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Preventing Urinary Incontinence in Active Women

Patty Kulpa, MD


No matter what you've heard, incontinence—or involuntary urine loss—is not a normal part of aging. And it is treatable.

Millions of people have urinary incontinence. Women who participate in sports and exercise may be particularly susceptible because impact can weaken the pelvic floor muscles. These muscles are responsible for controlling urine flow.

Your doctor may prescribe various treatments, including drugs and surgery. But many women find help with less dramatic measures.

Fluid and Food

For starters, avoid drinking too much fluid. Limit fluid to less than 2 liters (or 2 quarts) per day, but your urine should appear clear like water. Don't limit your fluid intake before, during, and after exercise. Limit your fluid intake after 6 pm if you have problems with waking up at night to urinate or with bed-wetting. Also, add fiber to your diet to avoid constipation.

In addition, limit bladder irritants like nicotine, caffeine, alcohol, carbonated drinks, tea, chocolate, citrus fruits, tomatoes, apple juice, cranberry juice, spicy food, and foods with the sweetener aspartame.

Activity Selection

You may need to avoid sports that weaken the pelvic floor, like those involving jumping with legs apart. High-risk sports are gymnastics, volleyball, basketball, handball, karate, horseback riding, high-impact aerobics, and dance. Medium-risk activities are jogging, tennis, skiing, and skating. Activities with little risk include swimming, bicycling, walking, rowing, low-impact aerobics, and others in which at least one foot touches the floor at all times.

It may help to change sports for a while or modify your sport as you pursue other treatments. If you continue a sport that makes you incontinent, do Kegel exercises (below) before and during your workout, or insert a tampon.

Kegel Exercises

One of the most important steps is pelvic floor, or Kegel (rhymes with eagle), exercises. The pelvic floor muscles lie deep in your pelvis, and strengthening them can help you better control your urine flow.

Your goal is to stop urine leakage when exercising, coughing, sneezing, laughing, or lifting-all of which can put pressure on the bladder. Eventually, you'll be able to do Kegel exercises anywhere at anytime.

Ask your doctor to show you how to do Kegel exercises. He or she will feel your pelvic floor muscles with a finger while you try to contract these muscles. If you still cannot locate your pelvic floor muscles, a physical therapist or nurse can help you by using other aids and techniques.

A Kegel exercise should feel like you are stopping your urine stream or preventing the passage of stool. Firmly tense the muscles around your vagina and anus by inwardly lifting and squeezing them. Hold this contraction to the count of 5 (gradually work up to 10), then relax.

At first, do your exercises while lying on your back with your head and shoulders supported by a pillow and your arms at your sides. Bend your knees and place your feet flat on the floor about 12 inches apart. Eventually do Kegels while sitting and standing. Start with one set of 10, three times a day. Work up to 20 sets of 10 each day.

Here are other helpful hints for doing Kegel exercises:

  • Contract your pelvic floor muscles without lifting your buttocks, tightening your stomach or thigh muscles, or moving your legs.
  • Do not practice stopping your flow of urine. It will disrupt your voiding patterns.
  • Do not hold your breath or strain.
  • Be patient and faithful. Improvement takes 6 to 8 weeks. You need to do Kegel exercises indefinitely.

For further information and support, write to: National Association for Continence, Box 544, Union, SC 29379, or call 1-800-252-3337.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Kulpa is a sports gynecologist and urogynecologist practicing in Gig Harbor, Washington.