Understanding Urinary Incontinence in Athletes: Causes, Risks, and Solutions

2024-04-23 10:30:00

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

Although for a long time it was believed that the practice of sport protects against these involuntary discharges, we now know that sport, on the contrary, is one of the risk factors, along with age, pregnancy and vaginal delivery, Menopause, overweight and obesity, cough, chronic illnesses and repeated strain – whether manual work or sporting activities.

The links between “sport and urinary incontinence” were at the heart of the last Jeudis Sport Santé conference (1) given by Bernard Parrate, professor emeritus of anatomy, specialist in physical medicine and rehabilitation.

A very common disorder among athletes

Defined by a “involuntary loss of urine causing a complaint of significant social embarrassment”Urinary incontinence occurs in two types of situations. “Stress incontinence is caused by laughing, coughing or physical exercise. It should be differentiated from urgency, sudden and irreversible necessity.”

Whatever the cause, this disturbing and disabling symptom affects the quality of life in general, and in particular sleep, sex life and sports practice.

In this last area, studies show the extent of the phenomenon. Up to 72% of athletes, all age groups combined, report at least one urine leak during their exercise, whether alone or in a club.

Anatomical explanations

Professor Parratte explains them as follows: “We have thought for a long time that sport, because it strengthens the muscles that support the bladder (read elsewhere), protects against incontinence. And 20 years later we say the opposite: incontinence can be the result of repeated requests.” Certain exercises in particular – rowing, weight lifting – do more harm than others, because they increase abdominal pressure on the bladder.

It is for this same reason that pregnancy is a risk factor for urinary incontinence. “We have no predictive value for a maximum level of pressure that would cause incontinence.let the specialist know. It is very lonely. […] Not everything is clear. The intensity of the practice, genetic factors are also at play, but probably also, an increase in abdominal pressure as well as less resistance to the perineum. Also, to prevent this discomfort, it is important to increase the resistance of your pelvic floor.

Influence on sports practice

But, athletes, their trainers and treating doctors still need to be aware of this risk. “There is no information on the subject, points the doctor. The question is never asked during a consultation regarding a non-contraindication certificate for sports practice. It’s still taboo.”

And it is regrettable that, for this reason, studies show that 10% of women abandon their sports practice due to urinary leakage, or that 20% reduce their activity, with peaks of abandonment at ages when frequency increased urinary incontinence. (around 45/50 years and after 75 years).

However, there are two good stories to conclude: “A study has shown that urinary incontinence does not worsen with age in young athletes who continue to exercise despite leakage, and even improves.” And in particular: “The disorder is reversible!”

Adapted pelvic floor rehabilitation exercises, some rules of hygiene and diet (especially the fight against constipation that increases abdominal pressure), weight control and of course a better knowledge of risky sports help to fight against this disorder.

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