How many female weightlifters experience urinary incontinence?

Summary of an article investigating urinary incontinence (urine leakage due to the loss of bladder control) in female Olympic weightlifters.

Who

191 competitive female Olympic weightlifters aged on average 35.92±12 years with 6.31± 4.43 years of experience in strength training and 3.63±2.99 years of weightlifting experience (English-speaking countries: UK, USA, Australia, Canada, New Zealand).

Design

Online cross-sectional survey.

Outcome measures/tests

Incontinence Severity Index

Main results

Female weightlifters and incontinence:

37% of female weightlifters had given birth (72 women):
- vaginal birth 76.4%
- cesarean birth 12.5%
- vaginal and cesarean births 11.1%
36.6% (70 women) reported experiencing urinary incontinence at some point in their life, and 31.9% (61 women) experienced incontinence within the last 3 months.
16.2% reported athletic incontinence (urinary incontinence that appears only during exercise):
- type 1 athletic incontinence (urinary incontinence that appears only during exercise and started after starting weightlifting) 8.4%
- type 2 athletic incontinence (urinary incontinence that appears only during exercise and started before starting weightlifting) 7.9%
57.1% experiences incontinence during high repetition sets (with half of them reporting that leakage was more likely to occur at the end of the set)
67.5% reported that incontinence only happened with heavy sets
3.7% reported leakage with the use of a belt
maximal effort during competition was less likely to provoke incontinence than maximal effort during training (16.8% versus 24.6%).
incontinence during the competition was less prevalent than during training (17.8% versus 25.7%).
24.3% of uncontinent weightlifters had a pelvic assessment, but 77.1% of incontinent weightlifters were confident (or very confident) in their ability to perform pelvic floor exercises.
factors related to the Incontinence Severity Index score:
- parity (going through labour / delivery / giving birth)
- age
factors that DO NOT influence incontinence:
- BMI
- years of participation in resistance or weightlifting training
- competition total
incontinence happens during:
- squat
- clean & jerk
- snatch
- pulls
practices used to prevent/minimise incontinence:
- taking antibiotics (for recurring urinary infections)
- yoga and Pilates
- emptying bladder before and/or during training
- consciously engage the pelvic floor before the lift
- focusing on breathing
- bracing core before the lift or trying to not over brace the core
- wearing 1 or 2 pads
- using or avoiding using tampons
- practicing pelvic floor exercises
- pelvic mobility, lower back and hip stretching, massage or release work
- strengthening deep muscles and core
- not over-tightening the belt
- wearing dark clothing
- reducing drinking
- keeping low body mass
- crossing legs while sneezing

Take home message

For a clinician & coach

Almost 37% (1 out of 3) of female weightlifters experience urinary incontinence (leakage) at some point in their life, and 16.2% reported athletic incontinence (only during exercise). Incontinence happened most often during squatting, then clean & jerk, snatch, and was less common with pulls. Coaches should be aware that athletes may decide to train/compete dehydrated to prevent leakage.

For a parent

One out of every 3 female weightlifters experiences urine leakage at some point in their life. Incontinence happens most often during squatting, then clean & jerk, snatch, and is less common with pulls. Parents should know that athletes may train/compete dehydrated to prevent leakage, which is risky for their health and should be avoided.

For an athlete

One out of every 3 female weightlifters experiences urine leakage at some point in their life. Incontinence happens most often during squatting, then clean & jerk, snatch, and is less common with pulls. You should know that training/competing dehydrated to prevent leakage is risky for your health and shouldn't be done. Please see a 'pelvic floor physiotherapist/physical therapist'

Original article

Wikander L, Kirshbaum MN, Waheed N, Gahreman DE. Urinary incontinence in competitive women weightlifters. Journal of Strength and Conditioning Research. 2021.

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