Sports that damage the perineum and expose you to urine leakage

Exercising regularly promotes good health, but some movements take a toll on an unexpectedly strong area: the perineum. Located between the pubis and the anus, this group of muscles plays an important role in supporting all of our pelvic organs. Despite this, it continues to be too neglected in training, laments medical gynecologist Carol Maitre of the National Institute of Sport, Expertise and Performance (Insep). “The perineum weakens with pregnancy and then again with menopause, but sports practice can also expose the weakness and accentuate it,” she recalls. Among the deleterious effects of this loss of tone we find leakage of the urinary tract and descent of the organs. To protect against this, the doctor and two physiotherapists detail the list of mistakes that are most often made during our training.

Press on the belly band

When looking for exercises to tone your bum and improve your posture, you’ve surely come across bust lift videos (also called Bust Lifts).crunches), and its variations. Know that these exercises are not your perineum’s friends. “When we bring the shoulders closer to the pelvis, we inflate the stomach and increase the intra-abdominal pressure. As a result, we put more pressure on the organs, which will lead to flattening of the perineum. The muscle tissues of the latter will then stretch and leave more room for the urinary tract,” summarizes gynecologist Carol Maiter.

Force the arch

While it is important to avoid fighting too far during training, the opposite is also not recommended. “Some sports, like rowing, involve a lot of back bending. This will emphasize the arch of the lower back, and this pressure will also be reflected in the perineal area,” says the gynecologist.

Following this reasoning, the specialist also advises swimmers not to focus primarily on breaststroke movements, as this type of swimming is known to tire the lower back.

Use heavy weights

Dumbbell lifts can help build muscle in your arms, shoulders, or even your chest, but sometimes the movement isn’t always done correctly. “The most common mistake is forgetting to tuck in your stomach and forgetting to squeeze your perineum when you push. However, if this is not done, we fall back into a pattern of hyper-pressure,” observes Carol Maitre.

In practice, however, it can be difficult to maintain this contraction over time. “We can squat in our perineum for a set or two, but not 20. After a while it gets tired and cannot make this effort, especially if it is constrained by loads that are too heavy for our physiology,” emphasizes Sandrine Galiak Alanbari, a physiotherapist specializing in perineal rehabilitation (1).

Focus on ground impact sports

Handball, basketball, running, cardio and even Zumba are so-called “impact” sports that, as their name suggests, involve hitting the ground and moving quickly. “When you run, the effect of gravity is felt more. By pressing the foot into the ground, the force of the impact is transmitted through the legs to the perineum, which absorbs the shock as best as possible,” explains gynecologist Carol Maiter. By exerting pressure in this way, we are more exposed to incontinence problems, and this is strongly confirmed in the practice of running,” adds Sandrine Galiak Alanbari.

The number of kilometers traveled is not the only thing that is responsible for this pressure on the perineum, the intensity of the movement also contributes. “It is the case when we will make the tennis serve very quickly to play an extension, which will be followed by a quick start forward,” notes the gynecologist.

Trampoline abuse

In recent years, the mini-trampoline has been incorporated into fitness classes to work the cardio and lower body muscles. However, this is the tragedy of the perineum, as confirmed by physiotherapist Sandrine Galiak Alanbari. “Scientific studies even consider it to be the most harmful activity for this area, because intense and regular rebounds will act as a boomerang on the internal organs. After some time, the perineum will no longer be able to absorb the shock,” says the specialist.

What to do for prevention?

None of these sports and movements are contraindicated. It’s still possible to walk the asphalt, push the iron or sweat on a HIIT circuit, provided you respect some essential rules. First, we stop forcing ourselves to bind to the perineum during exercise. “Instead of focusing on the perineum at all costs, we focus our attention on our posture, grow tall and breathe well, exhaling as we draw in the lower abdomen,” explains Sabrina Fajau, physiotherapist, osteopath and author of the book. At Perina, we trust(2).

Then, along with sports practice, the physiotherapist recommends basic training, for example on the ball. Her partner, Sandrine Galliak Alanbari, in turn, promotes gentle yoga poses such as tree or small bridge. “To restore it better, the perineum must be placed on an unstable plane,” assures Sabrina Fajau. So we teach him to react spontaneously in the event of an imbalance.

Finally, in case of discomfort during activity, pain in the lower abdomen, or urinary leakage, experts strongly recommend that you contact a specialized health care professional (doctor, physiotherapist or midwife) to perform a perineal examination.

(1) Reconstruction of the female perineumBy Sandrine Galliac Alanbari, published by Dunod, 320 pages, €29.
(2) At Perina, we trustBy Sabrina Fajau, published by First Editions, 192 pages, €16.95.