For 6 days between Christmas and New Year I took a holiday, walking and wild-camping in the Lake District. The scenery was incredible though the two or three foot of unfrozen snow made the going difficult in some of the passes where we were the first to break trails.
Breaking trail in a not-so-easy foot of powder
Nearly every time I do a strenuous multi-day walk of 4 days or more I start to suffer from incontinence. I’ve found it both upsetting and embarrassing when it strikes and the very first time it happened I felt low for days afterwards. The most frustrating aspect is the fact that I leak within minutes of having found a suitable shrub and thinking I’d emptied my bladder. When the weather is inclement, you don’t want to be endlessly exposing yourself.
Having just come out of a white-out and with frozen fingers, this isn't the time to be needing the toilet every 5 minutes.
Interestingly, I don’t suffer from incontinence at any time other than on strenuous multi-day walks.
Until now nobody, other than Chris, has known about it. Incontinence isn’t exactly one of those things that you shout from the rooftops. Especially when you are in your twenties. It’s one of those problems that is most frequently associated with old age and ill health and when you are proud of being in fine health, you don’t want to admit that you can’t control your bladder.
I’m not the only one with incontinence
Imagine my relief when, just before I went away, a study was published on the British Journal of Sports Medicine about the impact of urinary stress incontinence in young and middle-age women practising recreational sports activity. Women in my own age bracket.
It is an epidemiological study so it is based on interviews with women. Therefore it relies on their answers. Given my embarrassment about the condition and my inability to speak about it to anyone before now, I think there is a fair chance that the numbers admitting to incontinence in this study may also be understated. Can the people who compiled the study be certain that every woman who answered that they don’t suffer from incontinence was being honest. Would I have answered yes to that question when incontinence only plagues me at such specific and infrequent instances?
What the study said
Incontinence was reported by 101 women (14.9%). Of these, 32 (31.7%) complained of incontinence only during sports activity, 48 (47.5%) only during daily life and 21 (20.8%) in both circumstances.
Interestingly body mass index and parity were significantly associated with the risk of incontinence.
Looking at the different sports activities, a higher rate of incontinence was found in women participating in basketball (16.6%), athletics (15%), and tennis or squash (11%). 10.4% of women abandoned their favourite sport, because of incontinence, and a further 20% limited the way they practised their favourite sport to reduce leakage episodes.
What causes it?
The study didn’t go into the possible causes of incontinence although I hope sometime someone will look further into the body mass index and parity connection.
Over the few years that I have started to suffer from it I’ve developed theories about the connection between the sphincter muscles and the abs and glutes. I wondered if the relentless walking that I do may eventually tire the abs and consequently also tire the sphincter until it can no longer keep the bladder sealed.
This in itself has ramifications for me, since I am usually out in the wild and (unsurprisingly) usually haven’t washed for several days when incontinence occurs. Is there a risk of infections to the bladder if the sphincter can’t keep my bladder sealed? I’ve certainly not had any problems when I’ve been out walking so far.
There doesn’t seem to be any knowledge about what causes incontinence in active women but I hope that this study opens the door for further studies to be carried out and for us to slowly understand the condition better.
Comfort in numbers
As for me? Suddenly I felt that I could go into my holiday armed with the knowledge that I’m not the only one. I may well ‘leak’ at some point during the walk, but it wouldn’t be something to get depressed about. There’s nothing wrong with me. It’s just one of those things that happens.
Falling in love with a retired sheepdog at the end of 4 days hard hiking
I hope that this post has given similar comfort to other women who suffer from activity-related incontinence.
To mis-quote the X-Files: “we are not alone”.
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