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R. Kafri1, M. Cal’e Benzoor1, S. Aloni2, R. Kislev-Cohen2, D. Adler-Portal2, G. Dar3
1Wingate Institute, Institute of Physiotherapy, Ribstein Center for Sports Medicine and Research, Natanya, Israel, 2Wingate Institute, Ribstein Center for Sports Medicine and Research, Natanya, Israel, 3University of Haifa, Haifa, Israel
Background: Judo is physically and emotionally challenging sport, especially for women, known for its high incidences of skeletal injuries as well as high prevalence of urinary incontinence. The increased intra-abdominal pressure amongst female athletes is one of the main causes of these disorders and may harm their sporting potential. Pelvic floor muscles (PFM) play essential role in preventing urinary incontinence by reflexive contraction during physical exertion. Relaxation is an integral part of rehabilitation of injuries and pain, as well as a training tool for whom dealing with physical and mental stress. Few interventional studies have examined effective treatment among young athletes.
Purpose: Examine the effectiveness of treatments combining PFM training for pelvic stability and relaxation techniques among Judo females' athletes.
Methods: Seventeen female Judo athletes who train regularly at the Wingate Institute > 20 hours/ week, mean age 25.9 ±1.9 years, participated in the study. They answered the Pelvic Floor Distress Inventory (PFDI-20) questionnaire, include 3 parts: Urinary Distress, Pelvic Organ Prolapse Distress, and Colorectal-Anal Distress. Participants examined with Trans-abdominal ultrasound (Mindray M5) during resting in crook lying. This examination included assessment of urinary bladder displacement during contraction and coughing. Assessments were performed pre intervention (PRE), immediately after (POST), and 3 months post intervention (POST3) (for long term assessment). Following the PRE assessment, the athletes were asked to contract PFM and cough again with ultrasound Biofeedback to achieve cranial (upward) bladder base displacement.
The intervention included six lessons of 45 minutes, every 2 weeks for 12 weeks, by a specialized physiotherapist in PFM rehabilitation. The lying down, kneeling and standing exercises were chosen, as they resemble Judo positions. During the exercises, participants were instructed to contract PFM while remaining in these positions and whilst transitioning between them. Last 5 minutes, a relaxation whilst lying position was completed every session.
The participants were guided to a 15-minute daily practice of relaxation technique and two exercises. The practice was recorded and transferred to the application developed for this study. Participants recorded their independent exercises in this application.
The intervention included six lessons of 45 minutes, every 2 weeks for 12 weeks, by a specialized physiotherapist in PFM rehabilitation. The lying down, kneeling and standing exercises were chosen, as they resemble Judo positions. During the exercises, participants were instructed to contract PFM while remaining in these positions and whilst transitioning between them. Last 5 minutes, a relaxation whilst lying position was completed every session.
The participants were guided to a 15-minute daily practice of relaxation technique and two exercises. The practice was recorded and transferred to the application developed for this study. Participants recorded their independent exercises in this application.
Results: None of the athletes were able to contract their PFM correctly at PRE time, 65% were able to correctly contract PFM at POST and all of them succeeded at POST3. The PFDI- 20 showed at PRE: 5/16 repot bowel urgency and 6/16 urinary urgency, 6 and 5 (POST), 3 and 5 (POST3) respectively. The results of the PFDI- 20 decreased from 6.17±8.0 (PRE) to 3.86±6.2 (POST), to 2.29±4.3 (PRE - POST3) (p=0.011). The eight participants that practiced 4-6 times a week showed higher significant decrease between PRE to POST compared to 5 participants who practiced 1-3 (i.e., PRE to POST – p=.03, d=.94 and PRE to POST3 p=.05, d=.83)
Conclusions: Teaching and training PFM contraction amongst Judo female's athletes increased their ability to correctly contract PFM which improved their urinary and bowel symptoms.
Implications: Pelvic floor training should be integrated into every female athlete's program training. This might further improve athlete ability in sport and prevent urinary incontinence.
Funding acknowledgements: NO
Keywords:
Sport
Incontinence
Pelvic floor exercise
Sport
Incontinence
Pelvic floor exercise
Topics:
Sport & sports injuries
Musculoskeletal
Pelvic, sexual and reproductive health
Sport & sports injuries
Musculoskeletal
Pelvic, sexual and reproductive health
Did this work require ethics approval? Yes
Institution: Ribstein Center , Wingate ,Israel
Committee: The Center for Sports Medicine and Research Wingate Institute
Ethics number: No 01-2021, June 26th 2021
All authors, affiliations and abstracts have been published as submitted.
