juillet 25

111 commentaires

Fuites urinaires chez une femme jeune : et si c’était le sport ?

De nombreuses personnes pensent que les problèmes de périnée ne concernent que les femmes âgées ou tout au moins ménopausées... La réalité est bien différentes puisque les fuites urinaires peuvent concerner certaines femmes après l'accouchement mais également des femmes jeunes sans enfants !

En effet dans le cadre d'une pratique sportive soutenue certaines femmes souffrent de problèmes urinaires bien avant d'être maman : Une étude interrogeant des sportives de haut niveau révèle que 52% d'entre elles présentent des fuites urinaires soit dans leur activité sportive, soit dans la vie quotidienne ; L'âge moyen des femmes interrogées dans cette étude est seulement de 23 ans !

Le sport et l'intégrité périnéale ne font donc pas toujours bon ménage, et ce même pour une simple pratique de loisir à partir du moment où elle est régulière. Evidemment il ne s'agit pas d'arrêter toute activité sportive qui reste indispensable à une bonne santé physique et mentale mais plutôt d'être avertie et d'agir en conséquence.

Pourquoi le sport peut fragiliser le périnée?

Il y a deux phénomènes qui expliquent la fragilisation du périnée par le sport :

  1. l'hyperpression abdominale, c'est-à-dire une poussée importante sur le périnée (lors d'un port de charge ou de mauvais abdos par exemple), 
  2. et la répétition de petits chocs liée aux sports d'impacts.

Le périnée n'est pas simplement un muscle, c'est un ensemble de muscles et de tissus de soutien c'est-à-dire de ligaments et de membranes appelées fascias. Les tissus de soutien ne sont pas capables de se contracter; on ne peut donc pas les renforcer.

L'hyperpression abdominale et les petits chocs répétés ont tendance à fragiliser les muscles mais aussi et surtout les tissus de soutien. Sur le long terme il peut y avoir apparition de fuites urinaires et/ou de descentes d'organes.

Voici une liste (non exhaustive) de sports et leurs conséquences sur le périnée.

Les sports et leur impact sur le périnée

Les sports à éviter absolument

Abdos "classiques", trampoline, cross-fit, boot camp

Ces sports ne permettent pas d'adaptations qui les rendraient acceptables pour le périnée: à oublier!

Attention à l'échauffement qui précède votre sport quel qu'il soit: dans de nombreux cas il comprend des abdos classiques mauvais pour le périnée; Donc même si votre sport est correct pour le périnée l'échauffement dans ce cas inverse malheureusement la tendance. C'est le même principe en ce qui concerne l'aquagym: être portée par l'eau est une très bonne chose pour le plancher pelvien mais si le cours intègre des abdos créant une poussée descendante (vers le périnée) l'activité devient néfaste. 

Les sports à impacts importants

Course à pieds, tennis, volley-ball, badminton, handball, basket ball, athlétisme, step.

Ces activités concernent de nombreuses sportives, notamment la course à pieds qui permet de se dépenser facilement, sans grosses contraintes d'organisation et pour un budget quasi-nul !

Même si ces sports sont à risque pour le périnée, ils peuvent être pratiqués en respectant certains règles :

1. Après un accouchement la jeune maman doit respecter une période sans sport de minimum 6 semaines: c'est notamment le délai  pour que la relaxine, l'hormone de la grossesse qui détend tous les ligaments du corps, cesse d'être produite. La rééducation périnéale chez un(e) kinésithérapeute ou un(e) sage-femme doit ensuite être effectuée, suivie d'un renforcement plus général incluant la sangle abdominale (Attention! pas de "mauvais abdos" même avec un périnée remusclé !)

2. Des centres spécialisés constitués de kinésithérapeutes et de podologues se proposent d'étudier votre foulée ou votre geste sportif: leurs conseils personnalisés en terme de posture sont précieux pour ménager votre périnée et tout votre corps pendant l'effort. N'hésitez pas à faire appel à eux même pour une pratique de loisir.

3. Après votre activité sportive prenez quelques instants pour vous placer dans des postures dites "inversées" c'est-à-dire avec le bassin plus haut que la tête: la pesanteur sera cette fois-ci bénéfique pour votre périnée qui sera soulagé du poids des viscères. Ça peut être la position du "pont fessier" ou bien tout simplement à quatre pattes mais en appui sur les avant-bras au lieu des poignets.

Dans ces postures alternez contractions et relâchement du périnée. Lors de la contraction vous pouvez imaginer que vous faîtes un "stop pipi". Prenez le temps de relâcher complètement ensuite: Le temps de relâchement doit être au moins égal au temps de contraction.

4. L'utilisation d'un pessaire (dispositif introduit dans le vagin dont le but est de maintenir les organes pelviens) lors du sport peut être utile, notamment si vous souffrez déjà d'une pesanteur au bas-ventre. Il s'agit d'un petit cube en silicone à placer au fond du vagin et qui va retenir les organes en place malgré les impacts liés au sport.  

Les sports à impacts minimes

Randonnée, marche, marche nordique.

Ces sports sont sans risque pour le périnée. Si vous expérimentez des fuites urinaires ou une pesanteur au niveau du bas du ventre lors de l'un de ces sports c'est que vous aviez déjà une fragilité périnéale : votre pratique sportive a révèlé un problème sous-jacent mais n'en est pas la cause.

Les sports "portés" ou sans impacts

Natation, vélo, vélo elliptique, roller, golf, Pilates (si adapté au grand public).

A pratiquer sans modération !


Prenez plaisir à faire du sport en respectant ces quelques règles... et prenez soin de vous!


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