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Seeking Female Triathletes for Survey Study
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To Triathletes,
We are a group of health care providers at Loyola University Medical Center in Chicago, IL who specialize in female pelvic floor disorders.
We have an interest in understanding what places women at risk for developing pelvic floor disorders, such as pelvic organ prolapse,
urinary and fecal incontinence and pelvic girdle pain.
We would like to invite Female Triathletes over the age of 18 years old to participate in our nationwide survey study to better understand the triathlete population.
The survey will take about 10-15 minutes. All answers will be confidential and no identifying information will be collected. This study was approved by our hospital’s Institutional Review Board.

https://www.surveymonkey.com/s/FemaleTriathleteStudy

If you would like to participate in a raffle for a $100 gift card to www.amazon.com , you will be asked for contact information at the end of the survey. This information will not be linked to any of survey answers.
We will be happy to share the results of our study when they are available.

Due to the nature of this research, we are not able give medical advice through this forum. Our contact information is given at the end of the survey if you would like to contact us regarding the study or for more
information regarding pelvic floor disorders.


Thank you in advance for participating!

Sincerely,
Johnny Yi, MD
Sandi Tenfelde, PhD, RN, APN
Colleen Fitzgerald, MD, MS

Department of Obstetrics and Gynecology
Division of Female Pelvic Medicine and Reconstructive Surgery
Loyola University Medical Center

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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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your survey had no way to explain that lack of menses is from suppressive therapy - I KNOW I am not the only one....
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Re: Seeking Female Triathletes for Survey Study [meuf] [ In reply to ]
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Thank you for your feedback. We will be able to analyze what we need according to the hormone therapy question listed earlier in the survey.
I appreciate your participation in the study.

Johnny
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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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anytime - I am a doc in women's health at Cornell - understand need for subjects!
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Re: Seeking Female Triathletes for Survey Study [meuf] [ In reply to ]
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yeah, I had that issue--then it asks how many menstrual cycles I've had, and it didn't like my answer (I wanted to NOT answer...as random instances of spotting here and there throughout the year wasn't a choice. But I had to pick one number.)


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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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I took the survey.

Question: Are you trying to demonstrate that endurance sports are bad for the female body?
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Re: Seeking Female Triathletes for Survey Study [TriBeer] [ In reply to ]
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Thank you for participating in the survey.
We are big proponents of triathlons and are fully supportive of exercise.
In fact, my wife is a triathlete and trains regularly.
We are interested in promoting healthy exercise and understanding how common pelvic floor disorders
are in women who are training and what factors may contribute to pelvic floor disorders.
Our goal is to promote women's health by encouraging exercise, prevent injury and
increase understanding and awareness of women's pelvic floor health.

Thank you for your comment.

Johnny Yi
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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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Thank you for the explanation.

Good luck with your survey.

Also, thank you for working on Women's health issues.
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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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These questions/symptoms sound very scary. My thought is that any woman who experiences those symptoms would be incapable of regular exercise, let alone competitive sports. A good warning to pay attention to health- don't let any issues progress.
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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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johnny.yi wrote:
Thank you for participating in the survey.
We are big proponents of triathlons and are fully supportive of exercise.
In fact, my wife is a triathlete and trains regularly.
We are interested in promoting healthy exercise and understanding how common pelvic floor disorders
are in women who are training and what factors may contribute to pelvic floor disorders.
Our goal is to promote women's health by encouraging exercise, prevent injury and
increase understanding and awareness of women's pelvic floor health.

Thank you for your comment.

Johnny Yi

as both a triathlete and physician (mostly women and many many athletes) I have not seen ONE athlete with pelvic floor dysfunction. all my referrals to gyn urology are sedentary women, many overweight.

not sure what population you get but I have NEVER seen pelvic floor disorders in women who train - cyclists, triathletes, runners....nor do I know any
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Re: Seeking Female Triathletes for Survey Study [TriGirrrrl] [ In reply to ]
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Thank you both for your comments. These symptoms may sound scary, but pelvic floor dysfunction can affect up to 1 in 4 women in their lifetime.
Approximately 11% of women will have surgery for pelvic organ prolapse of urinary incontinence in the US each year.

In regards to athletes and pelvic floor dysfunction, there are studies looking at the prevalence of athletes and these disorders.
We also know that women involved in high impact sports can have pelvic floor dysfunction.
A survey study that looked at women involved in endurance sports (triathletes were included in this) showed a prevalence of stress urinary incontinence of over 40%.

