ATHLETIC INCONTINENCE
Athletic incontinence is urinary incontinence ONLY experienced during athletics or sport. About 40-50% of female athletes report athletic incontinence, many of whom have not had children! The most common movements that cause athletic incontinence are deadlifts, squats, jumping and running. Leakage tends to happen with more weight on the bar, higher impact (like a higher or longer jump), and under fatigue (at the end of a workout). What do all these movement patterns have in common? They cause more STRESS on the pelvic floor and increase the intra-abdominal PRESSURE (the pressure within the abdomen resulting from the interaction of the abdominal wall and internal organs).
How can you learn to address athletic incontinence?
Learn to BRACE better!
A better brace not only improves athletic performance by helping you lift heavier, but it also improves coordination of your abs, pelvic floor and diaphragm. During a brace, you want simultaneous and equal co-contraction of these muscles so that intra-abdominal pressure is equally distributed throughout the trunk. Leakage occurs when there is a PRESSURE MISMATCH, where the pelvic floor isn’t strong or coordinated enough to remain contracted against the increased intra-abdominal pressure, or POOR PRESSURE MANAGEMENT, where pressure is directed downward onto the pelvic floor (similar to expelling gas).
To work on bracing, gradually increase the breath volume and brace intensity as the weight goes up. Inhale, Valsalva (i.e. close your glottis and hold your breath as if you were going to pop your ears), and contract the muscles of your core and pelvic floor as if someone were going to punch you in the belly. Keep your ribs stacked over your pelvis, and avoid pushing your stomach out or bearing down. Don’t change this when you add a belt!
How you wear a belt also matters: Tighten the belt on an EXHALE. You should still be able to slide a couple fingers between the belt and your abdomen.
Figure out the CAUSE of your leakage!
Leakage can happen with a pressure mismatch, but this could be due to muscles that don’t have enough strength, fatigue quickly, aren’t coordinating well, or are too tight and unable to produce sufficient force. Technique faults can also contribute to leakage when they change the pressure distribution during a lift. If you hit a leaking point in a lift, that means the pressure gage is too high for the pelvic floor at that point, or too focused on the pelvis (i.e. bearing down).
While adding in pelvic floor exercises may be helpful for some, for others, it can worsen the leakage. A pelvic floor physical therapist can help to assess your function and help you learn what strategies are going to help YOU!
Work sub-symptomatic threshold on offending movements!
When modifying training to improve your symptoms, try to accumulate lots of repetition at a level that is just below the symptomatic threshold. For example, you tend to experience leaking at a 100 kilo deadlift, train at 90% of that (90 kilos) and accumulate a lot of good reps without leaking. Make sure you’re addressing good bracing and pelvic floor coordination, as well as any technique faults. Retest your 100 kilo deadlift after about 4-6 weeks to assess improvement.
Not sure what you need? Book an appointment with Diana today!