Jen Pinarski is a mom of two who loves to run. She runs marathons and just completed her first six hour race! She even blogs about it. Jen reached out to me on twitter with questions about running and light bladder leakage (LBL). Like many women, Jen noticed some changes after her first child was born. "I was inactive and gained a lot of weight with my son," she said. With her second pregnancy, Jen stayed active and ran until hours before her daughter's birth. "The year after my daughter was born I experienced tons of leakage," Jen said. That's when she was diagnosed with cystocele, also known as a prolapsed or dropped bladder (a portion of the bladder descended into the vagina.) It's become such a way of life for Jen that she just ignores it. Even so, concerns popped up. "My biggest worry was I'd smell like a public washroom for the rest of my life," Jen said.
Talking to other moms helped her realize she wasn't alone. When I told Jen that one in three women experiences LBL she said, "Pretty much every woman in my circle of friends that I've talked to says she has it, so I think it's more like three in three." Jen gets asked a lot of questions about running and bladder control from the women who visit her running blog. She brought their questions to me. To help with the answers, I reached out to a brilliant woman who has been my gynecologist for over 25 years, Dr. Judith Brysk. MD, PLLC, in Birmingham, Michigan. Read her response to the questions that follow:
Q: Why do I never feel empty? Even if I go before I run, I still feel like I have to go.
A: As your heart rate increases and blood pumps harder and faster, the blood flow to everything goes up, including the bladder. Also, as you're running, your uterus and other organs are bouncing on the bladder. This may create the feeling of having to go, even when you don't have to.
Q: Can a pessary help support my pelvic floor?
A: If there's a question of prolapse you need to be evaluated for a pessary or surgery. (Pessaries are a type of medical devise shaped like the outer ring of a diaphragm, used to support the uterus, vagina, bladder, or rectum.) Just because it feels like you have a prolapse, doesn't mean you do. An evaluation helps determine if there are alternatives to surgery that can help.
Q: Why does light jogging cause no leaking for me, but a sprint will cause me to leak?
A: Sprinting causes an increase in intra-abdominal pressure which generates more pressure on the bladder. That added pressure can make the difference.
Q: I started running at the six to eight week mark after having each of my babies. Would it have been better for me to wait longer before running?
A: It may just be that your pelvic floor muscles hadn't recovered yet. Consider physical therapy. Pelvic floor strengthening therapy involves evaluating and teaching women how strengthen key muscle groups to prevent leakage.
Q: I’m childless and under 30, and had no leakage until I started running. Why am I leaking?
A: Not all leaking is due to child birth. There are a variety of reasons why women leak including bladder size, how much the bladder can hold, weight, and how much pressure is exerted on the bladder, among other things. Getting a urological evaluation is important to determine the cause and best possible solutions specific to your body. Some women feel uncomfortable talking with their doctors about LBL. Let your doctor know if you're sensitive by saying, "I'm kind of embarrassed to talk about this." We can do things to help. If we don't know there's a problem, we can't help you. In addition to the questions that Dr. Brysk answered, we had this one:
Q: What's the difference between a period pad and pads made especially for LBL?
A: LBL-specific pads are different than period-only pads. The LBL variety is designed to quickly absorb bladder leakage and lock away odor. There's a helpful demonstration video that does a great job of showing you the difference. To see it, click here.
Preparing for the run Preparation makes a difference. You prepare for a run by putting on the right kind of shoes, stretching, and properly hydrating. Drinking too much water can get you into trouble, and so can drinking too little. When you withhold water for fear of leaking, urine gets concentrated and aggravates the bladder, causing you to leak. You can also prepare for a more leak-free run by doing regular pelvic floor strengthening exercises, like Kegels, or Mula Bandah. Exercising your pelvic floor just five minutes, twice a day can make a significant difference in your ability to lessen the leaks.
What about you? How do you keep LBL from slowing you down?