Female Athletes and the Issue No One Wants to Discuss

It’s not uncommon to hear of athletes seeking physical therapy for musculoskeletal injuries of all parts of the body. Yet, there is a common issue in female athletes that largely remains unspoken and untreated- stress urinary incontinence.

According to the Mayo Clinic, stress urinary incontinence (SUI) is the unintentional loss of urine that is prompted by a physical movement or activity such as heavy lifting that puts pressure (stress) on the bladder. In a study by Thyssen et al (2002), it was found that of 291 female athletes surveyed, 151 women had experienced episodes of incontinence during their sport or during daily activities.

That is over 51% of female athletes!

In fact, urinary leakage is so common among elite female athletes and, in particular, female powerlifters that USA Powerlifting suggests in a Women Powerlifter ‘Helpful Hints/Tips’ section to wear a feminine pad any time during squatting and deadlifting to “avoid an embarrassing situation.”

Although this may be common, it is not how the body is supposed to respond to intense activities or heavy lifting. Incontinence is a physical manifestation of deficiency in the muscles of the pelvic floor. It is an inability of the core muscles to initiate and/or maintain activation during forceful activity, such as heavy lifting. The core can be thought of a cylindrical group of musculature that acts as a closed pressure system to provide stability to our entire body. The diaphragm is the top of the cylinder, the transverse abdominis, quadratus lumborum, obliques, and multifidi are the walls, and the pelvic floor muscles provide the base. A deficiency in one part of this system decreases the efficiency of the whole, meaning urinary incontinence is only part of the problem. The muscles of the pelvic floor need to be activated to prevent urinary leakage, but it also functions as the base for what is the cylinder stabilization of the core in order to protect the rest of your body from improper body mechanics and overuse.

Physical therapists trained in women’s health and pelvic rehabilitation are experts not only in dysfunctions of the movement system but have specialized knowledge retraining the muscles of the pelvic floor. They assist in re-educating the entire core to initiate and maintain activation throughout high-intensity sports and in daily activities to prevent episodes of incontinence and ultimately excessive stress and strain on the rest of the body, which can result in injury. Physical therapists will work with patients to promote core stabilization at the appropriate time, sequence, and endurance level. Additionally, they can help to identify movements that cause incontinence, the phase of the movement in which it occurs, and the intensity or duration at which it occurs to promote neuromuscular activation and motor control of the pelvic floor at those points so athletes can continue to perform safely (and dryly) doing what they love.

Body Gears has highly trained Women’s Health Specialists that can help you get answers and get back to the best you. In and out of training. Contact us today and schedule your Complimentary Women’s Health Screening.

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  1. Thyssen HH, Clevin L, Olesen S, Lose G. Urinary incontinence in elite female athletes and dancers. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):15–17.
  2. >Women Powerlifter ‘Helpful Hints/Tips’ http://www.usapowerlifting.com/women/ Friday, September 1, 2017