Introduction: Exercise can stress the pelvic floor muscles. Numerous women experience urinary incontinence while exercising or competing in sports. This study investigated pelvic floor muscle strength, urinary incontinence, and knowledge in contracting pelvic floor muscles among female athletes and untrained women.

Materials and methods: This was a prospective case-control study measuring pelvic floor muscle strength using vaginal pressure meas­urement. Participants answered questions regarding general health, urinary incontinence, and knowledge on pelvic floor muscles. Partici­pants were healthy nulliparous women aged 18-30 years, athletes and untrained women. The athletes had competed in their sport for at least three years; including handball, soccer, gymnastics, badminton, BootCamp and CrossFit.

Results: The women were comparable in age and height. The athletes (n=18) had a body mass index (BMI) of 22.8 kg/m² vs. 25 kg/m² for the untrained (n=16); p<0.05. The athletes trained on average 11.4 hours/week while the untrained women participated in some activity on average for 1.3 hours/week; p<0.05. Mean pelvic floor strength was 45±2 hPa in the athletes vs. 43±4 hPa in the untrained; p=0.36 for whether the athletes were stronger. Of the athletes, 61.1% experienced urinary incontinence (n=11) compared with 12.5% of the untrained women (n=2); p<0.05. Incontinence usually occurred during high intensity exercise. The athletes were more knowledgeable about the pelvic floor muscles; p<0.05.

Conclusion: There was not a significant difference in the strength of pelvic floor muscles of athletes and untrained women. This suggests that pelvic floor muscles are not strengthened during general training but require specific exercises. This holds especially for football, handball and sports with high physical intensity. Coaches need to pay special attention to training and strengthening women's pelvic floor muscles to reduce the occurrence of urinary incontinence.

Comparison of pelvic floor muscle strenght in competition-level athletes and untrained women

Table I Description of participating women

Table II The number of women and hours per week of training cross-classified by sport.

Table III Results of pelvic floor muscle strength measurements

Table IV The women's responses on urinary incontinence and knowledge of the pelvic floor muscles

Table V Number of women with urinary incontinence, cross-classified by sport

Table VI Logistic regression results for probability of urinary incontinence as a function of observed characteristics

Table VII Logistic regression results for probability of urinary incontinence as a function of observed characteristics with athletes classified by sport