Rug-pee study: the prevalence of urinary incontinence among female university rugby players

Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes

INTRODUCTION AND HYPOTHESIS

This study was aimed at identifying the prevalence and experience of urinary incontinence (UI) among elite female Gaelic sports athletes in Ireland.

METHODS

A cross-sectional study comprising an anonymous online survey of elite Gaelic sports (Camogie and Ladies Gaelic Football) players. Players were asked about their background information, knowledge of the pelvic floor and practice of pelvic floor muscle training (PFMT), as well as their experiences of UI. The prevalence and severity of UI was assessed using the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI-SF) questionnaire. Logistic regression was used to evaluate risk factors.

RESULTS

A total of 185 players responded (25 ± 5 years) and 95.3% (n = 176) were nulliparous. Forty-one percent (n = 75) of players had learned about PFMT and 13% (n = 24) had performed PFMT within the last 4 weeks. The ICIQ-UI-SF was completed by 159 players, with UI reported by 61.6% (n = 98), 52% (n = 51) of whom experienced stress urinary incontinence (SUI). A significant association was found between UI and longer weekly sporting activity time (OR 1.05, 95% CI 1.002 to 1.008). Parous players were more likely to experience UI (p = 0.025). Jumping and sprinting activities were the most commonly reported triggers, with pre-voiding and wearing protection (liners, pads) the most commonly adopted UI management strategies. Only ten players reported receiving treatment for UI.

CONCLUSIONS

Urinary incontinence is prevalent among this cohort of elite female Gaelic sports athletes. Many players used strategies to manage their UI whereas few sought help for what is a treatable condition. Findings suggest the need for education of players regarding pelvic floor health and treatment options available.

"Male athletes play well to feel good, and female athletes feel good to play well": Attitudes, beliefs, and practices pertaining to perceived sex-related differences in communication and interpersonal approach of strength and conditioning coaches in international women's rugby union

Effective communication and rapport building with athletes are key tenets of coaching. As the majority of empirical evidence to date has adopted an androcentric view of strength and conditioning, a potential knowledge gap exists regarding sex-related differences in physical preparation and coaching approaches. Therefore, this study explored the attitudes, beliefs and practices of strength and conditioning coaches (n = 8; M/F, 6/2) in elite level (international) women's rugby union using semi-structured interviews (mean ±standard deviation duration 59 ± 15 min). The interviews explored differences in coaching practices for elite female rugby players compared to males, with a specific focus on the interpersonal aspects of the athlete-coach relationship. Reflexive thematic analysis was used to generate a rich qualitative dataset. The analysis resulted in the identification of higher order themes: athlete engagement, and interpersonal approach. The coaches in this study consistently perceived important differences between male and female players in factors related to engagement and interpersonal approach. Coaches adopted differing coaching practices for male and female athletes. This study provides important contextual evidence for the understanding of differences in the interpersonal relationships of female rugby players compared to male athletes from the perspective of elite-level strength coaches.

Experience of Playing Sport or Exercising for Women with Pelvic Floor Symptoms: A Qualitative Study

BACKGROUND

Women participate in sport at lower rates than men, and face unique challenges to participation. One in three women across all sports experience pelvic floor (PF) symptoms such as urinary incontinence during training/competition. There is a dearth of qualitative literature on women's experiences of playing sport/exercising with PF symptoms. The purpose of this study was to explore the lived experience of symptomatic women within sports/exercise settings and the impact of PF symptoms on sports/exercise participation using in-depth semi-structured interviews.

RESULTS

Twenty-three women (age 26-61 years) who had experienced a breadth of PF symptom type, severity and bother during sport/exercise participated in one-one interviews. Women played a variety of sports and levels of participation. Qualitative content analysis was applied leading to identification of four main themes: (1) I can't exercise the way I would like to (2) it affects my emotional and social well-being, (3) where I exercise affects my experience and (4) there is so much planning to be able to exercise. Women reported extensive impact on their ability to participate in their preferred type, intensity and frequency of exercise. Women experienced judgement from others, anger, fear of symptoms becoming known and isolation from teams/group exercise settings as a consequence of symptoms. Meticulous and restrictive coping strategies were needed to limit symptom provocation during exercise, including limiting fluid intake and careful consideration of clothing/containment options.

