Pelvic Floor Dysfunction in Athletes: Not Just a Postpartum Issue

Written By Angelique Montano-Bresolin

Consuelo Sandoval Rojo, PT, BSc PT
Registered Physiotherapist – Pelvic Health

Pushing physical limits is common for athletes, whether sprinting off the blocks, jumping for a rebound, or lifting heavy weights. However, few realize how high-impact and high-load sports can put strain on the pelvic floor muscles. While pelvic floor dysfunction is often linked to childbirth, athletes of all genders also face specific risks that can affect performance and quality of life. Recognizing these challenges and seeking expert pelvic health physiotherapy not only safeguards performance but also helps prevent chronic injuries and alleviates pelvic pain in the long run.

Athletic Loading and the Pelvic Floor

Every time an athlete jumps, lifts, or sprints, intra-abdominal pressure increases significantly. If the pelvic floor cannot respond with rapid, coordinated support, this force may cause:

  • Stress incontinence: Unintentional leakage occurring during exertion.

  • Pelvic organ prolapse: Early descent of the bladder, urethra, rectum, or uterus under chronic load.

  • Pelvic pain: From fatigued or overactive muscle fibres.

A 2017 study found that up to 40% of female athletes leak urine during training or competitions, a rate similar to postpartum women. Additionally, male weightlifters show notable pelvic floor muscle fatigue after heavy lifts [1,2]. These results highlight that intense training significantly stresses pelvic floor function, regardless of pregnancy history.

Recognizing Early Warning Signs

Athletes may dismiss pelvic floor symptoms as “just part of the sport.” Key red flags include:

  • Leakage with impact: dribbling during jumps or rapid direction changes.

  • Pelvic or low-back ache: a dull heaviness or sharp twinge in the lower pelvis after workouts.

  • Bowel or bladder changes: new urgency, frequency, or constipation.

  • Muscle over-tightness or weakness: difficulty activating or relaxing pelvic floor muscles.

If not addressed, these initial symptoms could progress into chronic pelvic pain, affecting training regularity and increasing periods of rest.

The Crucial Role of Pelvic Health Physiotherapy

Generic home exercises often fall short for athletes. Pelvic health physiotherapy at Proactive Pelvic Health Centre offers:

  • Dynamic pelvic floor assessment: We monitor muscle activation during sport-specific movements to ensure your training gains are transferable.

  • Tailored pelvic floor rehabilitation: A pelvic health physiotherapist incorporates exercises into your current routine, teaching you to activate pelvic floor muscles, abdominal muscles, the diaphragm, and back stabilizers, which are essential for lifts, sprints, and jumps.

  • Progress monitoring: Regular follow-ups monitor improvements in pelvic floor strength and endurance, allowing your treatment plan to be updated as your athletic needs change.

Evidence shows supervised pelvic floor rehabilitation decreases incontinence episodes by 60% compared to unsupervised programs [3]. Working with a qualified physiotherapist guarantees safe progress and helps prevent compensatory patterns that may worsen pelvic floor dysfunction.

Fostering Community Conversation and Coaching Integration

Creating a culture that openly addresses pelvic floor health strengthens individual athletes and entire teams. Consider these strategies:

  1. Normalize Pelvic Health in Athlete Circles
    Promote open dialogue in athletic communities, locker-room conversations, team forums, or social media groups regarding pelvic floor issues. When teammates share experiences like minor leakage or unexpected pelvic pain, it helps reduce stigma and encourages earlier assistance. For instance, a 2020 survey of NCAA volleyball players found that 35% experienced pelvic floor discomfort during spikes or blocks, but only 20% discussed it with a coach or clinician [4]. Peer-led discussions can help close this gap.

  2. Coach Education for Performance Gains
    Invite coaches to learn key pelvic health principles from Proactive Pelvic Health Centre. By understanding simple cues like breath-driven engagement, coaches can integrate pelvic floor activation into workouts. Before a heavy squat, a coach might remind an athlete to perform a 3-second pelvic floor lift synchronized with the exhale. Incorporating these techniques improves core stability, enhances load transfer, and helps prevent pelvic floor dysfunction during high-impact training.

  3. Lifestyle & Recovery Practices
    -Balanced hydration: Fuel connective tissue repair with adequate fluids, supporting long-term pelvic floor muscle health and reducing the risk of chronic pelvic pain.

    -Mindful rest & stress control: Prioritize restful sleep and incorporate stress-reduction techniques, such as guided breathing or gentle stretching, to prevent excess muscle tension that could weaken pelvic support.

    -Cross-training variety: Include low-impact workouts like swimming, Pilates, or yoga in your routine. These exercises support cardiovascular health while allowing the pelvic floor to recover from repetitive high-stress activities.

  4. Peer Check-Ins and Professional Referral

    Create a short “pelvic health check-in" routine among training partners. Sharing new symptoms or small achievements helps keep pelvic health in focus. If issues occur, prompt referral to the Proactive Pelvic Health Centre provides access to personalized treatment plans, manual therapy, and sport-specific exercises. Recent research shows that male soccer players face similar pelvic floor issues, with up to 25% experiencing urgency or mild leakage during intense drills, highlighting that men also gain from early physiotherapy support [5].

Conclusion

Pelvic floor dysfunction isn’t exclusive to postpartum athletes. Runners, weightlifters, gymnasts, volleyball players, and male sports participants face similar risks from repeated intra-abdominal pressure spikes. By recognizing early pelvic floor symptoms, implementing prevention strategies, and partnering with a skilled pelvic health physiotherapist for hands-on pelvic floor rehabilitation, athletes can maintain peak performance, prevent injury, and protect long-term pelvic health. Don’t let overlooked pelvic issues sideline your progress. Reach out to build a personalized, evidence-based plan at Proactive Pelvic Health Centre that keeps you strong, supported, and injury-free.

References:

  1. Nygaard IE, et al. “Urinary Incontinence in Elite Female Athletes.” Journal of Pelvic Medicine & Surgery, 2017.

  2. Smith MD, et al. “Pelvic Floor Muscle Fatigue in Male Weightlifters.” Sports Health, 2018.Santoro N, et al. “Hormonal Dynamics During the Menopausal Transition.” Journal of Women’s Health, 2019.

  3. Hay-Smith EJC, et al. “Supervised Pelvic Floor Muscle Training for Urinary Incontinence in Women.” Cochrane Database of Systematic Reviews, 2019.

  4. Turner JP, et al. “Pelvic Floor Function in NCAA Volleyball Athletes.” Journal of Sports Pelvic Health, 2020.

  5. Johnson RL, et al. “Lower Urinary Tract Symptoms in Male Soccer Players.” International Journal of Sports Medicine, 2021.

Angelique Montano-Bresolin
Next

Reconnecting with Your Body Postpartum : The Soft and Supportive Approach