Johnny Yi
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Re: Seeking Female Triathletes for Survey Study [TriGirrrrl] [ In reply to ]
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Hmm... not sure I agree with you. I train a lot, have for 15+ years, and I have some of these issues.

AP

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"How bad could it be?" - SimpleS
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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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Can't do it because there is no option for international residents
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Re: Seeking Female Triathletes for Survey Study [noodlecat77] [ In reply to ]
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I am sorry that you were not able to participate. We limited this study to the continental US. Thank you for trying though.

Johnny
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Re: Seeking Female Triathletes for Survey Study [TriGirrrrl] [ In reply to ]
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This is so interesting to me as well...

As a physical therapist (one practicing women's health) and athlete, I do see athletic nulliparous women with incontinence and pelvic pain, in addition to postpartum women. Dancers seem to be common, cyclist, significant life stress, etc.

I agree that sedentary lifestyle certainly increases the apparent chances, but I have been really surprises when I start to drill down, how many women will admit they have dealt with some level on incontinence, even intermittently.

Ultimately, these are just our N=1 observations, I am interested to see what this study reveals. It is a very interesting condition and I hope that we continue to gain more knowledge about the subject. I think so many women are afraid to admit incontinence or feel it is 'normal'. I have to constantly tell women, just because it is common, doesn't make it normal.

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl
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Re: Seeking Female Triathletes for Survey Study [tridana] [ In reply to ]
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I always instruct my female patients (of all ages) to do kegels - and have a similar experience to TriGrrrl.
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Re: Seeking Female Triathletes for Survey Study [meuf] [ In reply to ]
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I don't disagree that the majority of patients I see with incontinence are somewhat sedentary, but I want women to know that it is not unheard of to be super fit and have incontinence.

Kegel's are wonderful - if done correctly and appropriately. Granted I am seeing a different population than an MD, but I would say it is at least 50% are doing a Kegel wrong and have been for years. Bearing down, bracing, contracting the obliques, timing is wrong, only do fast contractions, only do sustained contractions, only work on it while lying down. This does not even take into account women with vaginismus or similar that are leaking because there is too much tension and they are unable to coordinate the pelvic floor and pelvic sphincters correctly.

The way that triathletes sit on a bike seat (on the nose typically), the lack of a chamois, the number of threads dedicated to numb/sore/painful "nether regions" should all make people curious. Even the idea of trying to pee on the bike in a race - we are training our brains all the time - I am not saying any one thing is leading to incontinence in fit women (and Men), but I am seeing more of it. I have to believe that as education gets out and stigma is reduced we will only see more.

It is not normal to leak urine. I don't care how many kids you have had. Common is different than normal. As a human society we have to stop normalizing things that are common - but not normal. Incontinence, pain, etc, etc, etc.

Sorry - I will get off my soap box and go for a run now! Oh, And a huge thank you to you (Meuf) and TriGrrrl for even addressing it with your female patients. I am amazed at how many don't (or more likely can't due to time constraints).

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl
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Re: Seeking Female Triathletes for Survey Study [johnny.yi] [ In reply to ]
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Do you ever wear anything in your vagina such as a pessary or tampon to prevent urine leakage?

Do you know how a vagina works? Tampons don't go up the urethra...


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Re: Seeking Female Triathletes for Survey Study [tridana] [ In reply to ]
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Tridana- your thoughts are very insightful and I would have to agree. Common problems are not necessarily normal. We are very excited to get this study done so that we can share what we find with as many women triathletes as we can. On that note, we are more than halfway to completing our accrual and have less than one month left to get as many people as we can. Please spread the word for our survey! Thanks!
Johnny
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Re: Seeking Female Triathletes for Survey Study [Agilecipher] [ In reply to ]
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Agilecipher- thank you for completing our survey. Some women wear pessaries or tampons in the vagina. For this purpose, they work by stopping the urine by pressing against the urethra with coughing, laughing, sneezing, etc. You are correct. These are placed inside the vagina, not the urethra. I am sorry if this question was misleading.

Johnny
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Re: Seeking Female Triathletes for Survey Study [tridana] [ In reply to ]
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tridana wrote:
I
Kegel's are wonderful - if done correctly and appropriately. Granted I am seeing a different population than an MD, but I would say it is at least 50% are doing a Kegel wrong and have been for years.

