High Impact Athletes and Urinary Incontinence

Imagine flying through the air—thinking about your position, your landing, whether someone will catch you—when you suddenly begin leaking urine while wearing skin-tight clothing made of thin material for the audience, teammates and judges to see. This is the embarrassing reality for many high-impact athletes during practice and performance.

does urinary incontinence affect anyone?

Urinary incontinence (UI) is typically thought of as a condition that only affects the older population or women who have recently given birth, but it is not uncommon for young athletes as well. In fact, athletes are 2-3 times more likely to report UI in daily life activities than non-athletes. A 2018 research study found that 61% of elite teenage gymnasts reported UI. The most common reason for UI in these populations is what is categorized as stress urinary incontinence (SUI), which is the leakage of any amount of urine during high-impact activities like sports, sneezing, or coughing. Due to the inherent sensitivity surrounding UI, many athletes do not report these symptoms, instead opting to adjust their performance or clothing to avoid urine leakage. While researchers have found that gymnasts have the highest prevalence of SUI, other high-impact athletes experience SUI as well, with basketball (42%), football (50%), tennis (50%), and volleyball players (58%) also demonstrating high prevalence. 

What causes urinary incontinence?

There are a wide variety of theories about why SUI is so common in this population. Studies have shown that athletes in high-impact activities—like dance, gymnastics, and cheerleading—have a higher prevalence of SUI than athletes involved in low-impact activities. This can be due to the intense forces involved in hitting the ground while jumping and the increased core strength needed for lifts, tight flips, and jumps. When landing during high-impact activities causes a downward pressure, and athletes do not have a strong enough pelvic floor to overcome this pressure, UI can occur. This may explain why higher-impact activities are associated with increased risk of UI. Interestingly, 15% of competitive swimmers also experience SUI, even though they experience no increased forces from hitting the ground hard. Instead, this may be caused by the increased pressure of the water around them.

What else contributes to young athletes with Urinary incontinence?

The adolescent experience brings its own set of challenges, but these athletes also have the pressure of balancing grades, training, practice, and performance, on top of their bodies developing at a fast rate. For many athletes, especially females, other healthy habits or priorities may take a backseat during adolescence; this can be where the “female athlete triad” occurs. Defined by low weight or insufficient eating, menstrual disturbances or absence of a period, and low bone density, the female athlete triad (which can occur in men as well) can develop for a variety of reasons, including eating disorders, poor eating habits due to stress or time availability, or low self-esteem. The female athlete triad, most specifically low body weight, has been found to be related to higher prevalence of UI.

can Physical therapy help with Urinary incontinence?

Physical therapy has been shown to be an effective treatment for stress urinary incontinence. Physical therapists provide education to the athletes on the anatomy and function of their pelvic floor, teach strategies to overcome the pressure from hitting the ground hard when landing, and train the pelvic floor muscles to contract more effectively during high-impact activities. There is strong evidence that strength training for the pelvic floor can treat and prevent future UI non-invasively, safely, and efficiently, with minimal financial cost to the patient. Most importantly, physical therapy provides a safe and comfortable environment for young athletes to improve their symptoms, performance, and self-esteem.

The dedicated pelvic floor therapists at the DMU Clinic are not only specially trained to help with pelvic floor disorders such as incontinence, but they are also knowledgeable about athletics, sports, and the performing arts such as dance, gymnastics, and musical performance. They work tirelessly with their patients to help them meet their goals of being able to return to the activities they love! For more information, visit the Des Moines University Physical Therapy Clinic website or call 515-271-1717.

Disclaimer: This content is created for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition.

Courtney Harms

Courtney Harms is a DPT student originally from Rockton, IL. She enjoys hiking, kayaking, dancing, and playing board games. She hopes to practice in SW Wisconsin/SE Minnesota where she can provide holistic physical therapy care to a wide variety of patients while enjoying the natural beauty of the Mississippi River region.

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