Analysis: Many Gaelic football and camogie players accept pelvic floor symptoms as normal instead of seeking out the professional help they need
Think problems with your pelvic floor only happen to women after having a baby? Or when you get older? Think again. New DCU research involving 780 female Gaelic games players found concerning figures about how common pelvic floor issues are. We found that 55% experienced stress urinary incontinence, (which is leaking when coughing, sneezing or sprinting), while 54% reported involuntary leakage of gas or stool and 57% presented with sexual dysfunction.
Being older and having previously given birth were indeed factors that increased players' risk of experiencing these issues. This is likely due to age-related changes in the muscle and connective tissues, as well as the impact of menopause. For those who have had children, the weight of the growing baby and pelvic floor changes during pregnancy, alongside labour can also increase the risk of pelvic floor issues.
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From RTÉ Radio 1's Inside Sport, what are the barriers stopping women returning to Gaelic games post childbirth?
But pelvic floor dysfunction was common in active women across all age groups. So why do otherwise healthy active women present with these conditions? High impact activities like repeated sprinting and jumping that are common in sports like Ladies Gaelic football and camogie can place a demand on the pelvic floor muscles, which may aggravate players’ symptoms.
These conditions can affect players both on and off the field. It can impact their quality of life and mental wellbeing, leading to feelings of embarrassment, fear and frustration. But also, negatively influence their sporting performance and contribute to dropping out of sport altogether to avoid an accident in public. This is especially worrying as preventing drop out in women's sport in Ireland is a key priority. Many players believe that these symptoms are part and parcel of the game and accept them as normal, meaning they don’t seek out the professional help they need underscoring the real need for education amongst players.
Unfortunately, when the pelvic floor is brought up in the media, with friends or in the changing rooms, it tends to begin and end with leaking urine, leaving other symptoms out of the conversation. However, the reality of pelvic floor dysfunction goes beyond this, yet stigma continues to silence many players about these common symptoms. For example, 62% reported faecal urgency characterised by an intense need to use the bathroom straight away.
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From RTÉ Radio 1, Chartered Physiotherapist Aoife Ni Eochaidh answers listeners' questions about pelvin floor physiotherapy
This is a real practical concern in the context of women’s sport, as some grounds may lack accessible toilets, and if the bathroom is too far away, or not available to players, this can lead to huge anxiety for the player. Constipation also affected 57% of players. This is concerning because constant straining can cause pressure on the pelvic floor. This can be prevented by staying hydrated, eating enough fibre (kiwis can be a great help!), using a stool to elevate your feet and swapping straining for deep breathing techniques while going to the bathroom.
Athletes in general tend to have poor knowledge of pelvic floor but especially related to sexual dysfunction. One in 10 players reported vaginal tightness, with one potential cause being an overactive or non-relaxing pelvic floor, which can be just as problematic as a weak one. That is why it is vital that players are taught not just how to strengthen their pelvic floor, but also to fully relax their pelvic floor between contractions. A simple way of ensuring this relaxation is to take a deep diaphragmatic breath after each contraction, expanding your waist in all directions.
Just under one in 10 players reported a prolapse sensation, occurring when the pelvic organs shift from their usual position leading to a lump or bulge in the vagina. While this is lower than what has been reported in other recreational athletes, it is important that everyone with these symptoms seeks out care for appropriate treatment.
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From RTÉ Radio 1's Drivetime, new research involving over 400 current female inter-county players has highlighted significant gaps in health supports across Gaelic games.
So what can we do to tackle this and keep female Gaelic games players playing our native sports long-term? Just as we screen players hamstring strength or ACL risk, we should proactively screen players for their pelvic health and refer players with symptoms to specialist women’s health physiotherapists. Pelvic floor training should also be embedded into the strength and conditioning programmes for all women’s teams.
Rather than just telling players to remember to do their Kegel exercises at home, which are commonly forgotten, making this training as part of their routine strengthening programme ensures they are actually done. Learning how to correctly contract and relax the pelvic floor in the training environment can also normalise the conversation and help address and prevent future issues. Alongside this, more awareness and education around both the pelvic floor and pelvic floor dysfunction is needed, not only to challenge the stigma, but highlight the benefits to players of seeking care early.
Pelvic floor issues aren’t an inevitable price to pay for being a woman and playing sport. There are many treatments available, and with the right support, training and education, we can ensure that these issues are not just treatable, but preventable.
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The views expressed here are those of the author and do not represent or reflect the views of RTÉ
