(646) 355-8777

Herman & Wallace Blog

Leaking Athletes Take Their Training to the Floor

While running on my treadmill, I watched a commercial advertising specially designed pads as “the solution” for women athletes who “leak” during their sport. Before my introduction to Herman and Wallace Rehabilitation Institute, I would have rushed to the nearest store to buy a case of them. When we don’t know how to fix a problem, we tend to cling to bandages to cover them, allowing us to ignore them. With 29 years of running and racing and 2 natural childbirths under my belt, leaks have happened, and it is common. However, leaks due to urinary stress incontinence are not normal and do not stop simply because you place a contoured, sporty, sanitary pad in the lining of your shorts.

A 2016 cross-sectional study by Ameida et al. investigated urinary incontinence (UI) and pelvic floor dysfunctions (PFD) such as constipation, anal incontinence, pelvic organ prolapse, vaginal laxity, and dyspareunia in female athletes who participate in high-impact sports. The 67 amateur athletes and 96 non-athletes completed an ad hoc survey to determine PFD symptoms. Artistic gymnasts, trampolinists, swimmers, and judo participants were among the athletes with the highest risk of urinary incontinence. Although the athletes had a higher risk of UI, they reported less constipation, less straining to relieve themselves, and less manual assistance for defecation than the non-athletes. The authors were able to conclude that high impact sports or sports requiring a strong effort put athletes at risk for UI, uncontrolled gas expulsion, and even sexual dysfunction. They emphasize a need for attention to be given to pelvic floor training for rehabilitation as well as preventative strategies and education for high risk yet asymptomatic athletes.

In 2015, DaRoza et al. performed a cross-sectional cohort study to determine the urinary leakage in 22 young female trampolinists based on the volume of their training and level of ranking. Leakage was assessed by the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-UI-SF), and another questionnaire determined each athlete’s championship ranking and training volume. An astounding 72.7% of girls reported urine leakage since starting to perform on the trampoline, and the greatest severity was significantly associated with the highest training volume. The impact of UI on the athlete’s quality of life was greatest in this 3rd tertile. The authors recommended these athletes with a high frequency of UI be educated on the impact of their sport on their pelvic floor muscles and proposed they get treated by pelvic health professionals to minimize or resolve the incontinence.

Thankfully, none of the above researchers or medical professionals advises the study participants to just use a pad and carry on with their sport. Urinary incontinence is a real problem in athletes, and its prevalence is appalling. Even young girls without any birthing of babies to blame are leaking. Making females (and males) aware of the impact sports can have on their pelvic floor and educating them that urinary leakage is not normal are essential missions for healthcare professionals. “The Athlete and the Pelvic Floor” course can help integrate pivotal aspects of pelvic rehabilitation into sports medicine, as some conditions just may require training to move down to the pelvic floor for complete recovery.


Almeida, MB, Barra, AA, Saltiel, F, Silva-Filho, AL, Fonseca, AM, Figueiredo, EM. (2016). Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: A cross-sectional study. Scandinavian Journal of Medicine & Science in Sports. 26(9):1109-16. http://doi:10.1111/sms.12546
Da Roza, T, Brandão, S, Mascarenhas, T, Jorge, RN, Duarte JA. (2015). Volume of training and the ranking level are associated with the leakage of urine in young female trampolinists. Clinical Journal of Sport Medicine. 25(3):270-5. http://DOI:10.1097/JSM.0000000000000129

Manual Therapy – Use your Head to Guide your Hands
Beth Anne Travis: Certified Practitioner

Upcoming Continuing Education Courses

Aug 16, 2019 - Aug 18, 2019
Location: WakeMed Health & Hospitals

Aug 16, 2019 - Aug 18, 2019
Location: BodyWorx Vitality

Aug 16, 2019 - Aug 18, 2019
Location: Piedmont Healthcare

Aug 16, 2019 - Aug 18, 2019
Location: Dignity Health Care of Stockton, CA

Aug 17, 2019 - Aug 18, 2019
Location: Ochsner Health System

Aug 23, 2019 - Aug 25, 2019
Location: PeaceHealth Southwest Medical Center

Aug 23, 2019 - Aug 25, 2019
Location: Inova Physical Therapy Center

Aug 23, 2019 - Aug 25, 2019
Location: The Sage Colleges

Aug 23, 2019 - Aug 25, 2019
Location: Loyola University Stritch School of Medicine

Aug 23, 2019 - Aug 24, 2019
Location: Mizzou University of Missouri

Aug 23, 2019 - Aug 25, 2019
Location: Mizzou University of Missouri

Sep 6, 2019 - Sep 8, 2019
Location: Advanced Physical Therapy of Little Rock

Sep 6, 2019 - Sep 8, 2019
Location: Bon Secours St. Francis Health System

Sep 7, 2019 - Sep 8, 2019
Location: Franklin Pierce University

Sep 7, 2019 - Sep 8, 2019
Location: Spooner Physical Therapy

Sep 13, 2019 - Sep 15, 2019
Location: Huntington Hospital

Sep 13, 2019 - Sep 15, 2019
Location: Mary Free Bed Rehabilitation Hospital

Sep 13, 2019 - Sep 15, 2019
Location: Loyola University Stritch School of Medicine

Sep 13, 2019 - Sep 15, 2019
Location: Lee's Summit Medical Center

Sep 13, 2019 - Sep 15, 2019
Location: Princeton Healthcare System

Sep 14, 2019 - Sep 15, 2019
Location: Aurora Medical Center

Sep 20, 2019 - Sep 22, 2019
Location: Marathon Physical Therapy

Sep 20, 2019 - Sep 22, 2019
Location: Viverant

Sep 21, 2019 - Sep 22, 2019
Location: Carolinas Healthcare System - Union

Sep 27, 2019 - Sep 29, 2019
Location: Catholic Health Administrative and Training Center

Sep 27, 2019 - Sep 28, 2019
Location: Fort HealthCare

Sep 27, 2019 - Sep 29, 2019
Location: Fort HealthCare

Sep 27, 2019 - Sep 29, 2019
Location: Good Shepherd Penn Partners

Sep 28, 2019 - Sep 29, 2019
Location: Regions Hospital

Oct 4, 2019 - Oct 6, 2019
Location: Thomas Jefferson University