Any suggestions how to learn doing them correctly?
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Re: Seeking Female Triathletes for Survey Study [Kivisisalik] [ In reply to ]
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Kivisisalik wrote:
tridana wrote:
I
Kegel's are wonderful - if done correctly and appropriately. Granted I am seeing a different population than an MD, but I would say it is at least 50% are doing a Kegel wrong and have been for years.


Any suggestions how to learn doing them correctly?

I usually teach women when I am examining them but from description - think about squeezing a tampon (and holding) I usually tell women to squeeze for a count of 10 with 8,9,10 being even harder do them whenever you can! Waiting at red lights, stop on subway/bus, waiting on line....
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Re: Seeking Female Triathletes for Survey Study [TriGirrrrl] [ In reply to ]
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TriGirrrrl wrote:
Kivisisalik wrote:
tridana wrote:
I
Kegel's are wonderful - if done correctly and appropriately. Granted I am seeing a different population than an MD, but I would say it is at least 50% are doing a Kegel wrong and have been for years.


Any suggestions how to learn doing them correctly?


I usually teach women when I am examining them but from description - think about squeezing a tampon (and holding) I usually tell women to squeeze for a count of 10 with 8,9,10 being even harder do them whenever you can! Waiting at red lights, stop on subway/bus, waiting on line....


Sorry for the delay - life's been crazy! I like TriGirrrrl's description.

here is another thing you can try:
1) lie on your back with your knees bent, place your fingers just on the inside (toward the center) of your hip bones
2) now try doing the contraction above - squeeze a tampon. you can also think of what you would do to stop the flow of urine, a gentle pilates imprint, or imagine what contraction you would do to bring your finger tips closer together.
3) if you are doing the contraction correctly you should feel your fingers sink in a little (or feel the muscle below your fingers 'broaden'); if you feel your fingers pop up, you are engaging your obliques to complete the contraction.
4) if you feel your fingers pop up - try 10% effort; it is important to be able to differentiate your 'low abdominals/pelvic floor' from your obliques. Often times women are pushing when the obliques activate which only makes incontinence worse.
5) you can also try to actually stop the flow of urine. I hesitated writing this because you have to be very cautious doing this. Only perform ONCE during a bathroom break and I recommend not more than 2x per day. You can cause urine retention if done excessively.
6) finally when you feel you have mastered the contraction on your back: Try sustained holds (the 10 seconds suggested), then try quick flick contractions (on/off, on/off x 5-10) - both on your back.
7) Progressions: on your back with movement: bridge, leg slide, arm movement; seated, standing, walking, running, biking etc.

Lots of info, but you can PM me if you want!!

One final thought on pelvic floor contractions. Some women have incontinence not because they don't have pelvic floor tone, but because they are too tense. The example I give people: if you walked into my office with your shoulders at your ears and complained of weakness in your shoulders - my first job would be to teach you to relax those muscles, then use them correctly. The same applies to your pelvic floor.

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl
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Re: Seeking Female Triathletes for Survey Study [Kivisisalik] [ In reply to ]
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Kivisisalik wrote:
tridana wrote:
I
Kegel's are wonderful - if done correctly and appropriately. Granted I am seeing a different population than an MD, but I would say it is at least 50% are doing a Kegel wrong and have been for years.


Any suggestions how to learn doing them correctly?

Two other suggestions that are a little less clinical:

1) Ben wa balls. Seriously. It's what they're for, and they can be fun. The smaller, steel ones are best for strengthening; the larger ones (often called duotone balls) are more for pleasure only. If you're new to them, try one at a time to start - just pop it in and wander around. If you're leaving the house, you may want to wear some sturdy undies that will catch the ball for you if you lose your grip; probably don't want to go chasing it across the grocery store floor.

2) Try Kegels during sex. Works in almost any position; just give an intentional clench with each thrust. You can also have both of you stay perfectly still and just start squeezing - that's one of the tantric practices and it can be mindblowing for both partners.

This link will take you to a pretty decent write-up that may help with proper muscle activation.

Cheers!

-mistress k

__________________________________________________________
ill advised racing inc.
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Re: Seeking Female Triathletes for Survey Study [mistressk] [ In reply to ]
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they also make vaginal weights - the more clinical version of the benoit balls.
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