4 Athletic performance and pelvic floor dysfunction?

Most women will have a pelvic floor that is strong enough for their daily activities; however, it is not uncommon for athletic females to experience problems due to dysfunction of their pelvic floor muscles. This can have serious consequences.

Teixeira et al. (2018) identified that urinary incontinence (UI) can impact on social and mental wellbeing and as a result can cause problems, such as social isolation, low self-esteem, depression and a lower quality of life. They also reported that 20% of women had given up playing sport due to UI. In addition to this there are several risk factors for pelvic floor dysfunction, and these are older age, obesity, childbirth, menopause and exercise (Teixeira et al., 2018). Activity 2 introduces the problems athletes may face around pelvic floor dysfunction.

Activity 2 Pelvic floor health and athletes

Select the answer for

Question 1a

here

Watch the animation below that gives more detail about the pelvic floor, why athletes are prone to pelvic floor dysfunction, and what can be done to restore function to these muscles.

Download this video clip.Video player: sfps_1_animation_pelvic_floor_health_front_and_end_boards.mp4

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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.

End transcript

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Then answer the following True/False questions.

1. Due to their strong pelvic floor athletes are less likely to experience urinary incontinence.

False

True

 

a. 

False

b. 

True

The correct answer is a.

Discussion

False. Athletes are more likely to experience UI as their pelvic floors can be weakened by high intensity exercise or their overtight pelvic floors can affect their function negatively.

Select the answer for

Question 1b

here

2. Pelvic floor muscles run across the pelvis from pubic bone to coccyx.

False

True

 

a. 

False

b. 

True

The correct answer is b.

Discussion

True. The muscles of the pelvic floor run across the pelvis.

Select the answer for

Question 1c

here

3. In both males and females there are two openings in the pelvic floor.

True

False

 

a. 

True

b. 

False

The correct answer is b.

Discussion

3. False. Males have two opening in the pelvic floor for the urethra and the anus, but females have an additional opening for the vagina.

Select the answer for

Question 1d

here

4. Exercising, sneezing, and coughing will all strengthen the pelvic floor muscles.

False

True

 

a. 

False

b. 

True

The correct answer is a.

Discussion

False. All these activities can add to increase pressure on the pelvic floor and cause UI.