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28. Urinary Leakage - Women in Sport

This episode is an extract from a Bay Games Get Together that focuses on a subject that is often considered a little taboo... what are we talking about?

Urinary incontinence. It affects many women who participate in sport and exercise. It does not discriminate with regard to age, and it affects younger athletes and older athletes alike.

Mat's introduction to this issue occurred during a functional fitness competition when two of his female mates mentioned they were going to change their shorts because the next workout included double-unders. Who knew? Every woman participating in high-impact sports, that's who!

Enter Courtenay Polock - an exercise physiologist from Sydney who is on a mission to make women pee-free! And it's not just about convenience... This is a physiological condition that deserves remedial treatment and in this chat Mat and Courtenay explain why that is!

On The Unleashing Potential Podcast, we interview progressive individuals who are unleashing their potential on the world around them. We take a deep dive into how they got to where they are, what lessons they have learned along the way, and how their experiences can impact us all.

Feel free to share this episode with your training buddies, mates, or colleagues who you think would be interested.

Meanwhile, let’s get into it – enjoy the show and, as always, be kind to yourselves, be brave, have fun, and lead by example.

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Links to connect with Courtenay Polock:

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Read the transcript
Mat Lock

we should move rapidly on to the subject that Courtenay has been itching to get to. And as I think Ed said, at the beginning, Courtney is on a mission to make all women pee free. And even that term pee free or your relief region around paying a little. And it was really funny. I know Ed already said it when I skirted around. And what he didn’t mention earlier was because I’m a British gentleman, and I was trying to trying to be gentle on the subject, which is ridiculous. And as you quite rightly corrected me and said, well look, the medical terms and continents, so let’s use that, shall we? Because it’s the correct term. What we’re talking about is incontinence. But But I was introduced to them last year, at an event we did in Canberra, hey Scotty, I said this great event. And long story short, we were about to get into the next workout. And two of my female friends said, Oh, we’ve got to go and change. We’re going to put out black, black shorts on our route, a little bit of banging, isn’t it like costume change based on an event? And they looked at me? And she started laughing? And they said, Do you have no idea? Do you I thought, what are we talking about? And so they educated me about the fact that next week, I had double unders in it. And both of them who are mothers as well. And I know Courtney, bear with me. But they said Yeah, well, we’re gonna pay ourselves a little bit for sure. We always do. It’s double unders. That’s just what happens. And I don’t know that they use the word, it’s normal. But for them, it’s accepted. It’s normal. It’s just what it is. That’s what happens. So we wanted to help, I guess, get the message across that you’re wonderfully passionate about that. As Ed said earlier, and he was quoting you that even though it’s really common, it’s not normal. Actually, there’s a whole bunch of stuff that can be done to help either help it improve it or get rid of it entirely. But I’m hoping you’ve got your Berlin there with you caught it, because, oh, he’s not bringing him alone. Because if you could talk to us a little bit about the whole subject of incontinence as it pertains to women in sports. And just when someone says, I’ve got a really weak bladder, what was your answer to that be?

Courtenay Polock

Well, let me Yeah, I get a bit excited about this topic. So feel free to just cut me if I ramble.

So

where do I even start, but if you have a weak bladder, sometimes, it’s actually like women get really confused with the whole weak bladder thing, because there is actually like sensitivity of the bladder, which becomes hyperactive, maybe you are constantly going to the bathroom. However, most of the time, in terms of incontinence, or most of the things that I see that’s more common, especially in the athlete world, is like a pressure based incontinence that’s associated with pelvic floor issues. So it could be weakness, or tightness, something’s not working correctly in that core based unit that’s actually creating this incontinence rather than a weak bladder. So obviously, that’s this is generalized. Lots of this is very individualized to people. So your symptoms could be different. So I just want to make that pretty clear that this is just sort of generalizations I’m talking about. But it is pretty much that system, core canister system, which I’ll actually let me describe my balloon right now.

Mat Lock

We did an ad takeoff to accordion I chatted the first time we spent money again, you haven’t seen my balloon.

Courtenay Polock

Oh, this is totally not my original idea, by the way. So I own it. And it’s deflated a little bit. But um, the whole core canister is basically like a pressure regulating system. So you don’t actually have like empty space in your abdominal cavity. But this is just a visualization of to see how everything kind of works. But it’s basically pressure building up inside your abdominal cavity and when it’s going to go where it’s going to go is where is weaker. So this E is your diaphragm at the top, which is obviously attached to your lungs, your abdominals, or what we call transverse abdominus, which is your deepest layer of your core, wraps around his spine like a bit of a course there and then you have your pelvic floor at the bottom. So if you’re excessively lifting, for example, and you’re brace your abdominals and you’ve taken a really big inhalation, breath, everything here is all pressurized everything but I’m really bad at doing this by the way, sorry. But everything here is going to bold downwards. And if your pelvic floors like muscle is not actually strong enough to withstand the pressure that’s bearing downwards then you go To get basically, its job pelvic floor, his job is to hold urine in. So if it’s not working well, it’s gonna come out, basically.

