Masters Athletes and Incontinence

October 17th, 2011

Introduction

Urinary incontinence has a high prevalence amongst the older population in general and particularly in older athletes, with prevalence rates up to 60%. The condition presents as a significant barrier to sports participation and socialising socialisation. Risk factors include being overweight, lack of general fitness, persistent straining or heavy lifting, chronic constipation or cough and, for women, childbirth. There are at least 2 types of urinary incontinence; stress urinary incontinence (SUI) and urge urinary incontinence. Stress urinary incontinence is the most prevalent in older athletes and occurs where there is involuntary leakage of urine during coughing, sneezing, lifting, or exercise. But fear not, there are ways we can beat it including Kegal exercises.

The Problem

A recent review of urinary incontinence in athletes reported that SUI appears to have a higher prevalence in athletes than the general population. It also appears the prevalence is higher in running and jumping-based sports, compared to lower impact activities. This may be due to progressive fatigue of the pelvic floor muscles. During high impact activities the repetitive strain on these muscles may result in fatigue, possibly leading to SUI. In support of this progressive fatigue theory, one study reviewed showed that the prevalence of SUI is greater in the latter part of a training session or competition event.

The Solution

There are a number of potential solutions to the problem.

1. All athletes, regardless of age or gender should undertake a pelvic floor assessment with a trained professional in order to prevent or manage the risk of SUI.
2. Where needed, further consultation with your family doctor may be valuable. They may recommend a referral to a Urologist, Urogyeanocologist or specialist continence physiotherapist.
3. Athletes, particularly female athletes should ensure pelvic floor exercises, sometimes called ‘Kegal exercises’ are performed regularly and correctly.

Pelvic floor exercises are deceptively easy to perform but are often performed incorrectly. The following brief instructions may assist. However, you should seek the advice of a trained professional if you are unsure.

1. Correctly identify the muscles that need to be exercised by sitting or lying comfortably with the muscles of your thighs, buttocks and abdomen relaxed.  Tighten the ring of muscle around the back passage as if you are trying to control diarrhea or wind, and then relax.
2. Practice this movement several times until you are sure you are exercising the correct muscles. Alternatively, when passing urine, try to stop the flow mid-stream, and then restart it. You should feel an inward, upward lifting sensation, followed by a relaxation. Women may feel a tightening of the vagina; men may feel a tightening of the scrotum.
3. Exercise these muscles by tightening and drawing in around the anus and the urethra at the same time, lifting upwards and inwards. Hold for a count of five, breathing normally, and then relax.
4. Rest for at least 10 seconds, and repeat the ‘lift, hold and let go’ sequence for up to 10 repetitions.
5. Do NOT hold your breath, or tighten the buttocks, thighs or abdominal muscles.
6. Repeat this program three to five times every day.

Remember ‘Perfect Practice makes Perfect’ and seek help if needed. You might also want to check out these websites for more detailed information:

• http://www.bladderbowel.gov.au/
• http://www.continence.org.au/ (The ‘Resources’ link has some excellent information)

Source: Popova-Dobreva, D; (2011). Urinary Incontinence among athletes. Bulletin of the Transilvania University of Brasov Series VIII: Art • Sport • Vol. 4 (53) No. 1

Written by Masters Athlete supporter Rob Stanton who is an Accredited Exercise Physiologist and co-founder and Director of Vector Health. Rob has over 15 years experience in the assessment and prescription of exercise for masters athletes, rehabilitation and in the management of chronic disease. He is a former coach of Australian Powerlifting teams and has worked with athletes from grass roots to Olympic level. Rob can be contacted by email at rob@vectorhealth.com.au for help with resistance training and conditioning programs.

Alcohol Consumption and Body Weight

September 7th, 2011

Introduction

Most masters athletes enjoy a quiet drink or two, some like a few loud one or three! For me, masters sport is about fitness, fun and friendship. Theoccasional drink with friends and fellow competitors is part of life as a masters athlete. At most masters games and indeed most competitions I go to, there is always the pre-event socialising and the post-event partying, both normally accompanied by a drink or three. Alcohol contains 29 kilojoules (7.1 Calories) per gram, almost as much as fat (37 kJ, 9 Cal), and more than carbohydrate (17 kJ, 4.2 Cal) or protein (17 kJ, 4.2 Cal) per gram. While I’ve always believed alcohol might tend to pack on the weight, recent research doesn’t confirm a positive relationship between alcohol consumption and weight gain - at least in light to moderate drinkers.

