“Exercising is great for the heart.” “Getting a move on can improve the muscles.” “Physical activity can do wonders for bones.”
Whatever the message, we all know there are plenty of benefits to reap from exercising, but putting the words into practice can spark fear in the six million Australians living with incontinence.
Incontinence affects one in three women over the age of 65 and while many know fitness can improve overall health, the thought of having an accident in public leaves many ladies feeling embarrassed, ashamed and avoiding physical activity altogether.
“It’s one of those taboo topics that’s often not really spoken about. But it does happen in the gym and we embrace anyone to come on in, because you can exercise around incontinence issues,” Carissa Evans, an exercise physiologist at Fernwood Fitness, says.
While plucking up the courage to talk about your condition and symptoms can be daunting at first, it’s important to be as honest as possible so trainers can provide the best exercises for your individual circumstances. Exercise can be tailored for individual needs so every woman can make the most of her fitness journey, without worsening her incontinence.
“Us trainers need to be aware of health issues when we’re training our clients, just to make things as comfortable as possible for them,” Evans says.
While high-impact activities such as running, skipping and jumping can accelerate heart rate and are often discussed as great exercises for over-60s, they’re also likely to increase the risk of leakage and usually won’t be recommended to women experiencing incontinence. Similarly, deep squats or activities that require people to hold their breath place downward pressure on the bladder and are therefore unsuitable for women with this condition.
“If you’re doing lots of crunches, lots of deep squats, that can actually make incontinence worse. They will definitely be something to avoid,” Evans says. “Make sure that you’re keeping the resistance training to an appropriate level, so you’re not really straining, not really holding your breath and not really exerting that downwards pressure, which any trainer should be able to help you with.”
Opting for one-on-one personal training is a great option for women who want to exercise but aren’t sure where to start. A personal trainer can tailor exercises for individuals to create an easy-going and non-judgemental environment. A trainer will also normalise the condition so you can feel confident working out. They may also recommend exercises, such as pelvic floor exercises, to complete at home.
Women can generally strengthen their pelvic floor muscles by imagining they’re holding the flow of urine or holding in wind and trying to squeeze, which pulls up and holds the muscles in that area.
“A lot of women start to see very fantastic results within four to six weeks,” Evans says of pelvic floor exercises. “But not all women do, which is important to remember.”
Furthermore, personal trainers can often identify a factor increasing leakage and target that to prevent it.
“If you’re overweight, weight loss can actually help reduce the stress on the bladder,” Evans says. “I’ve had ladies come in and simply do weight loss. They’ve actually seen a decrease in their incontinence issues.”
Fitness experts like the ones at Fernwood Fitness can also offer advice on the types of gym equipment that are best for women experiencing bladder leakage.
Exercise bikes and cross-trainers are ideal for women with incontinence who want to focus on their cardio, because they allow you to increase your heart rate without having the same impact on the bladder as certain exercises, weight-lifting machines and treadmills do.
Fernwood also offers group classes that are designed to be low-impact so women can enjoy physical activity while still managing and improving incontinence.
“We’re not going to have the girls running, jumping, skipping, those sorts of things. It’s all based on light resistance training,” Evans says. “Sometimes we’ll get them to use the machines. Other times, it will be light hand weights.”
The best part is that these classes are often targeted at over-50s, so you’ll be exercising with women of a similar background.
“A lot of women in the same class will actually be having the same problems, whether they mention it or not,” Evans says.
Fernwood offers Lite Pace and step classes – both of which are recommended for people with incontinence and are led by a qualified trainer. Lite Pace classes are ideal for beginners and provide the foundation to build aerobic fitness and muscle conditioning. Step classes offer high-energy exercises designed to target the legs, buttocks and thighs, while providing a cardio workout.
“We have some ladies in here who do experience incontinence on a daily basis. They’re well into their exercise programs and it’s just about taking precautions,” Evans says. “But in some of our classes, we’ll have a little bit of a laugh. It’s a very common thing.”
Aerobic training is particularly beneficial for women with incontinence and includes exercises such as cycling, swimming and uphill walking. These activities get your heart rate up and increase blood flow around the body – without causing downward force on the bladder. Aqua-based water exercises – known as hydrotherapy – are another great option.
There are also other small changes women can make to get the most out of their exercise experience when dealing with incontinence, such as using the bathroom before a workout and avoiding caffeine.
“A lot of ladies have actually mentioned to me that they find it easiest when they wear black, just in case they do have those little accidents in here,” Evans says.
While some women refrain from drinking fluids completely before hitting the gym, it’s vital to remain hydrated with water – especially when working out.
“Exercise is something that every woman should do, no matter your health, no matter your age,” Evans says. “Exercise is very, very important, particularly as you start to get older.”