Teenage Female Athletes are at Risk of Urinary Leakage

The below blog has been taken from www.myPFM.com - an amazing global resource dealing with pelvic floor health, raising awareness in the community, media and amongst health care professionals. There you can:

• find pelvic floor health specialists in your country,
• learn about pelvic floor health,
• have an online pelvic health appointment,
• volunteer to help others as well as
• assist in promoting pelvic health in your region.

Most women think that urinary leakage only happens as you get older or after you have babies. While those are common times that urinary leakage starts, it can happen to anyone at any time. In fact, there are many teenaged athletes that have urinary leakage. One study found that more than 25% of female college athletes (who had never given birth) had urinary leakage during their sport.

High-impact sports that involve running and jumping often see urinary leakage.

A recent study found that in young volleyball players, up to 75% had some degree of urinary leakage—that means that on a team of 12 players it is likely that 8 of them are having leakage! (Pires, 2020)
Other sports that had a high likelihood of urinary leakage were:

• trampolining (72%),
• soccer (50%),
• running (45%)
• cross country skiing (45%),
• basketball (35%), gymnastics, hockey, and ballet.

Why do high impact sports are more likely to have athletes with urinary leakage? 

The pelvic floor muscles act as part of the core and support the pelvic organs.  They contract to close off openings to keep pee, poop, and gas in and relax to open and let these out.  When the pelvic floor muscles aren’t working properly, they do not provide this support, and this can lead to urinary leakage.

The most common type of urinary leakage called stress urinary incontinence (SUI).  This happens when stress (pressure) is placed on the pelvic floor muscles, but the muscles do not counteract the pressure.  There are two reasons why this could happen.  First, the pelvic floor muscles can be strong but not have an effective precontraction before high impact activities (Bo, 2015).  Think about what you do if you know someone is going to punch you in the stomach—you would tighten your abdominal muscles to brace yourself without thinking about it.  The same thing happens with your pelvic floor muscles when they are working properly.  Right before you jump, sneeze, laugh, etc., the pelvic floor muscles should contract to brace against any pressure that might be put on it.  When this doesn’t happen, we often get urinary leakage.

On the other hand, this contraction may be happening, but the muscles might be too weak to withstand the pressure placed on them.  Over time, the muscles are overloaded, stretched, and become weak (Bo, 2015). Being an athlete and looking fit does not mean that your pelvic floor muscles are strong and coordinated.

You’re an athlete and you have stress urinary leakage, so what can we do?

Pelvic floor muscle training is the recommended first choice of treatment (Bo, 2015). While you can do this at home, studies have shown that pelvic floor muscle training under the supervision of a skilled therapist is more effective than training at home alone.

A pelvic floor physical therapist is specially trained to evaluate and treat muscle conditions. They can perform a full body assessment (including the back and hips which can contribute to pelvic floor symptoms). They will address your individual issues and tell you what is causing the urinary leakage. Your therapist should also give you an individualized treatment plan to address any weakness, tightness, and incoordination that may be happening.

To learn more about the pelvic floor check out these resources below:

• Ask your healthcare provider for a referral to a pelvic therapist.
• In Australia you can search for a pelvic health physiotherapist here https://choose.physio/find-a-physio
• Find a pelvic therapist on your own at www.myPFM.com There are links to 4 free searchable databases under Find a PT.
• Watch myPFM Pelvic Floor Muscle Training Playlist on YouTube
• Learn more about the pelvic floor muscles with their book: My Pelvic Floor Muscles The Basics
• Sign up for the myPFM email newsletter!
• Check out SRC Restore, our revolutionary new compression garment shown to improve the Quality of Life for women with symptoms of mild urinary leakage & bladder and uterine prolapse. It works through the use of a patented Anatomical Support Panel, specifically the gusset panel to provide continuous even compression to the entire perineal area which has been said to activate pelvic floor muscles through a possible proprioceptive feedback loop.

For health care providers, check myPFM online courses to help your athletes with urinary leakage. Consider joining their Ambassador Program and most of their courses are included with membership!

• The Hip and Urinary Incontinence: A Look at What Keeps Us Dry with Lauren Trosch PT, DPT, OCS

• Dance Medicine with Julia Rosenthal PT, DPT, OCS

• Introduction to Pelvic Floor Impairments in Runners with Amanda Olson PT, DPT, PRPC

• Rehabilitation and Gait Strategies for Pelvic Floor Dysfunction in Runners with Amanda Olson PT, DPT, PRPC

• Pelvic Floor Rehabilitation Strategies for Common Proximal Orthopedic Running Injuries with Amanda Olson PT, DPT, PRPC