Mat Lock

So think, um, we I know, this one’s gonna rile you, but we had Philippa centers note saying that in her opinion, and she claims to be a medical doctor. In her opinion, it’s, it’s okay to pee during double unders, for example. And for those watching who are not familiar that it’s a skip a jump rope, and the rope passes under your feet twice for every jump. So you’re lending quite heavily. So here, it’s a gymnastic move, but reasonably high impact. And that was ultimately what lots of women experienced incontinent through. But she said, it’s okay to pay during double unders, that it’s a correlate of intensity. So it just means that you’re working really hard. I’m going to stand back now and let you take that one on, Courtney. I mean, what, what you’ve just described to me didn’t necessarily sound like what Philippa has said, I’m guessing you don’t agree?

Courtenay Polock

Well, no, are entirely well, bait, well, I guess it is correlated with intensity, because the higher the intensity is, and the lower like the lace strength your pelvic floor is, then it’s going to come out. So it is you going up in intensity. And this is building and building and building pressure, and your pelvic floor can’t withstand it, that is true, it is going to be correlated with the intensity. But that doesn’t necessarily mean it’s okay to keep doing that. Because it means this is too weak to withstand the amount of criminal pressure that’s building in here. So I always talk to my ladies about working towards your weakest link, basically. Or I kind of try and describe it a bit like a knee injury, because it’s a muscle, your pelvic floor is a muscle, it’s just inside you. And when it’s injured, for example, or not working properly, it’s going to cause leakage rather than pain. Whereas if you have knee pain, you would stop because it’s too hard. Or you would say, I’ve got this knee issue. Now I can’t squat the normal amount of weight that I can. So I’m going to just practice technique and back off the way. Like that’s exactly what you should be doing with your pelvic floor. And you call work or sorry, court recruitment. I’m saying that you’re not like you’re working harder, which is a good thing. And it’s okay to pay at that level. It’s just like, I definitely don’t agree with that. But

I feel like I should just leave that. I don’t think that’s okay, I’ll come and save your coding before you say something, you

Mat Lock

know,

Ed Morrison

we’ll bring you in on this because we’re talking off air before, we’ve seen a guest the development of a lot of perhaps the education of the functional fitness space and how that’s improved over the last decade, this attitude that, you know, paying yourself during double unders or box jumps or cleans, is okay. I guess we’ve we’ve probably seen functional fitness competitions where people have in fact done that and sort of gets brushed off by athletes. Sometimes it’s just Oh, yeah, that’s just what happens to me. And, you know, as long as, as long as I’m finishing first, then you know, it’s not a big deal. I don’t see it as a problem. How do we how do we turn the tide on that, but it’s okay, it doesn’t really matter if you’re finishing first. This is this is not something that’s okay. Just like kind of doesn’t matter if you’re finishing first. If you’ve got around and back like that, that’s a problem that we wouldn’t want people to try and replicate.

Will Henke

Right? It’s one of those things where the thing to coach has to be again, they have to give a shit enough to learn about it and say something and not be like, Oh, yeah, like, go get it, go get them up and clean that up, you know, clean up on aisle four, instead of like making banter and joking about it, they should be like, Listen, I see that you have because that means your pelvic floor is weak. And that’s a muscle that you need to have in order to live safely. If you fix your pelvic floor, your like your list will be able to go up because when you have that intra abdominal, intra thoracic cavity that you’re bracing, when you’re doing things like squats, deadlifts, whatever it is, if you can’t pressurize that cavity enough, you’re not going to be able to one to keep your internal organs as pressurized or as safe as possible. And to you’re not gonna be able to utilize that pressurization to help you lift more. So when it comes to performance athletes, it’s imperative, you don’t see a lot of elite level Olympic lifters. When a girl catches a snatch, you don’t see them start peeing everywhere. You don’t see that they want to go to the Olympics, they have to take that stuff seriously. It’s the same stuff that you talked about as far as like, in functional fitness competitions. If someone like does gross amount of butterfly pull ups or muscle ups, and they tear their hands, all the cool blood, it’s like, now you can’t train like now you can’t train anymore, or you have to train around that. Or you know, there’s so many things that goes into but at least with that they can’t continue because their body’s telling them like I can’t grab the bar don’t do that same thing, you know, the pelvic floor, they don’t have the ability to do that because it doesn’t hurt. And I think that’s a pretty big issue and you know, that I’ve seen and I think it’s just bringing awareness to like, hey, this isn’t funny, like you should probably get that looked at. And here’s a recommendation to go, or some pelvic floor exercises that are very brief level, I know there’s different phases or different stages of urinary incontinence and pelvic floor dysfunction. And I think it’s not as simple as, you know, go do some key goals, or go do some, some some movements that are going to help the pelvic floor, I think it’s understanding like, Hey, this is what you can do for now. But I recommend going to see like an exercise physiologist to actually help solve that problem internally.

