Staying hydrated is essential for everyone, but athletes have an even greater need to maintain proper hydration. And adaptive athletes are no exception. As any doctor can tell you, water is the most important nutrient for life and has many important functions including regulating temperature, lubricating joints and transporting nutrients and waste throughout the body.

How to manage fluid intake and incontinence to get that competitive edge!

Yet many adaptive athletes may restrict fluid intake due to incontinence or fear of having an accident. Avoiding dehydration is fundamental to competing safely. Too many adaptive athletes are walking a fine line with hydration habits and potentially doing more harm than good to their bodies.

The amount of water athletes lose varies due to sweat product, exercise duration and intensity, the room temperature and the altitude. High altitude and high temperatures can increase fluid loss.  What most people don’t know is that exercising in the cold can also present problems because the cold can impair your ability to recognize fluid loss and can increase fluid loss through respiration.

Studies have found that athletes who lose as little as two percent of their body weight through sweating have a drop in blood volume which makes the heart have to work harder to circulate blood. A drop in blood volume may also lead to muscle cramps, dizziness, fatigue and heat illness. In short, avoiding dehydration and its complications can give you a competitive edge against your peers and improve your overall bladder health. Two birds, one stone!

Hydration Needs for Athletes

Because there is wide variability in sweat rates etc., it is nearly impossible to provide specific recommendations or guidelines about the type or amount of fluid you should consume on or before game day. There are, however, two simple methods of estimating adequate hydration (provided by the American College of Sports Medicine):

1. Monitoring urine volume output and color. A large amount of light colored, diluted urine probably means you are hydrated; dark colored, concentrated urine probably means you are dehydrated.
2. Weigh yourself before and after exercise. This might be a challenge but if you can do this a few times then you can establish an average weight loss during exercise. Any weight lost is likely from fluid, so try to drink enough to replenish those losses. Any weight gain could mean you are drinking more than you need.

What about the Sports Drinks hype?

Contrary to the hype spouted in Gatorade commercials, sports drinks have limited value for most people. They can be helpful to athletes who are exercising at a high intensity for 60 minutes or more. Fluids supplying 60 to 100 calories per 8 ounces helps to supply the needed calories required for continuous performance. But it’s not actually necessary to replace losses of sodium, potassium and other electrolytes during exercise. The exception is when you find yourself exercising in extreme conditions over 3 or 5 hours (a marathon, Ironman or ultra-marathon, for example) you may likely want to add a complex sports drink with electrolytes.

General Guidelines for Fluid Intake

As we’ve mentioned it not realistic to make specific fluid recommendations for all athletes however, most people can use the following guidelines as a starting point, and modify their fluid needs accordingly.

Hydration Before Exercise

• Drink about 15-20 fl oz, 2-3 hours before exercise
• Drink 8-10 fl oz 10-15 min before exercise

Hydration During Exercise

• Drink 8-10 fl oz every 10-15 min during exercise
• If exercising longer than 90 minutes, drink 8-10 fl oz of a sports drink (with no more than 8 percent carbohydrate) every 15 – 30 minutes.

Hydration After Exercise

• Weigh yourself before and after exercise and replace fluid losses.
• Drink 20-24 fl oz water for every 1 lb lost.
• Consume a 4:1 ratio of carbohydrate to protein within the 2 hours after exercise to replenish glycogen stores.

Fluid Intake & Incontinence

So for those of you keeping track, you could end up drinking nearly 100 fluid ounces of water during a single sporting event. There’s no set percent that will be absorbed by your body, it all depends on how hydrated you are starting out – only your kidneys know the exact amount! As you drink fluids and they are absorbed into your bloodstream, the blood flows through the kidneys and is filtered. The kidneys balance the chemicals and amount of water in your bloodstream. So depending on your body’s needs, some water will be turned into urine and some of it will be kept in your blood to maintain this balance.

This can leave quite a lot of urine in your bladder demanding release. Now think about the size of your bladder; its max capacity is about 16 ounces.  So urine management isn’t just a theoretical problem!

So what are your options?

There are a few options out there, but let’s be honest, most of them aren’t that great. In no particular order, you can use:

• Diapers/Pads
• Condom Catheters
• Intermittent Catheterization
• Permanent Foley catheterization

OR

• Men’s Liberty

The most important thing when it comes to managing incontinence is to be sure to check out the 3 C’s: Cost, Complications and Caregiving. Make sure whatever you choose is within your budget, low on complications and increases your independence.

I won’t harass you with all the details of every complication associated with many of these outdated methods here (however, if you are curious, I recommend checking out our blogs on the subject). However, there is a healthier option available for men. Men’s Liberty is an innovative hydrocolloid external catheter that seals securely to the skin for 24+ hours. It’s used by adaptive and able bodied athletes for fluid management during skiing, weight lifting, cycling, racing, shooting and many other sports. With an 8 ounce integral collection chamber and attachable 1000ml leg bag the Liberty is keeping adaptive athletes dry and comfortable from the locker room to the winner’s podium.

_Sources

• _{Consensus Statement of the 1st International Exercise-Associated Hyponatremia Consensus Development Conference, Cape Town, South Africa 2005. Clinical Journal of Sport Medicine. 15(4):208-213, July 2005.}
• _{Exercise and Fluid Replacement, ACSM Position Stand, American College Of Sports Medicine, Medicine and Science In Sports & Exercise, 2007.}
• _{Institute of Medicine. Water. In: Dietary Reference Intakes for Water, Sodium, Cholride, Potassium and Sulfate, Washington, D.C: National Academy Press, pp. 73–185, 2005.}