Urinary incontinence (UI) is a prevalent issue among women who engage in weightlifting and other physically demanding sports, with a significant number of female athletes reporting this condition. A study reveals that 41.7% of female athletes experience UI, highlighting a widespread concern. Despite these figures, the exact reasons for UI remain elusive, though it can be triggered by activities such as weightlifting and jumping. The phenomenon poses a barrier to women's participation in sports and fitness activities, yet it often remains unaddressed.
Research underscores the prevalence of UI in athletes compared to sedentary women. A Norwegian study found that athletes are three times as likely to experience UI, while a meta-review reported 75.6% of female volleyball players experiencing stress incontinence. The issue is compounded by the fact that only 7% of women with UI consult their doctors, even though 35% report distress over the condition. The standard treatment involves Kegel exercises to strengthen the pelvic floor muscles, which support the bladder, uterus, vagina, and bowel.
The pressure exerted on pelvic organs during heavy lifting is a potential factor contributing to UI. However, research indicates that heavier weights do not necessarily impact the pelvic floor more than lighter ones. The complexity of UI, as a multifactorial issue, prevents experts from pinpointing a single cause. The Valsalva manoeuvre—a technique involving breath control and abdominal pressure—may play a role in UI among weightlifters. A study recorded that 74.5% of high-level female powerlifters aged 18 to 35 experienced UI during training.
"Elite athletes (in the absence of other risk factors, eg childbirth, obesity, etc) are more likely to experience UI than sedentary women" – POGP (Pelvic Obstetric and Gynaecological Physiotherapy)
The impact of UI extends beyond weightlifting to include activities like CrossFit and volleyball, where jumping is involved. Despite its prevalence, research on UI in women during weightlifting remains in its early stages, necessitating further studies to fully understand the issue.
"is a very topical area" – Dr Gillian Campbell, Gráinne Donnelly, and Christien Bird
"in its infancy" – POGP (Pelvic Obstetric and Gynaecological Physiotherapy)
Dr. Rori Alter explains that UI during weight training indicates exceeding one's load tolerance. This analogy highlights how insufficient strength leads to failure at the weakest link.
"When women leak only during weight training like this, it means they have reached and exceeded their load tolerance" – POGP (Pelvic Obstetric and Gynaecological Physiotherapy)
"If this was the first day you were lifting and I said: 'Lift a hundred kilos', and you’re not strong enough to do that, your weakest link would fail you" – Dr Rori Alter
Athletes like Sarah Skoruppa advocate for alternative techniques, emphasizing "bracing up" rather than down to alleviate pressure on pelvic organs.
"One thing that is widely taught is to brace down, to put pressure on the pelvic organs. But now I also focus on bracing up" – Sarah Skoruppa
Emily Westray and Cristina Rigden bring attention to the normalization of UI within gym environments.
"Women pee. In my gym you see it all the time" – Emily Westray
"If I peed myself and there was a puddle of urine I’d just laugh and walk off" – Cristina Rigden
"If you wee yourself, you just rock on" – Cristina Rigden
The POGP urges women not to accept UI as an inevitable consequence of physical activity but instead seek specialist help.
"It should not be accepted as a ‘price to pay’, but should be a trigger for a women to seek specialist help from a pelvic-health physiotherapist" – POGP (Pelvic Obstetric and Gynaecological Physiotherapy)