Exercise solution for gym-going women with continence concerns

Women with continence issues are reluctant to continue many sports and gym programs, but new research has found a way to help women undertake resistance training that will help reduce the risk of stress urinary incontinence.

It involves women engaging in a Kegel exercise program that will tighten pelvic floor muscles before they commence resistance training, with the combined exercises helping to prevent or control urinary incontinence.

This is a prevalent problem: Urinary incontinence affects up to 70% of women worldwide, with stress urinary incontinence reported as the most prevalent sub-type.

Some women suffering from stress urinary incontinence—which is the involuntary loss of urine on effort or physical exertion—say the condition reduces their quality of life, leads to social isolation, and results in them modifying or avoiding sport completely.

However, efforts to maintain resistance training—which includes exercises using free weights and/or machines—actually lead to improved urinary continence.

Donelle Cross, from the College of Nursing and Health Sciences at Flinders University, says her research has identified that some incontinent women who continued to perform resistance training experienced an improvement in their daily continence.

"Physically active women tend to have stronger pelvic floors, and this is thought to contribute to a successful continence mechanism when there is an increase in their intra-abdominal pressure," says Cross.

A recent study found over 8% of the incontinent women no longer experienced urinary leakage during their daily life after performing resistance training, which suggest its positive impact on pelvic floor strength and women's ability to timely and effectively activate their pelvic floor muscles.

And the new research showed that combination of Kegel exercises before resistance training provided the most effective results.

The new research—"Does a Kegel Exercise Program Prior to Resistance Training Reduce the Risk of Stress Urinary Incontinence?" by Donelle Cross, Marilynne N. Kirshbaum, Lolita Wikander, Jing-Yu Tan, Simon Moss and Daniel Gahreman—studied incontinent women before they commenced resistance training, comparing groups with and without prior Kegel exercises. They recorded their Incontinence Severity Index score, pelvic floor muscle strength, and body composition (such as body mass index, fat, and muscle mass) both before and after exercising.

Results that have been published in the International Journal of Environmental Research and Public Health demonstrated that resistance training reduced stress urinary incontinence to a significantly greater extent, but only if preceded by Kegel exercises and maintained over time.

A positive correlation was found between the average strength of pelvic floor muscles and stress urinary incontinence. Participants in the group doing Kegel exercises before their resistance training demonstrated a significant increase in muscle mass and concomitant reduction in fat mass.

"A dedicated program of Kegel exercises preceding a resistance training program improved average pelvic floor muscle strength and was effective in reducing stress urinary incontinence among incontinent women," says Cross.

The results of this study strongly supported the notion of pelvic floor assessments and supervised Kegel exercises before performing resistance training.

Participants in this study were reminded frequently to activate their pelvic floor muscles as part of engaging their core when attempting the resistance training exercises, which contributed to the successful results.