Transcript
NARRATOR
Why does a coach need to be concerned about the pelvic floors of the athletes they coach? Because pelvic floor issues, such as urine leakage affect at least 40% of athletes, and surprisingly, athletes are more affected than the general population.
Athletes in high impact sports like gymnastics and trampolining are most affected due to the increased pressure placed on these muscles. The pelvic floor is a group of muscles and ligaments that run across the pelvis from the pubic bone to the coccyx to form a cradle that supports the bladder, bowel, and uterus.
In males, there are two openings in the pelvic floor, for the urethra and the anus. While females have a third opening for the vagina. The pelvic floor musculature is about 1 centimetre thick, or about the width of your hand. It is these muscles that maintain continence or keep us dry by contracting when we exercise, laugh, sneeze, or cough.
These activities increase pressure on the pelvic floor, and can cause leakage in individuals with pelvic floor dysfunction. Pressure on the pelvic floor increases significantly during pregnancy, because the foetus, placenta, and amniotic fluid add to the weight that needs to be supported.
In addition, the release of the hormone relaxin that enables joints to become looser for childbirth can cause the ligaments in the pelvic floor to become stretched. Childbirth has the greatest impact on the pelvic floor muscles, as when the baby passes through the pelvis, the muscles are stretched and can be significantly damaged. This can lead to complications, such as urinary incontinence after childbirth.
Athletes are prone to pelvic floor dysfunction, but there are two differing theories as to why this is the case. The popular theory is that repeated high impact activities like running and jumping place repeated pressure on the pelvic floor, causing it to become stretched and weak.
The second theory is that high impact exercise has a training effect, and causes a tighter, stronger pelvic floor. The muscle tightness means that the pelvic floor will not have its full range of movement available. Therefore, when increased pressure is placed on the muscles and ligaments, the pelvic floor is unable to respond and resist the additional force.
For an athlete worrying about whether their pelvic floor is going to let them down can take up their mental focus when they should be focusing on their pre-performance routines, and staying relaxed and confident under pressure.
But it does not have to be like this, as pelvic floor muscles can be strengthened through exercises. These exercises help to isolate the pelvic floor muscles, and contract them slowly or rapidly. It takes about 14 days of repetitive training to build up neural pathways between the brain and the pelvic floor muscles to enable you to control them, and about three months of training to increase their size and strength, and regain control.
As knowledge in this area grows, coaches and trainers adopt more progressive approaches where pelvic floor work is becoming an integral part of an athlete's strength and conditioning work, rather than being seen as isolated work done as rehabilitation when dysfunction occurs.