Get up and go, but don’t go mad

Figures published by the Irish Sports Monitor last month show that women are closing the gender gap with the numbers in sport, and that individual exercise such as working out at home or in the gym is the most popular for both sexes, with running showing a particular increase in women aged 20 to 44.

That’s the good news; the bad news is that fewer than half of all adults are involved in some type of sport.

Now that men and women are both pounding the pavements and pumping iron in the gym, is there anything women need to think about before plunging in?

"Women these days try so hard to compete with men in work and leisure alike, when in fact our bodies are so different and we do need to treat them differently," says Leah Bryans, a chartered physiotherapist at the National Maternity Hospital (NMH) in Holles Street, Dublin.

Lower levels of testosterone mean that women don’t build muscle to the same extent as men. Women’s knees are particularly prone to injury and women are more susceptible to stress fractures when they overtrain.

On the other hand, there is also some evidence that in endurance exercise women’s capacity is actually greater.

The female pelvis has been described as a “portal for prolapse” [in which the womb slips out of position] and indeed as many as 50 per cent of women, including some who have not had children, have some form of prolapse and many don’t know it.

It’s a sobering thought that one in five of all women will have at least one operation for either incontinence or prolapse, according to Dr Gerry Agnew, consultant obstetrician gynaecologist at the NMH. Childbirth, coughing, obesity and everyday activities such as heavy lifting with caring activities or shopping bags can all contribute to the problem.

As Bryans puts it, “We are structurally not designed to lift very heavy weights.” But genes also appear to play a role in determining how good the collagen in our tissues is to start with.”

Slow to exercise

Hormonal fluctuations in women during pregnancy and menopause can affect the supportive nature of the tissues around the reproductive organs.

Women should be slow to exercise strenuously too soon after childbirth or while breastfeeding when the hormone relaxin is relaxing ligaments in the pelvis and around the body. Bryans encourages women to think of pregnancy as lasting 12 months rather than nine, to allow the body time to recover fully.

Any woman with pelvic floor dysfunction can seek the advice of a chartered physiotherapist in women’s health and continence on what exercises she should do and which to avoid.

Some exercises will place more stress on the pelvic floor than others by increasing internal abdominal pressure. Pelvic-floor support needs to be included when engaging in any high-impact exercise and if it’s vulnerable, she should choose a low-impact exercise programme until the pelvic floor is strong again.

Once better, effective breathing and bracing techniques should be incorporated into any exercise programme to ensure the health of the pelvic floor is maintained.

Women in their 30s and 40s still require high-impact exercise such as running, skipping and step aerobics in order to optimise bone mass in advance of the menopause.

Walking, a popular choice, can be improved by varying the speed.

Dancing may be even better, with the change in speed and range of movement, according to Moira O’Brien, fellow emeritus professor of anatomy at Trinity College Dublin and president of the Irish Osteoporosis Society.

Resistance exercise such as working with weights and rubber bands is also important for maintaining muscle mass and strengthening bone as women age.

Proper technique

With exercise being essential for women at every stage of life, it’s a question of getting a thorough assessment and learning the proper technique for whatever one chooses to do, whether it’s lifting kettlebells or doing a plank.

Getting exercise advice is not easy. Some gym staff are very knowledgeable and helpful but some can give quite cursory guidelines on what to do, and may not supervise technique closely.

Physiotherapists advise listening to the body. If it hurts, stop. Start slowly and build up gradually. It can take up to three years for a novice to do what those who have been exercising for years can do.

Overall the advice is to enjoy whatever exercise you choose so that it’s something you’ll be happy to keep doing.

For more information, see getirelandactive.ie; holditsister.com; Irish Society of Chartered Physiotherapists at iscp.ie and 23 and a half hours: What is the single best thing we can do for our health? on YouTube