When we think about sports injuries in young athletes, we often think about ankles, knees, or shoulders. But there’s another area that plays a huge role in performance, confidence, and long-term health, and it often goes untreated: the pelvic floor.
Pelvic floor symptoms such as leaking urine, pelvic pain, or pressure are more common in young female athletes than most people realize. These symptoms can be confusing, embarrassing, and often brushed off as “normal.” They aren’t something athletes should have to live with, and help is available.
Pelvic floor dysfunction, specifically urinary incontinence is reported in 18-80% of females, an average of 48% across a wide range of sports. Breaking the stigma and improving early recognition/treatment can make a huge difference for young athletes.
What Is the Pelvic Floor, and Why Does It Matter?
The pelvic floor is a group of muscles at the bottom of the pelvis that:
- Support the bladder, uterus, and bowels
- Help control bladder and bowel function
- Work with the core to support posture, balance, and movement
During sports, these muscles help manage pressure when athletes run, jump, lift, land, and change direction. When the pelvic floor isn’t working well, symptoms can show up both during exercise and daily life.
Common symptoms include:
- Urinary leakage
- Fecal leakage
- Pelvic or lower abdominal pain
- Constipation or straining
- Vaginal or pelvic pressure/heaviness
How Physical Therapy Can Help
Pelvic floor physical therapy focuses on the whole body, not just one area. Treatment may include:
- Breathing and pressure-management strategies
- Core and hip strengthening
- Movement retraining for jumping, landing, and lifting
- Education on bladder habits and hydration
- Support for safe return to sport
When to Reach Out for Help: For Myself, My Child, or Athlete?
Consider talking to a physical therapist, PCP, GYN, or other healthcare provider if an athlete experiences:
- Leaking during sports or daily activities
- Pelvic, lower abdominal, or hip pain
- Feelings of pressure or heaviness
- Ongoing constipation
- Menstrual changes or missed periods
- Fear or avoidance of certain movements
Early support can prevent symptoms from worsening and help athletes stay active and confident!
Why It's Often Missed: The Stigma
Many athletes do not report symptoms because:
- They think leaking or pain is “normal”
- They feel embarrassed or ashamed
- They fear being seen as weak or dramatic
- They feel pressure to “push through” symptoms
Creating a supportive environment, especially from athletic trainers, parents, and coaches can help reduce stigma and encourage early care for greatest results.
Impact on Sport and Daily Life
PFD can affect multiple aspects of an athlete’s performance and well-being, including:
- Lower confidence
- Avoidance of jumping, running, or high-impact movements
- Reduced hydration due to fear of leaking
- Protective movement patterns and inefficient mechanics
- Decreased jump height and slower sprint times
- Increased injury risk
- Sport dropout
Pelvic floor health is directly tied to core stability, force transfer, and movement efficiency.
In addition, hormonal changes during puberty influence tissue elasticity, pelvic support, and muscle function. This can lead to decreased energy availability, resulting in menstrual dysfunction and low bone density. Healthy fueling is crucial for pelvic floor health, performance, and injury prevention.
Starting the Conversation Matters!
Whether you’re an athlete, parent, or coach, helping normalize these conversations can make a lasting difference. Pelvic floor health is part of overall health and it deserves attention just like any other injury or concern.
Rebullido, T. R., Gómez-Tomás, C., Faigenbaum, A. D., & Chulvi-Medrano, I. (2021). The prevalence of urinary incontinence among adolescent female athletes: A systematic review. Journal of Functional Morphology and Kinesiology, 6(1), 12. https://doi.org/10.3390/jfmk6010012