Courtenay Polock

Can I also just quickly jump in here and say that for women that are listening to this going totally pee, like, why the big deal, most women don’t actually realize that that’s the first sign of a possible or prolapse, which for anyone that doesn’t actually know is where your pelvic organs will descend downwards, and often come out on the outside. So that is very serious and very uncomfortable, and is very much a big impact on your life. If that happens, and is much harder to treat. Sometimes it doesn’t like it, depending on what stage it is, is you really do that much about it, or it requires surgery. So just because you’re only weighing now, doesn’t mean that you’re not then at risk of something worse happening. It’s kind of like, I’ve got to reinstall shoulder, I’m just gonna keep doing this overhead press. And then all of a sudden, you’ve torn your rotator cuff and you go, I wish I just sort of stopped. That’s what we’re doing. Like we’re at the pain, we’re stopping before the actual further injury, or doing something about it. So it’s, it is actually going to further on down the track. Most of the ladies that end up with prolapse, don’t know this until they’ve got prolapse and say I wish someone had told me that that was something I should have watched out for.

Will Henke

Sure. The big, big point you brought up about the internal organs is the reason that you like I said, when you pressurize your abdominal cavity, when you slot it’s literally there to protect your organs. And if you’re peeing, and there’s a leakage, you’re now potentially putting your organs at risk for the prolapse, right? So I think it’s just it’s under making that connection, where it’s like, this is going to happen, your organs are going to shift down in your body, like there’s going to be a shift of the things inside you that help you to survive, your vital organs are going to shift out. Yeah,

Mat Lock

sure, absolutely. Um, and so, Courtney, all of this is, of course, relevant, and important unless you’ve had children. So in the post postpartum phase, so once you’ve had children, it’s perfectly normal to pay yourself during training. Is that correct? No, no. I hear that so often. Oh, yeah, but but I’ve had children, that that’s why that’s just the way it is.

Courtenay Polock

Yeah, it’s because your pelvic floor has been under so much load, like you’ve carried a growing fetus like baby for nine months along with your organs, that’s downward pressure, your pelvic floor is going to start stretching underneath your organs and become really, really weak. And then you’ve got it having a natural birth, you’re pushing a baby out of your muscle, possibly, coring, causing tearing, if that’s pretty common, and then being re stitched back up. So you probably cause affected there. Or if you having a C section, you’ve cut through your diaphragm, sorry, not your diaphragm, your transverse abdominus, this one, but it cut through hay, which is part of that core unit, so then you can’t regulate the pressure in there, and it will still affect your pelvic floor. So most women also say, Oh, I had a C section, my pelvic floor spine, you’ve still carried a baby, you’ve now got a compromised core unit because it’s not functioning in its proper motor control anymore. So like, it’s really common, because it’s been under load and strain. But it still doesn’t make it okay or normal. It’s just something that you really need to pay attention to after some women are don’t have any issues at all, which is like lucky them. But all the women have problems. Sorry, problems after that.

Will Henke

I think it’s also noting that understanding that if a woman has a six pack that’s not indicative to meaning they have a strong pelvic floor or their core is strong. Plenty of women that I know have a six pack that are just shredded, but their pelvic floor is weak. That doesn’t just because there’s 600 doesn’t mean their pelvic floor is strong. That’s a thing. I have a strong core i have a six pack that’s inaccurate.

Courtenay Polock

Yes, I agree with that. Because often more than not people who can really have super shredded often recruit their core wrong because four were fully abdominal bracing rather than focusing on their really deep us support muscles or stabilizing muscles as well. So not all, often when I test through like trans abdominal ultrasound show women how they’re actually contracting their pelvic floor. It’s always wrong with the ones who are more fit. Sometimes like more than often not then the ones who don’t do anything because they’re not overtraining, all of these external core muscles rather than their deeper

postural muscles I’ve

Ed Morrison

put a thought we’ve already we touched I guess on incontinence in the in the postpartum phase. But what other what other aspects of training? Would you be looking at for somebody who’s in postpartum? like somebody’s returning to exercise? Is it perhaps aerobic training that you get them to return to you first? Or is it strength based training? I know it’d be very individual for each person. But what would be some of the key sort of right, let’s progress you in this fashion. As you return back to training? Well, perhaps I’ll start with you.

