The NHS estimates that up to six million people in the UK suffer from urinary incontinence. If you are one of them, it will almost certainly affect your running and, worse, add stress to your daily life. You are not alone – in fact, in a recent WR online survey, almost 40 percent of you admitted to having leaks from time to time. But you certainly are not powerless to solve the problem – it’s time to take control of your bladder…
Types of incontinence
There are two main types of incontinence – stress and urge. With stress incontinence, urine leaks out when your bladder is under pressure; for example, when you run or sneeze. Urge incontinence is when you suddenly feel an urgency to pass urine but don’t quite make it to the toilet in time. You may suffer from one or both types, but stress incontinence is more common and it’s the one that causes most problems for runners.
The stress test
One in five women over the age of 40 complains of stress incontinence. As your bladder fills up, your pelvic floor muscles work to keep your urethra (the tube that runs from your bladder to the outside) closed. The urethra should only open and let urine out when the brain tells it to. But if your pelvic floor is weak, any increase in pressure – such as a good cough – can overcome the muscles and urine leaks out. Childbirth weakens your pelvic floor, as does getting older – this is especially the case after the menopause.
Getting to a healthy weight can make an enormous difference, reducing the pressure on the bladder.
About six out of ten cases of stress incontinence will improve by strengthening the pelvic floor muscles. But it won’t be good enough to squeeze the muscles a few times only when you remember. You need to have and follow a training plan, just as you do for a running event.
The muscles you need to squeeze are the same ones you use if you are passing urine and need to stop halfway through. Squeeze them quickly five times and repeat this exercise five times. Then do five long squeezes, trying to hold to a count of five each time. Alternate these short and long blocks for five minutes. Do this set of exercises at least five times a day. You can be sitting, standing or lying down when you do them. When this becomes easy, begin holding to a count of ten. If you are patient and dedicated, you may find you have no more problems after about five months.
The next step
If self-help is unsuccessful you will need to get a referral from your GP to see a physiotherapist or a continence adviser. They will ensure you are squeezing the correct muscles and may suggest other options, such as electrical stimulation or increasingly heavy vaginal cones/weights to work very weak muscles.
For those few who have no luck with these options there may be surgical options and your GP can refer you to a gynaecologist to discuss which type of operation might suit you.
There is only one tablet that helps stress incontinence. Its side effects are significant so it’s reserved for those women who are not fit enough to have surgery.
On the run
Running does not cause stress incontinence but it can reveal it. Running hard, running downhill and sprinting all increase the pressure on the bladder, which may cause some leaking. Try these tips to minimise any problems:
• Empty your bladder just before you set out.
• If you are running a long distance, factor in a toilet stop, as a full bladder leaks more and you will need to drink fluids when you’re running for a long time.
• Use a thin sanitary towel or incontinence pad. If wearing one makes you self-conscious, invest in a running skort.
• To minimise leaks, try squeezing your pelvic floor muscles when you run (don’t become frustrated if you can’t because it is hard to do).
• You may leak more at different times in your menstrual cycle so keep a note to see if there are better times than others for those sprint sessions.