The pelvic floor is a structure composed of muscles and connective tissue, underneath the pelvis, and whose function is separate the pelvic cavity and the perineal region. It is present in males and females, although in the latest is larger because it also contains the birth canal. Its main function is supporting organs such as the bladder, intestines and uterus (in women), and in the maintenance of the continence and intra-abdominal pressure.
When there is a dysfunction of the pelvic floor some consequences are: urinary incontinence, pelvic organ prolapse (when an organ slide from its position into the vagina) or sexual dysfunctions.
Physical exercise carries many health benefits, but it is also related with some pelvic floor problems in female athletes, the most common one being urinary incontinence.
Many young women have no knowledge about pelvic floor function, and how sports practice may be related with some of its associated problems. Sports practice increases intra-abdominal pressure, especially in high impact disciplines.
There are two opposing theories relating exercise and pelvic floor dysfunctions:
- Female athletes have stronger pelvic floor muscles.
- Female athletes may overload, stretch and weaken their pelvic floor muscles.
If the pelvic floor musculature is weaker than the surrounding muscles, it may not be able to contract simultaneously with them, causing urinary losses, especially in conditions of physical exertion. Nevertheless, pelvic floor muscles training has been related with an improvement in some symptoms, as muscular strengthening allows a better blood supply and nerve activity in the area.
The National Institute of Health and Care Excellence of the United States recommends women with incontinence to perform at least 8 pelvic floor contractions, 3 times per day. There are different exercising options, such long squeezes or fast short squeezes, with fully relaxation between them.
Women who carried out pelvic floor training were 17 times more likely to report an improvement of their symptoms or total cure, so it should be the first treatment of choice for any type of urinary incontinence.
With the increase of women practicing sports, educational campaigns should be in place to provide enough information and remove the “shame” and secrecy of these situations. It would encourage them to get treatment and solve the problem.
Pelvic Floor in Female Athletes: From Function to Dysfunction
Carvalhais A, Da Roza T, Sacomori C
Women’s Health and Biomechanics pp 145-153