Understanding REDs and Urinary Incontinence
Did you know that your pelvic floor muscles need fuel just like the rest of your body?
When dancers or athletes don’t get enough energy it can lead to issues like urinary incontinence. Proper fuelling supports your pelvic health, performance and confidence.
In 2023, the International Olympic Committee (IOC) expanded the Relative Energy Deficiency in Sport (REDs) conceptual health model to include urinary incontinence as a potential indicator of low energy availability (LEA).
What is urinary incontinence?
Urinary incontinence is the involuntary loss of urine.
This includes:
stress urinary incontinence (leaks with physical exertion, sneezing, laughing, or coughing)
urge urinary incontinence (leaks associated with urgent need to go to the bathroom)
or mixed urinary incontinence (experiencing both)
How REDs and Urinary Incontinence are related
The muscles of the pelvic floor help control urinary continence (no leaks) and manage intra-abdominal pressure.
These muscles are subject to the same consequences of underfueling as any other skeletal muscles and tissues.
An under fueled muscle has less strength, endurance, and glycogen stores to support physical activities and a decreased training response
How urinary incontinence could affect dancers
A study of over 200 female professional dancers between ages 18-41 revealed that 34.6% of dancers experienced urinary incontinence, with stress incontinence being most common
Urinary incontinence can impact performance in several ways including:
causing performers to stop or reduce their training
contributing to a loss of concentration, avoidance of certain skills
and/or worry about recurrence, odor, or leak visibility
Dancers tend to underreport this issue and providers and dance educators/coaches don’t feel empowered or comfortable asking.
Many other high level athletes experience urinary incontinence at significant rates as well.
Low energy availability, high impact, high intra-abdominal pressure and high load activities, along with hypermobility all increase the risk of urinary incontinence.
Written by Dr Brooke Winder and Dr Julie Wiebe