Stress urinary incontinence is a surprisingly common, though rarely talked about, problem that affects many girls and women. It refers to any accidental leaking of urine, specifically during a certain activity like coughing, sneezing, or laughing. So, in other words, laughing so hard you pee. Stress incontinence is common during other activities, too – like jumping and landing, for example. So it’s no surprise that female athletes who participate in high-impact sports, such as gymnastics and cheerleading, have an even higher rate of stress urinary incontinence.
In fact, one survey found that over 25% of female athletes who competed in high-impact sports reported some type of urinary incontinence, and 15% of those athletes reported that their urinary incontinence had a negative impact on their social life and desire to play sports. Even more importantly – over 90% of the athletes had never told anyone about their problem.1 It’s sad, though not surprising, that many girls don’t want to talk about their incontinence. It can be uncomfortable to talk about. But understanding why something happens is the first step to making sure it doesn’t happen again. So – let’s talk.
Let’s use tumbling in gymnastics and cheerleading as an example: Hitting the ground during a tumbling pass puts forces up through the joints in our legs and spine, and our abdominal cavity. We contract our abdominals and hold our breath to stabilize our spine and protect our organs from being jostled around. This increases the pressure in our abdominal cavity, which does the job of protecting our spine and organs, but pushes down on our bladder and the muscles of our pelvic floor.
The muscles of our pelvic floor are located in the bottom of the pelvis like a hammock. Their role is to support our organs and control bladder and bowel urges. In other words, they help us make it to the toilet. However, when we increase the pressure in our abdomen dramatically, like when we hold our breath when we land a tumbling pass, we essentially push urine out of the bladder and have so much force on the pelvic floor muscles that they don’t get a chance to contract to stop the urine from leaking.
When hitting the ground during a tumbling pass, or any other high impact activity, it’s important to “brace” your pelvic floor for the impact. To do this, exhale as you tighten the pelvic floor muscles and abdominals. This way, there will not be as much pressure down on the bladder and the pelvic floor muscles will be pre-contracted so they can handle any increase in pressure. Athletes participating in high impact sports need pelvic floor muscles that are stronger than the typical athlete’s. Therefore, pelvic floor muscle training can be beneficial, as well.2 Don’t know how to contract your pelvic floor muscles? Don’t worry – you’re not alone! Schedule a physical therapy evaluation or Wellness Visit with us today! For more information on injury prevention in high impact sports, check out our recent blog on injury prevention in cheerleading. Or if you’d like to learn more about the pelvic floor, check out our recent post on post-partum physical therapy. Have more questions? Reach out to us anytime at firstname.lastname@example.org!
Jess Danahy, PT, DPT