary incontinence in women. Cochrane Database syst. Rev. May;14;(5)