Despite the overwhelming health benefits of the sport, athletes are still urged to give their bodies an occasional break. One way to do so is through strategic changes in diet. However, not all people who play sports have bladder issues. Some simply take an extended break period that leaves them unable to work out for weeks or months at a time, while others find they need to take extended breaks every few months to keep playing their sport safely and effectively.
Sports with bladder problems are becoming more common, especially amongst younger athletes who are using more physiological training methods rather than formal one-hour long training sessions. In some cases, this results in bladder problems that can become severe.
Modern training methods such as plyometrics and the more recent CrossFit style of training (sport-specific workouts with various exercises and protocols) use activities that some athletes cannot perform because of their age or physical capacity. For example, some older players who lack sufficient strength may find they cannot do some plyometrics such as squat jumps and box jumps. These exercises can have marked effects on the lower pelvic floor mechanism, "the muscles responsible for the coordination of bladder emptying". The loss of function can, in some cases, allow the bladder to become a 'fusiform pouch', a condition where a person has a full bladder while sitting down and the urine is stored in the lower abdomen. This may lead to an increased risk of emptying your bladder involuntarily while sitting or standing due to stress or fear.
No matter what technique athletes utilise, these issues do not discriminate based on sex, age, athletic ability, or physical fitness level. In fact, studies have shown that younger and less experienced athletes are more likely to have bladder issues than older and more experienced athletes. "This may relate to recent changes in athletic training methodology. More frequent training sessions with intervals of rest may be more taxing for the lower urinary tract, which can lead to functional impairment over time."
Due to the increase in the severity of bladder problems, researchers are looking into different ways to prevent these issues. Thoughts on this topic are not new; "exercise-associated urinary incontinence (EAUI) has been reported since the 1960s, but its prevalence in athletes has increased in the past years". Currently, most treatment options for EAI involve secondary prevention measures such as intermittent hydration and pelvic floor muscle training.
Although these measures help prevent or reduce symptoms resulting from bladder problems in athletes, they do not treat the root cause of the issue.
"Early detection is a key component in treatment for urinary incontinence". "Physiological training is the only truly effective treatment for urinary incontinence. However, in some cases, these techniques can be more of a distraction than therapeutic."
The reason for this is that bladder problems in athletes are seen as an inconvenience rather than a medical problem, and the majority of physicians do not treat them. "Concerning diagnosis, physicians tend to focus on physical signs such as nocturia and/or neurological deficits such as UTI and/or pelvic pain."
The most crucial aspect of bladder problems in athletes is their safety and how they affect performance.
Even though bladder problems in athletes are becoming more common, most people with these issues do not seek treatment. This is especially true for women who are less likely to seek treatment than their male counterparts. "This can be explained by the fact that IAD is considered normal among female athletes". However, most doctors will likely diagnose male athletes with prostate issues rather than bladder issues because it is common for men to experience problems related to the prostate.
"For women, the lack of research on EAUI results in little information regarding its treatment and prognosis."
The increase in menstrual products, hygiene products and sanitary napkins makes it more difficult for women with bladder problems to remain silent about their symptoms.
Because bladder problems are most commonly found in female athletes, they are being treated by female health professionals. However, there are still many doctors who do not know how to handle the symptoms of bladder problems. "The lack of knowledge regarding IAD among physicians can be explained by the fact that most women with health issues look for the advice of their gynaecologist, who is usually a woman."
There have been several cases where women have experienced urinary incontinence during physical activity, but they were told it was an isolated incident. "They were advised to maintain their activity level, but no further workup was recommended. Lacking the correct diagnosis, they continued to experience urinary incontinence."
There are some low-level side effects associated with bladder problems in athletes that may include: "irritation of nerves resulting in chronic pain, lower back pain, muscle strains, genital atrophy and/or weakness", "bladder stones", and "urinary tract infections".
The most common side effects associated with bladder problems in athletes are related to urinary frequency. It is possible to experience an increase of up to almost 100% over the average amount of time spent urinating during physical activity. This can lead to increased pressure within the bladder which can cause it to become too full.