Stress Incontinence and Female Athletes

Posted by Brigham and Women's Hospital March 13, 2014

Nearly one in three young women experiences stress urinary incontinence during exercise.

Author: Joy Shine, MSPT, CLT, a senior women’s health physical therapist in the Department of Rehabilitation at Brigham and Women’s Hospital Joy also works with the Women’s Sports Medicine Program, directed by Elizabeth G. Matzkin, MD.

As a part of your training routine, you may be focused on strengthening a variety of muscle groups in your legs, arms, or abdomen. But there’s an important area you may be missing. Did you know that nearly one in three young women experiences stress urinary incontinence, or urine leakage, during exercise?

During physical activity, especially high-impact sports like running and jumping, there is an increase in intra-abdominal, or belly, pressure,” explains Joy Shine, MSPT, CLT. “The pressure causes the bladder, bladder neck, and urethra to move downward, allowing the involuntary passage of urine.”

A Training Routine for Your Pelvic Floor Muscles

Pelvic floor muscles support pelvic organs and prevent urinary leakage. If these muscles are not coordinated well enough, however, they will not effectively do their job. The good news is that simple exercises can be done to help strengthen the pelvic floor muscles and prevent urinary leakage during exercise, as well as coughing, sneezing, laughing, or heavy lifting – other common causes of stress urinary incontinence.

  • Pelvic floor muscle exercises (commonly known as Kegel exercises) are performed by contracting the pelvic floor muscles, providing closure around the anus, vagina, and urethra. During a pelvic floor muscle contraction, a squeeze and upward lifting sensation can be felt around the vagina and anus when contracting these muscles correctly. Performing three sets of 8-12 slow-velocity repetitions, two to four times a day, are advised for pelvic floor muscle strength training.
  • “The Knack” is a pre-contraction and hold of the pelvic floor muscles before and during activities that increase intra-abdominal (belly) pressure.

“The beauty of these exercises is that they can be done anywhere and at any time,” says Joy. “It’s important, however, to make sure that you are doing these exercises correctly and regularly for maximum effectiveness.”

Seeking Treatment for Urinary Incontinence

Talk with your doctor if you are experiencing symptoms of stress urinary incontinence. In some cases, your primary care physician may recommend that you work with a pelvic floor physical therapist who can guide you in the proper contraction of your pelvic floor muscles and give you tips for properly engaging your pelvic floor muscles. If these exercises don’t provide enough control over symptoms, a urogynecologist can provide additional treatment options.

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No Need to Stress about Stress Urinary Incontinence

Posted by Brigham and Women's Hospital January 29, 2013

Dr. Vatche Minassian says stress urinary incontinence is common and very treatable.

Dr. Vatche Minassian, Chief of Urogynecology at Brigham and Women’s Hospital, is the guest author of today’s post on stress urinary incontinence, the third post in a series about pelvic floor disorders that impact the quality of life in women.

The other day I saw a young woman who had delivered her first baby a few months ago and was complaining of urine loss with laughing and sneezing. Her condition, a common one, is known as stress urinary incontinence. She was worried that she would need surgery to stop her urine loss since her mother and her grandmother both had surgery for incontinence. Her pelvic exam was normal and she had no obvious reason for her incontinence, other than the fact her pelvic floor muscles had weakened due to her pregnancy and delivery.

I reassured her that surgery was not her only option and that, in her case, I would first recommend strengthening her pelvic floor muscles with exercises and physical therapy. We also discussed weight loss and other conservative measures. By the time she left the office, she was less anxious and was eager to start getting in shape as a way to rehabilitate her pelvic floor muscles.

Many of my patients are surprised to learn that urinary incontinence is a very common condition. More than one in three adult women lose urine, making urinary incontinence more common than conditions like diabetes or heart disease. Urinary incontinence affects women of all ages, and its frequency increases with age. Despite these high numbers, very few women talk about their condition, and even fewer women seek care for incontinence. When women with incontinence are asked why they are not seeking help, they commonly say: “I’m too embarrassed,” “I thought this is part of life or part of the aging process,” “My mother has it and my grandmother had it,” “I did not know treatment is available,” “I do not want to have surgery,” or “I have other more important things that I need to take care of.” It is really unfortunate so many women silently suffer and live with incontinence for so long before seeking care.

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