Why active women need a stronger pelvic floor
Why do I leak when I play sport or exercise?
Activities that increase abdominal pressure, such as jumping, jogging, skipping...and even laughing, coughing and sneezing...are likely to cause the small leaks of urine known as "stress incontinence".
Because physically active women are more likely to be engaged in these high-impact activities, they are more likely to experience these symptoms, and need stronger pelvic floor muscles than the average woman to withstand the effects of their activities.
It's so embarrassing - what can I do about it?
For the great majority of women, stress incontinence responds extremely well to pelvic floor exercises. Building pelvic floor strength has been identified as a successful approach by numerous researchers, and is the recommended first line of therapy for this condition. Active women are already committed to fitness and a lifestyle that incorporates exercise programs, so it's just a question of incorporating some different exercises into daily life.
I've never heard of it happening to anyone else, so why does it happen to me?
It happens to large numbers of active women but most are too embarrassed to talk about it.
Research has shown that over 30% of Australian women over 45 report that they leak during physical activity, and 13% of 18-23 year olds say it happens to them too. You are definitely not alone.
Maybe I should just give up, or switch to another sport.
Research shows that many women give up exercise for this reason alone, but rarely tell anyone the truth behind their decision. It is thought that stress incontinence is a barrier to physical activity for about 10% of women, and therefore has an overall long-term negative effect on their physical well-being.
Low impact activities are less likely to cause a problem, so some women initially switch to them. However, it is possible that if the symptoms aren't addressed, they can become worse, and leaks can occur during, for example, pilates or yoga, when previously they only occurred during, for example, jogging.
I don't play sport but I do visit the gym regularly. Surely that's good for me?
It depends what you are doing when you visit the gym. There's evidence emerging that exercise routines that focus on strengthening the abdominal muscles may actually worsen any existing pelvic floor weakness, and may lead to new problems emerging.
When an activity occurs that increases intra-abdominal pressure (eg jumping, sneezing etc), slack in the weakest muscle absorbs some of this pressure. If the rectus abdominis muscle (the "six pack" muscle at the front of the body) has been strengthened out of proportion to the pelvic floor muscles, then the latter will have to bear even more pressure than they would otherwise. Mary O'Dwyer explores this idea in detail in My Pelvic Flaw and Michelle Kenway describes a complete and detailed program of safe exercising techniques in Inside Out.
So, although regular gym-based exercise is generally good for everyone, women should respect the needs of their pelvic floor, and avoid exercises that focus on the "six pack". Remember that exercise routines designed for young men are not necessarily suitable for middle aged and older women.
Take our poll on the right of this page to provide feedback on your gym experience.
I've been wearing pads, but is there anything else I can do?
If you are generally happy with your pelvic floor strength, and you only experience stress incontinence during exercise, you may decide that you would prefer a temporary solution. Pads can work for some women, but depending upon the physical activities you take part in, they can be insufficient to catch the urine leaks, and they can be visibly bulky under your clothing.
Some women find it is possible to position a tampon internally so that it presses on the neck of the bladder and thus reduces leaks.
But the best option for most women will always be to strengthen up those muscles!
What are the best exercisers for strengthening the pelvic floor for physically active women?
All our pelvic floor exercisers can play a role in strengthening the pelvic floor, so it is a question of choosing the type of exerciser that suits you most.
Exercisers that offer progressive feedback (PFX2, Pelvexiser and Peritone) are generally preferred by women who are serious about building substantial pelvic floor strength, whilst Smartballs may be an option for women who want to maintain existing strength levels. Vaginal weights are a popular choice for women who want to improve muscle strength without having to do large numbers of pelvic floor "squeeze and lift" contractions.
It's a good idea to consider your own preferences before you make a decision. Are you already able to locate your pelvic floor muscle, and now want to build strength? Or do you need help to locate the muscle and know if you are squeezing correctly? Do you want a product you can use while you move around? Or are you able and willing to allocate the time each day to laying still while you exercise your pelvic floor?
Ask yourself these questions, then
- visit our Selecting Exercisers page
- print and read our leaflet on the different types of exercisers and what they do, and
- visit our Online Shop.
- To learn more about the benefits of each exerciser, read the more detailed information provided on each exerciser's own page, or email us if you have any questions about exercisers. Or seek advice from a health professional such as your GP, a women's health physiotherapist or gynaecologist.
I'm a fitness professional. What can I do to help my clients?
This is an important issue for fitness professionals, who may be losing clients regularly without know why.
Specialist researchers have made a number of recommendations regarding what you can do:
• Be aware that for the majority of women, strengthening of the pelvic floor muscles alone will overcome stress incontinence
• Talk openly about the problem, and display information brochures
• Avoid exercises that focus on strengthening the rectus abdominis muscle. Exercises such as crunches can put too much pressure on the pelvic floor muscles, creating new problems and worsening existing conditions, particularly in middle aged and older women. For more information, read Inside Out by Michelle Kenway with Judith Goh.
• Include low impact activities and pelvic floor muscle contractions in your exercise programs, but be aware that over 50% of women can't produce an effective contraction on brief verbal instruction, and 30% can't produce one after thorough individual instruction by a health professional
• Introduce other options, such as exercise aids, or suggest consultations with specialist health practitioners.
Pelvic Floor Exercise offers glossy product brochures for display and provides a rewards scheme for fitness professionals. Read more about our services to health and fitness professionals.
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