The Athlete and the Pelvic Floor

The occurrence of pelvic floor dysfunction in athletes is well documented, and includes both urinary and fecal incontinence in athletes who participate in high-impact sports. (Bo, 2004; Nygaard, 2011; Vitton et al., 2011) Even in women who have not experienced childbirth, urinary incontinence is a common condition. (O'Halloran et al., 2012) Pelvic pain in athletes is also common, with diagnoses ranging from abdominopelvic pain, labral tears, groin injuries, sacroiliac joint pain, coccyx pain, and pubis symphysis pain. Integration of pelvic floor evaluation and rehabilitation concepts are not, however, common components of sports medicine.

The lumbo-pelvic and hip complex is intimately related to pelvic floor function by way of musculoskeletal stability, mobility, and function. Too much tension can cause compression and pain, whereas weakness or underutilization of the pelvic muscles for stability and strength can lead to issues of pain as well as incontinence. The pelvic floor can often be implicated when there is functional limitation in bowel, bladder, and sexual health as well, yet athletes are not typically asked about these issues. In general, many people are too shy or embarassed to bring up concerns such as genital pain or difficulties with daily function related to bladder and bowel health.

This course is designed to bridge the gap between pelvic floor therapists and sports medicine/musculoskeletal practitioners; we will examine the role of the pelvic floor and pelvic girdle in relation to the hip and spine of the athlete, as well as looking at gender specific issues the athlete may have in relation to assessment and rehabilitation of this region. The goals are to provide participants with an insight into the pivotal role of the pelvic floor in relation to sports injuries and musculoskeletal dysfunction, consider differential diagnoses and an evidence-based approach to treatment and resumption of the athlete’s chosen sport.

Audience:

This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

Prerequisites:

None

References

Bø, K. (2004). Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Medicine, 34(7), 451-464.

Nygaard, I. E. (1997). Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female Olympians. Obstetrics & Gynecology, 90(5), 718-722.

O'Halloran, T., Bell, R. J., Robinson, P. J., & Davis, S. R. (2012). Urinary Incontinence in Young Nulligravid WomenA Cross-sectional Analysis. Annals of Internal Medicine, 157(2), 87-93.

Vitton, V., Baumstarck-Barrau, K., Brardjanian, S., Caballe, I., Bouvier, M., & Grimaud, J.-C. (2011). Impact of high-level sport practice on anal incontinence in a healthy young female population. Journal of Women's Health, 20(5), 757-763.