When parents think about sports-related injuries, they often picture sprained ankles, knee pain, or pulled muscles. But young female athletes can also experience pelvic floor issues, and the symptoms are frequently overlooked, hidden, or dismissed as a normal part of training.
Urinary leakage, pelvic pressure, constipation, and pelvic pain are not problems reserved for pregnancy or older adulthood. They can affect teenagers and young women, including athletes who have never been pregnant.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles and connective tissues located at the base of the pelvis. These muscles help:
- Support the bladder, bowel, and reproductive organs
- Control urination and bowel movements
- Manage pressure during running, jumping, and lifting
- Coordinate with the diaphragm, abdominal muscles, hips, and back
- Provide stability during athletic movement
During high-impact activities, the pelvic floor must quickly respond to repeated changes in pressure. If it cannot appropriately absorb and manage that pressure, symptoms may develop.
Pelvic Floor Issues Are More Common Than Many Parents Realize
A systematic review found that reported urinary incontinence among adolescent female athletes ranged from 18% to 80%, with an average prevalence of approximately 49%. Rates varied significantly depending on the sport and study, with higher rates frequently reported in activities involving repetitive impact.
Sports that may place greater demands on the pelvic floor include:
- Gymnastics
- Trampoline
- Cheerleading
- Volleyball
- Basketball
- Soccer
- Track and field
- Distance running
- Dance
- Weightlifting
Participating in these sports does not mean an athlete will develop pelvic floor dysfunction. It simply means that repeated jumping, landing, running, bracing, and lifting require the pelvic floor to manage significant and frequent loads.
Signs Parents Should Look Out For
Young athletes may not volunteer this information. They may feel embarrassed, believe their symptoms are normal, or worry that reporting them will affect their ability to participate.
Possible signs of pelvic floor dysfunction include:
- Urine leakage while running, jumping, lifting, laughing, or sneezing
- A sudden or frequent need to urinate
- Going to the bathroom repeatedly before practice or competition
- Avoiding water to prevent leakage
- Wearing pads during sports
- Constipation or straining with bowel movements
- Pelvic, lower abdominal, tailbone, hip, or lower-back pain
- A feeling of pressure or heaviness in the pelvis
- Difficulty relaxing the abdominal or pelvic muscles
- Holding the breath during challenging movements
- Avoiding certain drills, exercises, or events without explaining why
Even a small amount of leakage is worth discussing. It may be common among athletes, but it should not automatically be considered a normal or unavoidable part of sports.
It Is Not Always a “Weak” Pelvic Floor. One of the biggest misconceptions is that every pelvic floor issue is caused by weak muscles. Some athletes have pelvic floor muscles that are overactive or have difficulty relaxing. Others may have strong muscles but poor coordination, timing, endurance, or pressure management. An athlete might brace her abdomen, hold her breath, grip her glutes, or tense her pelvic floor throughout an activity. Over time, this can contribute to pain, difficulty emptying the bladder or bowel, and other symptoms.
How Sports Can Challenge the Pelvic Floor
The pelvic floor does not work alone. It coordinates with breathing, the abdominal wall, hips, feet, and the rest of the body.
For example, when an athlete lands from a jump, her feet, ankles, knees, hips, core, and pelvic floor all help absorb the force. Limited ankle mobility, poor landing mechanics, reduced hip strength, breath-holding, or excessive abdominal bracing may change how that force is managed.
Fatigue can also play a role. An athlete may have no symptoms at the beginning of practice but experience leakage or pelvic pressure after repeated drills because the muscles are no longer responding as efficiently. The answer is not necessarily to stop playing. Instead, the athlete may need help improving coordination, load tolerance, breathing, strength, and movement mechanics.
How Parents Can Start the Conversation
Pelvic health can feel like an uncomfortable subject, especially for teenagers. A calm, matter-of-fact approach can make the conversation easier.
A parent might say:
“Sometimes athletes leak urine, feel pelvic pressure, or have pain during sports. It’s more common than people realize, and you wouldn’t be in trouble or have to feel embarrassed if that happened to you.”
Avoid joking about leakage or calling it normal. Even well-intentioned comments may discourage an athlete from speaking up. Parents should also avoid encouraging athletes to limit water before practices or competitions. Dehydration is not a safe solution for urinary leakage and may negatively affect health and athletic performance.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy for a young athlete begins with a detailed conversation about symptoms, training demands, toileting habits, breathing, and movement.
Treatment may include:
- Breathing and pressure-management strategies
- Hip, core, glute, and lower-extremity strengthening
- Running, jumping, landing, or lifting mechanics
- Pelvic floor coordination and relaxation
- Bladder and bowel habit education
- Mobility exercises
- Gradual return to symptom-free training
Care should be individualized and age-appropriate. An internal pelvic floor examination is not automatically required, and any evaluation or treatment should be clearly explained and performed only with appropriate consent.
When Should an Athlete Be Evaluated?
Consider speaking with a pediatrician, sports medicine provider, or pelvic floor physical therapist if symptoms:
- Happen repeatedly
- Cause pain or embarrassment
- Affect hydration habits
- Interfere with training or competition
- Lead the athlete to avoid activities
- Are accompanied by blood in the urine or stool, recurrent infections, significant abdominal pain, or unexplained weight or menstrual changes
Pelvic floor symptoms do not mean a young athlete is unhealthy, damaged, or unable to continue her sport. Early support can help her understand her body, improve movement strategies, and participate with greater confidence. Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]