The female athlete population has a high prevalence of pelvic floor dysfunction (PFD), putting them at increased risk for urinary incontinence.[1,2] Very few studies have investigated the use of a home exercise program (HEP) to prevent PFD in sports, particularly running.[3] While PFD prevalence is high, the advocacy for preventative recommendations is low; most incontinent women irrespective of age report never speaking about their condition to anyone and having no knowledge of preventative measures.[1,4] This study investigated whether a 1-time educational workshop on pelvic and core health and a generalizable HEP had positive changes in reported PFD at 2-week and 6-month follow-ups for female runners.

A pilot study was conducted where participants attended a workshop comprised of education about the pelvic floor and core muscles and about the pelvic health and orthopedic-based HEP of breathwork, posture, strengthening, and stretching of the hips, back, trunk and pelvic floor muscles. A blinded assessor evaluated overall core strength (CoreFirstR Strategy, using 0-5 scale) pre- and post-workshop. Questionnaires evaluated the frequency of leakage during jumping, landing from jumping, running, during competition, approaching the finish line, during other sports, coughing, sneezing, heavy lifting, walking to the bathroom, sleeping, and hearing running water. Time points were baseline (i.e., pre-workshop) and 2-week and 6-month follow-up. Paired samples t-tests and McNemar’s tests were used for comparisons.

A total of 22 female participants (age: 44±11 years; BMI: 22±2 kg/m2) enrolled in the study and completed the 2 week and 6 months follow up. Overall core strength improved after the workshop by 2 stages. HEP adherence was 86% and 55% through two-weeks and six- months, respectively. Significant improvements in the incidence of reported incontinence were found after two weeks for jumping (41 to 5%, p=.006), landing from jumping (46 to 9%, p=.003), coughing (64 to 14%, p=.001), sneezing (59 to 14%, p<.001), and walking to bathroom (59 to 32%, p=.016), and after six months for coughing (64 to 14%, p=.001), and sneezing (59 to 23%, p=.006).

Educating competitive female runners and providing a generalized HEP focused on pelvic health had immediate positive changes in overall core strength and PFD at 2 weeks, which were maintained through 6 months. Future studies are needed with larger cohorts and randomized controlled study designs.

PFD is reported as a barrier to women's participation in sport and fitness activities and may be a threat to women's health, self-esteem, and well-being.[3,4] Currently, there are no standard recommendations or training programs for the prevention of PFD in female athletes.[5] Providing a 1-time in-person workshop focused on pelvic health education and pelvic health and /orthopedic exercises can have immediate, and long-lasting improvements, in competitive female runners' core strength and PFD.

Kinder, Jennifer PT, DPTSc; Cheuy, Victor PhD; Davenport, Todd E. PT, DPT. Integrating Pelvic Health and Orthopedic Programs to Treat Incontinence at the Community Level for Female Runners: A Pilot Study. Journal of Women's & Pelvic Health Physical Therapy 47(3):p 191-202, July/September 2023. | DOI: 10.1097/JWH.0000000000000271
Teixeira RV, Colla C, Sbruzzi G, Mallmann A, Paiva LL. Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis. Int Urogynecol J. 2018;29(12):1717–1725. doi:10.1007/s00192-018-3651-1.
Sorrigueta-Hernández A, Padilla-Fernandez BY, Marquez-Sanchez MT, et al. Benefits of physiotherapy on urinary incontinence in high-performance female athletes. Meta-Analysis. J Clin Med. 2020;9(10):3240. doi:10.3390/ jcm9103240.