Urinary Incontinence in Athletes: Myths & Solutions with Gizele Monteiro

The Causes Behind Urine Leakage and Diastasis

Running, due to its repetitive impact, and other high-intensity sports, generate pressure on the pelvis that can weaken the pelvic floor muscles. These muscles, which act as a support network for organs like the uterus, bladder, and intestines, can weaken and lose their ability to coordinate with the abdomen and spine.

Furthermore, abdominal diastasis — the separation of the abdominal muscles, common after pregnancy but also possible in women who haven't given birth — significantly contributes to the problem. A weakened abdomen with diastasis compromises core stability, which is essential for pelvic control and incontinence prevention. The specialist compares the body to a house: if the floor (pelvic floor) and walls (abdomen) are compromised, the structure (spine) and functionality become disorganized.

Specific Strengthening: The Path to Recovery and Performance

The good news, according to Gizele, is that urinary incontinence has effective prevention and treatment through specific exercises. She emphasizes that traditional sit-ups or planks are not enough, as these exercises often don't activate the deeper layers and necessary coordination.

Understanding Core and Pelvic Floor Activation

Gizele Monteiro uses the "zipper" analogy to teach correct activation: imagine a zipper moving up from the perineum to the navel, simultaneously contracting the pelvic floor and deep abdomen. This contraction should draw the navel inward without holding your breath in the abdomen, focusing instead on thoracic breathing.

Two essential practical exercises are:

1. Contraction and Relaxation: Contract the pelvic floor muscles (as if holding back urine) and, simultaneously, activate the abdominal "zipper," drawing the navel inward. Perform 2 to 3 sets of 5 to 10 repetitions.
2. Sustained Contraction: Contract the pelvic floor and activate the abdominal "zipper," holding the contraction for 5 to 10 seconds. It's crucial to maintain normal breathing without holding your breath. Perform 2 to 3 sets.

These exercises, which may seem simple, require body awareness and are fundamental for restoring strength and coordination. Gizele's patients report significant improvements in just five days, including reduced nighttime urinary frequency and elimination of leaks during activities.

The Importance of a Multidisciplinary Approach

Gizele emphasizes the importance of a multidisciplinary team. While physiotherapists treat dysfunction with specific techniques and equipment, specialized physical education professionals, like her, work on performance and maintenance, ensuring the athlete continues training without recurrence of the problem. In more severe cases, or after pelvic trauma during childbirth, the involvement of physical therapy is indispensable.

Impact on Performance and the Importance of Seeking Help

Ignoring urinary incontinence brings a series of negative consequences for an athlete's life, according to studies and Gizele's experience:

• Reduced performance: The fear of leaks leads to decreased training intensity and speed.
• Fear of competing: Many avoid races due to embarrassment.
• Shame and isolation: The often-silenced problem leads to social isolation.
• Abandonment of sport: Frustration and embarrassment can cause an athlete to give up their activities.
• Decreased quality of life: Affects sexual, physical, and emotional health.

Bruna Mahn shares her personal experience and highlights how core and pelvic floor strengthening is vital, not only to prevent incontinence but also to improve performance in sports like cycling, where bike control depends on hip and core stability. Correct activation can bring more lightness to running and more efficient breathing.

It is crucial for athletes not to normalize urine leakage and to seek specialized help. Initiatives like Gizele Monteiro's "Diastasis Zero Challenge," available on her Instagram, offer an accessible starting point to begin the journey of recovery and empowerment.

Urinary incontinence is a challenge with a solution. By demystifying the problem and offering practical tools, Gizele Monteiro and Stemma Performance invite athletes to invest in their pelvic and abdominal health, ensuring not only recovery but also a leap in performance and quality of life. You are not alone, and improvement is possible. Invest in your core and achieve your best self, both in and out of training.