Published Jul 24, 2014, EveryDay Health
For the millions of women who lose urine every time they cough, sneeze or laugh, exercise is high on the list of activities that can cause accidental leakage. But a new study suggests that not only do incontinent women avoid exercise but that vigorous exercise might increase the likelihood of incontinence; not just bladder leakage, but stool leakage as well.
Specifically, according to Colleen Fitzgerald, MD, a researcher at Loyola University in Chicago, one in three female triathletes suffer from urinary incontinence, 28 percent have inadvertent loss of stool and 5 percent have pelvic organ prolapse. What all of these conditions have in common is a weak and ineffectual pelvic floor, the group of muscles that keep your bladder, uterus, and rectum in place and in shape. The study was presented at the American Urogynecologic Society 2014 Scientific Meeting in Washington, DC.
If anyone is going to have strong muscles throughout the body, one would think it would be an elite athlete! But what this study demonstrates is that toned abs and calves do not correlate with a toned pelvic floor. While there seems to be an association between triathletes and these disorders, it’s unclear if vigorous exercise causes the problem, or if these are women are at high risk for other reasons and exercise worsened the condition.
The clear message, in any case, is that even if you exercise regularly and are really strong, you can still be one of the millions of women who have a weak pelvic floor and experience urinary or fecal incontinence.
While 80 percent of women do nothing about it, there are solutions beyond the pads and diapers that manage — not treat — incontinence!
Obesity is a known risk factor. Lose the weight and you might lose the diapers, but it needs to be in a healthy way since the Loyola study showed that 22% of athletes in the study reported eating disorders. Smoking cessation and healthy voiding habits also impact the degree and frequency of incontinence.
A Personal Trainer for Your Pelvic Floor
At the end of the day, since incontinence is a result of a weak pelvic floor and inadequate support of pelvic organs, strengthening the pelvic floor is the best first approach to treatment.
Kegel exercises are commonly recommended. And almost as commonly, they fail. Hence the multi-million dollar diapers industry! Studies show that few women do them correctly or consistently. Success is most likely in women who work with a pelvic floor physical therapist.
That’s right, a pelvic floor physical therapist. In one of my recent surveys only 20 percent of women were even aware of the existence of this highly specialized branch of physical therapy that can help strengthen pelvic floor muscles and effectively treat all types of incontinence.
The pelvic floor therapist uses a number of modalities, including biofeedback, bladder training and pelvic floor muscle exercises. Mild electrical stimulation is also often utilized to stimulate and strengthen pelvic muscle contractions.
Pelvic floor physical therapy works, but only a small percentage of women have access to and utilize this option.
Your Home Pelvic Floor Gym
A number of over-the-counter vaginal weighted cones and balls can facilitate the success of do-it–yourself pelvic floor exercises. But no scientific studies show that these products work, despite enthusiastic testimonials on the product websites.
InTone is a new FDA-listed prescription device that a patient can use at home. It not only utilizes pelvic floor stimulation, but also includes voice coaching and biofeedback to reproduce what a pelvic floor physical therapist does and in a recent clinical trial demonstrated improvement or resolution of incontinence in the majority of users.
What about surgery? Surgical procedures all have the common goal of supporting the urethra and base of the bladder. Success rates are high. But as in any surgery, there is risk of bleeding, infection, and injury to surrounding structures. While infrequent, mesh erosion may occur and require subsequent procedures. Excluding certain isolated situations, surgery should not be the first treatment option!
It’s time to talk about this taboo topic before diapers become the newest accessory in the Nike store. So yes, strengthen your calves and abs, but don’t forget to strengthen your below-the-belt muscles to be truly fit!