The Research

A recent review published in the prestigious peer-reviewed journal Nutrition Reviews looked at all research studies published between 1984 and 2010 that had examined the effect of alcohol on body weight.  31 studies were selected to be relevant, with high quality research design and methods.

The Findings

1. Overall results found no positive relationship between alcohol consumption and weight gain, except in studies on heavy drinkers (4 or more drinks / day).
2. Light-to-moderate alcohol intake (1 or 2 drinks / day), especially wine intake, may be more likely to protect against weight gain.
3. In contrast, consumption of spirits, was shown to be positively associated with weight gain.
4. Red wine may reduce the effect of alcohol on obesity due to it containing polyphenols.

So What?

The research strongly suggests that light-to-moderate alcohol intake, especially wine, has no harmful effects on weight gain. However, drinking spirits, especially whan taken with soft drinks that are high in energy (e.g. rum and coke or scotch and dry) appears a no-no for masters athletes wanting to manage their weight. Chapter 17 of my recently published book The Masters Athlete has a chapter devoted to weight control in masters athletes. Biased as I am as the author, it’s the only information I’ve ever read that examines what science says about losing weight safely and effectively as an older athlete.

Looks like that regular Friday night bottle of (white!) wine with my beautiful wife Claire at the end of a working week is good for my health and will remain on the agenda!

Source: Sayon-Orea, C. et al. (2011). Alcohol consumption and body weight: a systematic review. Nutrition Reviews, 69(8): 419-431.http://www.ajcn.org/content/81/1/215S.full

Browse related items: alcohol, antioxidants, weight loss

Why do we do it? Results from the World Masters Games (2009)

September 7th, 2011

Introduction

Sometimes I think I’m seen as a fitness fanatic, an obssessive-compulsive exerciser, an exercise addict. For me, it’s just normal, it’s what I do, it’s just part of my normal day. It’s only when I get together with mates or am hurting climbing a hill by myself on the bike, or 2 hours into a run in the heat that I sometimes think, why do I do these things? For me personally it’s about health and fitness, weight control (love that food!), it’s pushing the limits to see what my body can or can’t do, how I respond to training, and to be honest, keeping youngsters honest! Here is some recent research that found that for athletes competing at the 2009 World Masters Games in Sydney, it is socialising, getting physically fit and improving PB’s that are the key drivers. 

The Research

This study evaluated psychological constructs of health, physical fitness, mental health states, and social dimension factors in sport that were associated with factors to participate in sport and physical activity based on responses from the 2009 World Masters Games in Sydney. The sample consisted of 7846 athletes who competed at the games and who completed a 56-item sports participation survey using a 7-point Likert response (1 – not important to 7 – very important). Questions focuses on factors thought to promote participation, such as weight control, living longer, improving mental health (self-esteem, mood states), improving physical health and factors related to the athlete’s competitive perspective.

The Results

 The most significant factors related to participation of athletes at the World Masters Games in 2009 were the socialising environment of sport, getting physically fit, and improving personal best performances. Other factors such as weight loss, improving mental health, and living longer were not identified as important determinants of spprts participation at the Games. The table below shows the top 10 (of 56) ‘very important’ factors.

So What?

Getting more sleep improves performance

September 7th, 2011

Introduction

Sometimes it’s just not easy to get a good nights sleep. Maybe it is stress of work, family or relationships, training too hard, something we ate or drank earlier that day that keeps the mind racing. Whatever it is, you just toss and turn and always wake up feeling tired and below par when trying to train. So how important is sleep for sports performance? While little research has been conducted on sleep and it’s relationship to sports performance, here is some recent American research that says more sleep improves performance.

