Stress incontinence is defined as the involuntary loss of urine secondary to increased intraabdominal pressure that affects an individual’s quality of life. Activities such as sneezing, coughing or laughing can be enough to lead to involuntary leaking. High impact exercise is defined as an activity with “both feet off the ground at the same time, involving repeated increase in intraabdominal pressure.” This can include activities such as running, jumping, weightlifting, and CrossFit. We now know that high impact activity can lead to an increase in urine leaking during exercise. But urinary incontinence is HIGHLY under reported in this population, and women who haven’t had children can still experience leaking during exercise.
On average 25-45% of women report experiencing leakage at least once per year. Women aged between 20-39, 7% of this population report symptoms of urinary incontinence. This percentage continues to increase with age. Up to 79% of women aged 60-79 report urinary incontinence symptoms. (Goldstick et al 2013). In an athletic population up to 80% of athletes in gymnastics, trampolinists and ballet dancers have been reported as most affected by urinary incontinence. (Carls, C. 2007, Caylet, N et al 2006).
With numbers like this you must be wondering why does stress incontinence happen, and why can I experience this even without having a baby?
Stress incontinence occurs when there is an increase in abdominal pressure that is then placed on the bladder and pelvic floor. There are many different causes and reasons why stress incontinence occurs but if the pelvic floor is not able to withstand this increase in abdominal pressure leaking will occur. During high intensity activities this leads to increase in intraabdominal pressure which exacerbates any leaking symptoms that may be experienced.
A study by Nygaard, I et al 1990 reported that 30% of women who exercise experience leakage in at least one type of exercise. Certain risk factors such as:
– Number of children
– Participation in high impact physical activity
These factors can affect the likelihood of you experiencing these symptoms. (Melville et al 2005). This highlights the importance of education and treatment in this space.
Doumoulin et al 2010 states that physiotherapy is the first line of treatment of stress incontinence. Completing a pelvic floor exercise program can help address factors associated with increased risk of stress incontinence. By building on the pelvic muscle’s tolerance to this increase in abdominal pressure can help to decrease symptoms.
Other treatment options have been:
– Decrease fluid intake before and during training
– Reduce caffeine
As women’s health physiotherapists our main goal is to break the stigma surrounding incontinence especially in this space. From our experience, we know that there are good improvements to be made to improve your quality of life. The physiotherapists at Bump Fitness have the training and the expertise to be able to work with you and your desired sport if you are experiencing any leaking while training or competing.
Constantini, N. Urinary Incontinence in Physically Active Women and Female Athletes British Journal of Sports Medicine
Melville JL, Katon W, Delaney K, et al. Urinary incontinence in US women: a population-based study. Arch Intern Med 2005;165:537–42.
Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 2010;(1):CD005654. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women – PubMed (nih.gov)