Urinary incontinence isn’t exactly a topic most people are willing to talk about, but it’s a common pelvic floor disorder that affects many Australian women.
About one in three women across all sports experience symptoms of pelvic floor dysfunction and that rises to about 80 per cent in women who do high impact exercise like gymnastics and trampoline, or sports like weightlifting and powerlifting.
Gymnastics NSW Trampoline head coach and high performance manager Belinda Cox says it’s an area that needs to be addressed.
Belinda Cox oversees the trampoline program at Gymnastics NSW. (ABC Sport: Amanda Shalala)
“Pelvic health education has been non-existent in our current traditional education courses,” she said.
“We’ve been doing a whole lot of education with pelvic floor physiotherapists, where we’ve educated parents, athletes, coaches in what they can do before it becomes a problem.
“And also what we can do if it is a problem in any of their athletes.”
Imogen Florian, 23, is an Australian representative trampoline athlete and while she hasn’t experienced pelvic floor issues herself, she knows it’s a barrier for many.
Imogen Florian says it’s important to have more conversations around women’s health in sport. (ABC Sport: Amanda Shalala)
“It’s super important for our younger athletes coming through the ranks to feel more comfortable within themselves and being able to communicate any issues surrounding incontinence or pelvic health with their teammates, their coaches,” she said.
“Without that, you will see a drop off in participation within sport and we had seen that in previous years.”
Symptoms drive participants away
Senior physiotherapy lecturer at Monash University Jodie Dakic conducted a study of 4,500 Australian women with pelvic floor symptoms while they exercise — it found half of them stopped physical activity because of it.
“If we think about how important it is for women to be active and exercising for their health, and also all the work that we’re putting into trying to engage women and girls in sport … this is a really big, previously unrecognised barrier that we need to make sure we’re supporting women to overcome,” she said.
“And there are a group of women who are experiencing symptoms and continue to exercise with them.
“It can affect how they participate, their performance, and the enjoyment that they get out of playing sport.”
Jodie Dakic (right) says there are treatment options for women who experience symptoms. (Supplied)
Dakic says common symptoms include leaking urine, needing to rush to the toilet, pelvic pain, or chronic constipation. And not enough people are talking about it.
“In elite athletes, less than 10 per cent have told anyone within their support team about their symptoms,” she said.
“A lot of women don’t know what treatment options are available. And then I think there’s an acceptance.
“Whilst these symptoms are really common, they’re not normal. There is something that we can do to help women who are experiencing symptoms.”
“Things such as exercises to strengthen the pelvic floor muscles. Seeing a pelvic floor physiotherapist can help to get an assessment and a treatment of these symptoms.
“And things such as bladder training or looking at your fluid and food intake.
“Even short term modification to exercise to avoid provoking symptoms whilst you’re rehabilitating these muscles can be done and can stop women from having to stop exercising due to their symptoms.”
Anyone can be affected
Imogen Florian and Belinda Cox during a training session at Gymnastics NSW. (ABC Sport: Amanda Shalala)
Pelvic floor disorders can affect anyone, at any age — and while weak pelvic floors are often associated with pregnancy and childbirth, overactive pelvic floors can also be an issue — something Cox is passionate about addressing in gymnastics.
“We’re working really closely with coaches, from high-performance coaches all the way down to our grassroots coaches to really make sure that they’re aware of what is going on, that when the girls ask to go to the bathroom, that we don’t stop them,” she said.
“Making sure they do drink enough rather than tell them just to stop drinking, so all the old myths that we used to have around pelvic floor.
Gymnastics NSW has been getting pelvic floor physiotherapists to provide education to coaches. (ABC Sport: Amanda Shalala)
“In fact one of the biggest myths is the fact that we think that the girls don’t have strong enough pelvic floor.
“We know now, through working with the physios, that it’s the opposite, that the girls are hyper-mobile and in fact, are actually sometimes too strong in their pelvic floor.
“So we need to teach some exercises and work with the physios to learn how to relax better.”
The overriding message is though, while it might be uncomfortable to bring it up — doing so can make a world of difference.