The Research

Eleven healthy students on the Stanford University (USA) men’s basketball team (mean age 19.4 ± 1.4 years) maintained their normal (470 ± 66 minutes a night) sleep-wake schedule for a 2-4 week baseline period followed by a 5-7 week sleep extension period. During the extra sleep extension block, the athletes obtained as much nocturnal sleep  (624 ± 68 minutes a night) as possible with a minimum goal of 10 hours in bed each night. Measures of athletic performance specific to basketball were recorded after every practice including a timed court sprint and shooting accuracy (free throws out of 10, three-point field goals) . Reaction time, levels of daytime sleepiness, and mood were also monitored.

The Results 

Total nightly sleep time increased significantly during sleep extension compared to baseline by 110.9 ± 79.7 minutes. The athletes demonstrated a faster timed sprint following sleep extension (16.2 ± 0.61 sec at baseline vs. 15.5 ± 0.54 sec at end of sleep extension). Shooting accuracy improved significantly with free throw percentage increasing by 9% and 3-point field goal percentage increasing by 9.2%. Mean reaction time and the Sleepiness Scale scores decreased following sleep extension and the basketballer mood state scores improved with increased vigor and decreased fatigue subscales. Subjects also reported improved overall ratings of physical and mental well-being during practices and games.

So What?

This unique study highlights the importance of quality sleep in maximising both training and playing performance – at least in young basketball players. As highlighted in Chapter 15 (Recovery Strategies for the Masters Athlete) of my book The Masters Athlete, sleep is crucial for recovery, performance, and maximising the immune system in older athletes. The same chapter lists the actual key strategies for getting a good night’s sleep and highlights which recovery strategies science says work and how to use them. Indeed, from a health perspective, research has shown that getting between 7-9 hours sleep a night is crucial for longevity and prevention of some chronic diseases. Click here to read more.

Source: Mah, C. and others (2011). The effects of sleep extension on the athletci performance of collegiate basketball players. Sleep, 34(7): 943-950.

Browse related items: chronic disease, health benefits, recovery

It’s the carbs the day before that make the difference!

September 7th, 2011

Introduction

Most masters endurance athletes are aware that carbohydrate loading before an endurance event is crucial to last an event longer than 90 minutes. We know that the last three days before a triathlon, marathon or half-marathon, road race, regatta or carnival is the time to load up on the rice, the pasta, and the sports drinks. Here is some research that highlights that it’s the amount of carb taken the very day before the event may be equally critical. More importantly, this research was conducted on mongrels like us – older athletes. The researchers concluded that marathon pace was faster and better-maintained in runners who consumed greater than 7 grams of carbs per kilogram of body weight the day before the run.

The Research

An internet-based data collection tool allowed 257 competitors in the 2009 London Marathon (39±8 years, finish time: 273.8±59.5 min) to record a range of anthropometric (body measures such as weight, height), training and nutritional predictors of performance. The English sports scientists used complex multivariate statistical methods to quantify the change in running speed and estimate which of the predictors contributed to performance differences.

The Results

Gender, body mass index, training distance, and the amount of carbohydrate consumed the day before the race were significant predictors of the variability in running speed.  The analysis also revealed that those competitors who consumed carbohydrate the day before the race at a quantity of >7 g/kg body mass had significantly faster overall race speeds and maintained their running speed during the race to a greater extent than with those who consumed <7 g/kg body mass.

So What?

This reseach strongly supports the importance of high carbohydrate intakes for any masters athlete competing in any endurance event, especially marathoners and athletes involved with endurance events including team sports and masters athletes competing in many events in one day or day after day such as at masters games or championships. The table below gives examples of common foods and their carbohydrate content. It is taken from Chapter 16 (Nutrition for the Masters Athlete) of my book The Masters Athlete, the most definitive chapter related to sports nutrition for older athletes that you will ever read – biased as I am! The table below from my book will enable you to calculate how much carbohydrate you should eat the day(s) leading into an event to ensure you get the greater than 7 grams / kilogram of body weight you need to maximize your chances of PBs. Each of these serving sizes gives 50 grams of carbohydrate.

Table 1: Common foods that give 50 grams of carbohydrate per serving.

Source: Atkinson, G. and others (2011). Pre-race dietary carbohydrate intake can independently influence sub-elite marathon running performance. International Journal of Sports Medicine, 32(7): 611-617.

Browse related items: endurance performance, fruit and vegetables, nutrition, team sports