Pelvic Floor Health in Young Female Athletes

Young female athletes are often celebrated for their strength, agility, and dedication. They push their bodies to the limit, striving for peak performance in their chosen sports. However, beneath the surface of athletic prowess, a silent struggle can sometimes unfold: pelvic floor dysfunction.

Often overlooked or misunderstood, these issues can significantly impact an athlete's performance, comfort, and overall well-being. It's time to break the silence and shed light on pelvic floor challenges - issues that are very common but not normal - faced by young female athletes and the treatments I’ve used with them that can help.

The pelvic floor is a group of muscles that support the bladder, bowel, and uterus. They play a crucial role in bladder and bowel control, sexual function, and core stability. In young female athletes, the repetitive high-impact activities, intense training regimens, and even societal pressures can contribute to pelvic floor dysfunction.

While it might not be a topic openly discussed in the locker room, these issues are more common than many realize. And studies reveal the impact on athletes. One study found 25% of high school and college athletes experienced incontinence and 90% of those never told anyone. Another study showed that 10% of women admitted to stopping a sport they participated in due to incontinence.

It's important for young female athletes, their parents, and coaches to be aware of the potential signs of pelvic floor dysfunction.  Recognizing these symptoms early is key to seeking timely and effective help. Common symptoms can include:

  • Leakage with activity (stress urinary incontinence): This involves the involuntary loss of urine during activities that increase abdominal pressure, such as running, jumping, coughing, or sneezing. This occurs when the pelvic floor muscles aren't strong enough to counteract the increased pressure on the bladder.

Typical Interventions: Pelvic floor muscle training (Kegel exercises or relaxation), coordination with breathing, core strengthening, bladder retraining techniques, and activity modification.

  • Difficulty with urination (hesitancy, weak stream, incomplete emptying): This can manifest as trouble starting urination, a slow or intermittent stream, or the feeling that the bladder isn't completely empty after voiding. This can be due to overactive or uncoordinated pelvic floor muscles.

Typical Interventions: Relaxation techniques for the pelvic floor muscles, proper breathing exercises, and behavioral strategies to promote complete bladder emptying.

  • Pain with tampon insertion: This discomfort can range from mild to severe and may indicate increased tension or trigger points within the pelvic floor muscles.

Typical Interventions: Manual therapy to release muscle tension, pain management strategies, and education on proper body mechanics.

  • Constipation: Constipation can be linked to pelvic floor muscle imbalances affecting bowel function.

Typical Interventions: Education on proper bowel habits, dietary modifications, and pelvic floor muscle coordination exercises to aid in bowel movements.

  • Feeling like you have to pee all of the time (urinary frequency/urgency): Urinary frequency and urgency involve needing to urinate more often than usual with a strong, sudden urge, which can sometimes be related to pelvic floor muscle hyperactivity or bladder irritation.

Typical Interventions: Bladder retraining techniques, urge suppression strategies, and pelvic floor muscle relaxation exercises.

The good news is that pelvic floor dysfunction in young female athletes is often treatable with pelvic floor physical therapy. We have advanced training in assessing and treating the pelvic floor muscles and related structures. A comprehensive evaluation will involve taking a detailed history, observing movement patterns, and performing an internal and/or external examination to assess muscle strength, coordination, and tension.

Based on the findings, a tailored treatment plan will be developed. This may include:

  • Pelvic Floor Muscle Training (PFMT): This involves learning to correctly contract and relax the pelvic floor muscles to improve strength, endurance, and coordination. This is often more nuanced than simply "doing Kegels" and requires proper technique and individualized programming.
  • Biofeedback: This technique uses sensors to provide real-time visual or auditory feedback on pelvic floor muscle activity, helping athletes learn to control these muscles more effectively.
  • Manual Therapy: This involves hands-on techniques to release muscle tension, address trigger points, and improve tissue mobility in the pelvic floor, hips, and lower back.
  • Core Strengthening: Integrating exercises that strengthen the deep core muscles, which work in synergy with the pelvic floor, is crucial for stability and support.
  • Breathing Exercises: Proper diaphragmatic breathing can help to relax the pelvic floor muscles and improve overall core function.
  • Activity Modification: Guidance on modifying training techniques or activities that may be exacerbating symptoms can be helpful.
  • Education: Understanding the anatomy and function of the pelvic floor, as well as strategies for self-management, is an important component of recovery.

It's crucial for young female athletes experiencing any of these symptoms to seek help, because as I said (and I cannot overstate this) these issues are very common but not normal. Early intervention can prevent these issues from becoming chronic and allow athletes to continue pursuing their athletic goals with confidence and comfort.

By breaking the silence and addressing these unspoken struggles, we can empower young female athletes to thrive both on and off the field.

Tori Popp, PT, DPT, CMTPT, PCES has a special interest in treating athletes wishing to return to peak performance. Schedule an appointment with Tori today by calling or texting 920.729.2982.

Google Review (January 2025):

“I have a hard time opening up with people and going to Tori was a game changer. I was very nervous about opening up with what I have, no one to talk to about going through what I’ve been going through, but she answered all of my questions and didn’t make me feel nervous at all or dumb at all.”

~Emalee

PT Center for Women is one of the only physical therapy centers in Wisconsin that specializes in pelvic pain, pelvic muscle dysfunction biofeedback, and has a board-certified women's health clinical specialist! At PT Center for Women, the care we provide is as unique as every woman. Once you become a patient, our physical therapists design a personalized treatment program for you to help improve function and lessen pain. Our gentle, heartfelt approach to healing allows women to feel calm and comfortable, and pursue a program of care that can change their lives. Our goal is to provide women with a successful outcome for a happier, healthier life.

 

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