In our fifth `top tips’ blog for a healthy Run Reigate, Mr Anand Singh, the new urogynaecologist at Spire Gatwick Park Hospital, talks about a `wee’ problem which can be a big issue for women runners.
“Leaking a bit of wee is a common problem in female runners but one that is rarely talked about. Or, if it is, women think they must put up with it. But it doesn’t have to be that way and there is a lot you can do to help yourself.
Why does it happen?
Involuntarily leaking urine with little or no warning signs and no preceding urge to use the bathroom is called stress incontinence. It happens when there is a combination of increased pressure on the abdominal muscles and weak pelvic floor muscles. It can occur when coughing or sneezing, lifting a heavy weight, or doing a high impact activity like running,
The pelvic floor muscles act like a hammock to support the bladder, uterus, bowels, and vaginal walls. When the pelvic floor muscles are strong and healthy, they keep things where they should be.
Risk factors for stress incontinence
The pelvic floor muscles weaken as you get older, so this problem is more common in women over 65. It temporarily may occur in younger women following childbirth. Being overweight has also been identified as a risk factor.
How to help yourself
- Avoid fizzy drinks, alcohol and drinks containing caffeine as these irritate the bladder.
- Sip water slowly throughout the day to maintain hydration levels rather than taking large gulps just before the race starts. During your training runs, test out how much water your body can take on board without causing leakage.
- If you have a high Body Mass Index, then losing weight has been shown to reduce stress incontinence.
- The menopause leads to a reduction in oestrogen levels which maintain a healthy pelvic floor structure. A simple positive change could be extra oestrogen through HRT or vaginal pessaries. See your GP about this.
- Consider alternatives to high impact exercises during training and counter-balance your abdominal and core strengthening exercises with consistent pelvic floor muscle exercises too.
While there is plenty of advice online about how to do pelvic floor exercises, I highly recommend the NHS Squeezy app. It comes with an exercise plan and reminders so you can’t forget to do it. If you are committed to this, you should see results within two to three months.
Time to step up
If you are still having a few problems after three months, see a women’s health physiotherapist. It’s like having a personal trainer who can help you improve your technique for better results.
When to seek medical help:
If stress incontinence continues to be a problem, then it is time to see a urogynaecologist. There are’ several procedures which can help. The least invasive is intra-urethral bulking in which a small hydro gel is injected into the urethra to pad it out to support the neck of the bladder. It takes about 10 minutes under local anaesthetic, and you will notice the benefits straight away. You can be back running within 24- 48 hours but continue with your pelvic floor exercise regime.
Find out about other surgical options here
The last thing a woman wants to worry about when doing Run Reigate is leakage so be pragmatic – take on board some of the tips above and wear a pad if necessary. If you continue with your pelvic floor exercises you will be running future races with confidence rather than incontinence!