Run Well Juliet McGrattan (microsoft ebook reader TXT) 📖

are usually worse when you have been on your feet for a while and gravity has been at work.

Having a vaginal prolapse indicates that there is dysfunction of your pelvic floor and you shouldn’t add extra pressure to it by running. The high impact nature of running may make your prolapse worse. You need to be assessed and treated before you run again. Mild prolapses can usually be resolved with pelvic floor exercises. More severe prolapses may require insertion of a pessary (plastic ring or shelf) to supplement the pelvic floor muscles or possible surgery. Keeping to a healthy weight, avoiding constipation and delegating heavy lifting can help stop prolapses worsening too.

Q Running seems to help most health conditions. Can it help prostate problems?

A The prostate is a small gland that sits just below the bladder in men. It makes fluid which forms part of semen, and during ejaculation the muscles of the prostate contract and push the fluid out into the urethra to carry and nourish the sperm. The three most common types of prostate problem are prostatitis (inflammation, often due to infection), benign prostatic hypertrophy (BPH), where the prostate is enlarged, and prostate cancer. All three can cause prostate symptoms which include needing to pass urine frequently, difficulty initiating the stream of urine, a weak stream of urine and dribbling urine after finishing.

Physical activity is unlikely to have any bearing on prostatitis, although men with a chronic (greater than six months’ duration) prostatitis may find that exercise helps to reduce symptoms and increase wellbeing in what can be a challenging condition to control. Several studies, however, have examined the relationship between exercise and BPH. There have been conflicting results, with some showing that low intensity exercise might reduce the risk of BPH more than vigorous exercise and others showing that vigorous exercise might actually increase the risk of BPH. One study done in 2008 used data from the National Runners’ Health Study which included over 28,000 men. It relied on self-reporting of diagnosis and running distances but it concluded that exercise, regardless of the BMI, diet or 10km pace of the runner, may lower the risk of BPH and that potentially longer distances mean larger reductions. A Cochrane review (a systematic review of primary health research) in 2019 examined all relevant studies done to determine whether exercise could be used as a first-line treatment for the symptoms of BPH. Unfortunately, they found such low-quality evidence they were unable to draw any conclusions, so further research is most definitely needed.

The jury is also still out on exactly whether and by how much exercise might reduce the risk of prostate cancer. So far, it is pointing to yes – vigorous exercise may be most effective and the biggest risk reduction is in aggressive prostate cancer (see here).

Did you know?

The average number of times people pass urine in 24 hours is six or seven.

Q My bladder is so sensitive I have to visit the ­portaloo many times before a race and stop during runs. What can I do about it?

A Sometimes it isn’t a leaky bladder that causes problems, it’s an overactive one that doesn’t seem to hold much, always needs to empty and can make you live in fear that if you don’t go to the toilet you might wet yourself. Both men and women can suffer from an overactive bladder (OAB). Around 15 per cent of men have the condition and it is under-recognised and often under-treated in men because of their hesitancy to seek help. It’s particularly common in post-menopausal women where low oestrogen levels can lead to bladder muscle irritability and atrophy (thinning) and irritation of the tissues around the urethra and vagina resulting in increased urinary frequency.

Here are some things that might help:

• Stay calm In a race situation, nerves will almost certainly add to the problem, so try to relax and distract yourself.

• Avoid irritants OAB can be made worse by caffeine and alcohol, so steer clear of these.

• Drink plenty This may sound counter-intuitive, but simply reducing what you drink to avoid needing to go the toilet will just make urine more concentrated and irritating, and may harm your running performance.

• Train your bladder You may need to do this with professional help, but it is possible to retrain your bladder by gradually leaving longer and longer gaps between going to the toilet, aiming for every four hours. When you feel you need to go then change what you’re doing, distract yourself or do some pelvic floor exercises.

• See your GP If this is a new symptom for you then you may need to have some tests to look for an underlying cause such as urinary tract infection, diabetes, bladder or prostate problems. Once a diagnosis of OAB has been made then there are medications that can be used to relax the bladder. They aren’t without their side-effects, but can be very helpful for some people. Women with vaginal atrophy can use an oestrogen cream to plump up the thinned tissues and relieve symptoms. Bladder botox injections aren’t available everywhere, but can provide short-term, effective relief. In extreme circumstances, nerve stimulation and bladder surgery may be offered.

TRY THIS

AT HOME

Collecting a urine sample

Ever had a urine pot thrust into your hand at the doctors with advice to provide a sample? Here’s the best way to collect urine and minimise the risk of it being contaminated, which can mean a useless result.

1 Wash your hands. If you’re at home then wash your genital area too.

2 Wrap some toilet paper around the outside of the specimen pot, particularly if you’re a woman as aiming your stream of urine is tricky.

3 Unscrew the lid of the pot. Be careful not to touch the inside to keep it sterile.

4 Women should sit on the toilet with their legs apart and use one hand to hold back the labia so urine can flow out with minimal contact with the skin. Men can retract