How can you continue to exercise despite concerns about urinary incontinence, that little-known taboo that affects many women?

Still taboo, urinary incontinence is a real public health problem, mainly for women, at all ages: less than 25% of women under the age of 25 and more than 45% after the age of 75 report having experienced at least one episode. leakage of urine. And in 5% of them, incontinence is permanent.

Although exercise has long been thought to protect against these involuntary leaks, we now know that exercise is a risk factor, along with age, pregnancy and vaginal birth, menopause, overweight and obesity, cough, and menopause. chronic diseases and repetitive stress – be it physical labor or sports.

The connection between “sport and incontinence” was the focus of the latest Jeudis Sport Santé conference. ⁽¹⁾ Contributed by Bernard Parratt, Professor Emeritus of Anatomy and a specialist in physical and rehabilitation medicine.

An extremely common disease among athletes

Defined “involuntary loss of urine, causing complaints due to significant social embarrassment”Urinary incontinence occurs in two types of situations. “Stress urinary incontinence occurs due to laughing, coughing or physical activity. It must be distinguished from urgency, a sudden and irresistible need.”

Whatever the cause, this annoying and disabling symptom affects quality of life in general and, in particular, sleep, sex life and exercise.

In this latter area, research shows the extent of this phenomenon. Up to 72% of athletes of all age groups report at least one urine leak during training, both individually and in a club.

Anatomical explanations

R^R Parratt explains them this way: “We have long believed that exercise, because it strengthens the muscles that support the bladder (read elsewhere), protects against incontinence. And 20 years later we say the opposite: repeated requests can lead to incontinence.” Some exercises, particularly rowing and weight lifting, are more harmful than others because they increase abdominal pressure on the bladder.

For the same reason, pregnancy is a risk factor for urinary incontinence. “We have no predictive value for the maximum pressure level above which incontinence may occur.– says the specialist. It’s very individual. […] Everything is not clear. Intensity of practice and genetic factors also play a role, but also very likely increased intra-abdominal pressure coupled with less perineal resistance. Additionally, to prevent this discomfort, it is important to increase the resistance of the pelvic floor.

Impact on sports practice

But athletes, their coaches and their doctors should still be aware of this risk. “There is no information on this issue. points to the doctor. During the consultation to obtain a certificate about the absence of contraindications to sports, the question is never asked. It’s still taboo.”

And it is even more unfortunate that for this reason, studies show that 10% of women refuse to exercise due to urinary incontinence or 20% reduce their activity, with peaks of refusal occurring at ages when the incidence of urinary incontinence is higher. (around 45/50 years and after 75 years).

However, in conclusion, two good news: “The study found that in young athletes who train hard despite leaks, their urinary incontinence does not worsen with age, and even improves.” And especially: “The disorder is reversible!”

Adapted pelvic floor rehabilitation exercises, some hygiene and diet rules (in particular, combating constipation, which increases abdominal pressure), weight control and, of course, better knowledge of risky sports help combat this disorder.

1- Organized by the Olympic and Sports Committee of the Var Department.