Pelvic floor and sports
When we walk, run, jump or play sports, our pelvic floor is working to support our pelvic organs. The muscles and fascia of the pelvic floor sit like a hammock at the base of our pelvis that holds our organs in place. The pelvic floor counters the forces of gravity and abdominal pressure created when we exercise.
Having a strong and healthy pelvic floor provides support and allows you to challenge your body and get fitter, stronger and faster safely. Choosing the right kind of exercise or sport can protect your pelvic floor, and ensure even those with pelvic floor concerns can still reap the health benefits of being active.
Which exercise is safest for my pelvic floor ?
Low impact exercise, especially walking, has been found to decrease the risk of having pelvic floor dysfunction. However, this doesn’t mean that running and high level impact exercise is “bad” for the pelvic floor. Those who have no previous incontinence or prolapse symptoms can safely participate in a wide range of sports. Training for high-level sport and exercise should include pelvic floor muscle training to ensure they have the strength and protection needed for their physical activity.
If you're experiencing symptoms during exercise - such as leaking or heaviness, then reducing the level of impact is recommended until you've increased the strength of your pelvic floor. Modifying exercise to reduce jumping or running, and focusing on pelvic floor muscle training with the guidance of your pelvic floor physiotherapist can reduce your symptoms and help you work towards returning to high level activity.
There's also evidence that suggests young athletes have a higher incidence of “hypertonic” or “overactive” pelvic floor muscles. For these athletes, Pelvic Floor training that focuses on relaxation and release can also be an important part of sports training, to reduce pain and tightness in the pelvic region.
Is participating in sports a risk factor for incontinence?
Pelvic floor dysfunction impacts many athletes from different sporting backgrounds, and can also be a barrier to physical activity for a lot of people.
Playing sports or participating in activities has not been found to cause incontinence, but it may increase symptoms for some. Those who participate in high-impact exercises, such as Crossfit, gymnastics, and “jumping” sports report a higher incidence of incontinence (leaking urine) than those who are inactive. Around 30% of long-distance runners report urinary incontinence, which is similar to those in the general population. Trampolinists have reported the highest incidence of stress urinary incontinence - up to 80% of these athletes experience leaking during their training.
Positively, moderate and low impact exercise may have a protective factor for the pelvic floor. Some studies have shown that regular low impact exercise, like walking, actually reduces the risk of developing incontinence.
What about prolapse?
There's no evidence that suggests that exercise can cause pelvic organ prolapse. However for those who have a prolapse, high impact activity (running, skipping, jumping) can increase severity and symptoms of prolapse; such as feelings of heaviness and bulging in the vagina.
People who experience heaviness, pain, or bulging in the vagina during activity are encouraged to seek support from their Pelvic Floor Physiotherapist - who can direct on pelvic floor training and even devices like pessaries, which can increase support of the pelvic organs during exercise.
Laura Justin
@thefamilyphysio