Will Henke

Yeah, I think it’s limiting the amount of high impact movements, like if they’re going to do box jumps, they should be doing step ups and step downs, they should be doing extra work for their pelvic floor, at a minimum, to get that going. First. That should be the first thing is to get their core strong, and their pelvic floor strong and fixed before they start doing anything crazy. All the movement should be reintroduced, right, you shouldn’t be you should work on your strict static strength as far as you know, pressing horizontally vertically, pulling horizontally, vertically, you know, whether it be pull ups or things like that, it should be all very, very strict based, more of like a bodybuilding type to get the muscles strong. And then you can introduce it there into something like a 45, or CrossFit or Barry’s boot camp, whatever it is, then you can introduce those more high intensity as far as intensity, meaning speed and load, right? Everything should be very, very controlled. In the beginning. I always recommend like my sister had just had our second child about a year ago, the one she finished and she’s a nurse. So she understood and pelvic floor to get it read from there was alright, let’s work on some tempo based strict strength, get that going and understand positional strength and not just pressing back and forth, but understanding how things feel from start to finish.

Ed Morrison

Yeah, absolutely. Courtney, yeah, if you could add to that some other considerations or simply just re emphasize what we’ll was talking about.

Courtenay Polock

Yeah, I am a really big believer in trying to help women understand that their body is going to be capable of things that are very different to what they were pre pregnancy or pre baby. So I get a lot of women that want to return back to exactly what they were pre pregnancy, but their body has shifted so much. So they’re often learning body awareness, again, balance and their center of gravity is always different. They just don’t ever feel the same. So reconnecting with all of that is my initial form of like, where I would go first with returning to exercise. I’m very much like, say people who are very goal variant in terms of what they’re after for their training. So they might be wanting to return to running or return to even just spin class or the gym, or CrossFit, or whatever it is that they might be. So I would definitely taper more towards their individual needs. But range of motion and posture are huge as well, because often, they’re in this slumped, breastfeeding position, or they’ve got you know, they’re not sleeping well anymore. Sometimes they’ll be laying in the bed, sleeping at trying to stay awake whilst breastfeeding and have this terrible posture. So joint range of motion is often compromised. So getting, you know, like, are we also getting full extension overhead is often a problem. And even working on their postural muscles because their body has changed is way more important. And then moving into functional movement bodyweight first, and then loaded as obviously they’re progressing.

Mat Lock

That’s awesome. Thank you, Connie. And Willem, I knew this would happen. This, these topics and topics that certainly the two of you could talk about all day for. And certainly I know, Ed and I and the rest of us could listen all day. However, we have reached that time where we have to wrap it up. But what a great discussion. I know we’ve only scratched the surface, really, but but Courtney, if people want to get in touch with you, as an exercise physiologist who is clearly passionate about this subject, how would they get in touch with you?

Courtenay Polock

They can check out my social media. So my business is her exercise physiology that’s on Instagram, as well as Facebook, I have a website as well, I can check out so all my contact details are through there. But those are probably the best way to get in touch with me if anyone needs any help.

Mat Lock

No, thank you. And I know we’re planning we’re planning a seminar to dive deeper into these subjects. And we’ll have more details on that soon. We’ll I mentioned at the beginning about the Wonder Wonder Woman program, if anyone’s interested to take a look at that. I think you have a trial period available as well. Where would they go to find out details of that?

Will Henke

Yeah, so our website is the program by wonderful calm, and then you just navigate to the programs page. There’s a free seven day trial for that, that that program is included with all the rest of our programs you’ll have access to tomorrow, it’ll be four programs as we launch our new dumbbell program tomorrow. And then yeah, on Instagram is just w j Hankey is me on Instagram and the program by wonderful.

Mat Lock

Fantastic, thank you and be sure we’ve discussed some really important topics that more people need to know about and we plan to do exactly that. It’s 2020 people. Let’s move The Times and dispel these two moves. With that said, thank you so much for tuning in thank you to our broadcast partner, cosmic coffee. Until I guess Of course, Courtney and will a huge thank you for joining us tonight from Ed and myself. Until next time, be kind to yourselves be brave, have some fun, and lead by example.
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