Incontinence in Teenaged Athletes
Hello friends! Most people think that urinary leakage only happens as we get older or after we have babies. While those are common times that urinary leakage starts, it can happen to anyone at any time. In fact, there are many teenaged athletes that have urinary leakage. One study found that more than 25% of female college athletes (who had never given birth) had urinary leakage during their sport.
High-impact sports that involve running and jumping often see urinary leakage. A recent study found that in young volleyball players, up to 75% had some degree of urinary leakage—that means that on a team of 12 players it is likely that 8 of them are having leakage! (Pires, 2020) Other sports that had a high likelihood of urinary leakage were trampolining (72%), soccer (50%), running (45%) cross country skiing (45%), basketball (35%), gymnastics, hockey, and ballet.
Let’s talk about why high impact sports more likely to have athletes with urinary leakage. The pelvic floor muscles act as part of the core and support the pelvic organs. They contract to close off openings to keep pee, poop, and gas in and relax to open and let these out. When the pelvic floor muscles aren’t working properly, they do not provide this support and this can lead to leakage.
One type of urinary leakage is called stress urinary incontinence. This happens when stress (pressure) is placed on the pelvic floor muscles, but the muscles do not counteract the pressure. There are two reasons why this could happen. First, the pelvic floor muscles can be strong but not have an effective precontraction before high impact activities (Bo, 2015). Think about what you do if you know someone is going to punch you in the stomach—you would tighten your abdominal muscles to brace yourself without thinking about it. The same thing happens with your pelvic floor muscles when they are working properly. Right before you jump, sneeze, laugh, etc., the pelvic floor muscles should contract to brace against any pressure that might be put on it. When this doesn’t happen, we often get leakage.
On the other hand, this contraction may be happening, but the muscles might be too weak to withstand the pressure placed on them. Over time, the muscles are overloaded, stretched, and become weak (Bo, 2015). Being an athlete and looing fit does not mean that your pelvic floor muscles are strong and coordinated.
You’re an athlete and you have stress urinary incontinence, so what can we do? Pelvic floor muscle training is the recommended first choice of treatment (Bo, 2015). While you can do this at home, studies have shown that pelvic floor muscle training under the supervision of a skilled therapist is more effective than training at home alone.
A pelvic floor physical therapist is specially trained to evaluate and treat muscle conditions. They can perform a full body assessment (including the back and hips which can contribute to pelvic floor symptoms). They will address you individual issues and tell you what is causing the urinary leakage. Depending on your unique needs, your therapist may suggest the use of internal supports like the Poise Impressa, sea sponges, tampons, or they may recommend that you be fitted for a pessary. Your therapist should also give you an individualized treatment plan to address any weakness, tightness, and incoordination that may be happening.
To learn more about the pelvic floor check out these resources below:
Ask your healthcare provider for a referral to a pelvic therapist.
Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.
Watch our Pelvic Floor Muscle Training Playlist on YouTube
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
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Introduction to Pelvic Floor Impairments in Runners with Amanda Olson PT, DPT, PRPC
Rehabilitation and Gait Strategies for Pelvic Floor Dysfunction in Runners with Amanda Olson PT, DPT, PRPC
Pelvic Floor Rehabilitation Strategies for Common Proximal Orthopedic Running Injuries with Amanda Olson PT, DPT, PRPC
What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.
Written by Emily Reul, PT, DPT
1. Pires T, Pires P, Moreira H, Viana R. Prevalence of urinary incontinence in high-impact sport athletes: a systematic review and meta-analysis. J Hum Kinet. 2020;73:279-288.
2. Bo K, Berghmans B, Morkved S, Van Kampen M. Evidenced-based physical therapy for the pelvic floor bridging science and clinical practice. 2nd edition. 2015.