• Colin Liggett

Pelvic Floor Dysfunction in Athletes


Pelvic floor dysfunction is something I see on a daily basis on intake history forms of my athletic clients. It can be easily treated with Sensory Motor Repatterning (SMR) and is completely non-invasive.

Urinary incontinence has prevalence rates between 10% and 55% in 15 to 64-year-old women. The prevalence among young elite female athletes whom have not had children varies between 0% (golf) and 80% (trampolinists) with high impact activities, such as gymnastics and track and field, having the highest prevalence.

Though pelvic floor dysfunction is more prevalent in women, it can often be found in men. Pelvic floor dysfunction can cause lower back pain, incontinence, constipation, difficulty in starting or maintaining urine stream, pain during sex and impotence.

Traditionally, the go-to fix has been performing Kegals to increase the pelvic floor strength. This may be helpful, but it may also have the negative effect of increasing the symptoms. It’s not until the pelvic floor is tested for inhibition (under-activity) versus facilitation (overactivity) that a person should be assigned any form of Kegal (if at all).

In SMR, we consider the pelvic floor an important part of the core along with the transverse abdominus, rectus abdominus, multifid, psoas and quadrates lumborum. Together, they stabilize the trunk and transfer energy from the upper extremities to the lower and vice versa. The pelvic floor muscles move in unison with the diaphragm during breath, both descending while breathing in and ascending while breathing out. See video link below.

https://www.youtube.com/watch?v=dih56AMrTMo

Along with correcting compensation patterns related to the pelvic floor, breathing pattern assessment is a large part of the SMR solution for overcoming pelvic floor dysfunction.

When treating people with a history of pelvic floor dysfunctions, I rarely address the problem directly on the first visit. I treat clients fully dressed, in their gym gear. The initial visit is spent addressing the core, as 9 out of 10 athletes I see have an inhibited core. On the second visit, after checking that the core is firing correctly, we proceed to non-invasive pelvic floor testing. Once specific inhibition and/or facilitation is found in the pelvic floor, we can alter the neural patterning and correct the dysfunction.

References: http://www.ncbi.nlm.nih.gov/pubmed/15233598

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