CONCLUSION

Experiencing PF symptoms during sport/exercise caused considerable limitation to participation. Generation of negative emotions and pain-staking coping strategies to avoid symptoms, limited the social and mental health benefits typically associated with sport/exercise in symptomatic women. The culture of the sporting environment influenced whether women continued or ceased exercising. In order to promote women's participation in sport, co-designed strategies for (1) screening and management of PF symptoms and (2) promotion of a supportive and inclusive culture within sports/exercise settings are needed.

Applied sports science and sports medicine in women’s rugby: systematic scoping review and Delphi study to establish future research priorities

Objectives

In part 1, the objective was to undertake a systematic scoping review of applied sports science and sports medicine in women’s rugby, and in part 2 to develop a consensus statement on future research priorities.

Design

In part 1, a systematic search of PubMed (MEDLINE), Scopus and SPORTDiscus (EBSCOhost) was undertaken from the earliest records to January 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, the PRISMA extension for Scoping Reviews, and the PRISMA extension protocols were followed. In part 2, 31 international experts in women’s rugby (ie, elite players, sports scientists, medical clinicians, sports administrators) participated in a three-round Delphi consensus method. These experts reviewed the findings from part 1 and subsequently provided a list of priority research topics in women’s rugby. Research topics were grouped into expert-based themes and expert-based subthemes via content analysis. Expert-based themes and expert-based subthemes were ranked from very low to very high research priority on a 1–5 Likert scale. Consensus was defined by ≥70% agreement. The median research priority agreement and IQR were calculated for each expert-based theme and subtheme.

Data sources

PubMed (MEDLINE), Scopus and SPORTDiscus (EBSCOhost).

Eligibility criteria for selecting studies

Studies were eligible for inclusion if they investigated applied sports science or sports medicine in women’s rugby.

Results

In part 1, the systematic scoping review identified 123 studies, which were categorised into six sports science and sports medicine evidence-based themes: injury (n=48), physical performance (n=32), match characteristics (n=26), fatigue and recovery (n=6), nutrition (n=6), and psychology (n=5). In part 2, the Delphi method resulted in three expert-based themes achieving consensus on future research priority in women’s rugby: injury (5.0 (1.0)), female health (4.0 (1.0)) and physical performance (4.0 (1.0)).

Summary/Conclusion

This two-part systematic scoping review and Delphi consensus is the first study to summarise the applied sports science and sports medicine evidence base in women’s rugby and establish future research priorities. The summary tables from part 1 provide valuable reference information for researchers and practitioners. The three expert-based themes that achieved consensus in part 2 (injury, female health and physical performance) provide clear direction and guidance on future research priorities in women’s rugby. The findings of this two-part study facilitate efficient and coordinated use of scientific resources towards high-priority research themes relevant to a wide range of stakeholders in women’s rugby.

Elite female athletes' experiences of symptoms of pelvic floor dysfunction: A systematic review

INTRODUCTION AND AIMS

Pelvic floor dysfunction (PFD) is a collection of signs, symptoms and conditions affecting the pelvic floor and urinary incontinence (UI) is the most common type of PFD. Recent systematic reviews have indicated a higher prevalence of UI among female athletes compared to their non-athletic counterparts. To date, no review has been undertaken to investigate female athletes' experiences of PFD. This review aims to offer insight and understanding, through aggregation, summary, synthesis and interpretation of findings from studies that report elite female athletes' experiences of symptoms of PFD.

METHODS

The review protocol was registered in PROSPERO in August 2020. A systematic search was conducted in Embase, MEDLINE (OVID), Cochrane Library, CINAHL, PsycINFO and Web of Science for studies published in the English language reporting elite female athletes' experiences of symptoms of PFD. This review included primary research studies that involved elite female athletes of any age or ethnicity.

RESULTS

Of the 1922 citations retrieved in the search, 32 studies met the methodological criteria for data extraction and analysis. Five main themes emerged: (1) triggers for symptoms of PFD; (2) strategies adopted by athletes to manage/mitigate symptoms of PFD; (3) impact on QOL/daily life; (4) impact on performance; (5) impact on emotions.

CONCLUSIONS

The findings of this review suggest a need to further explore the experiences of PFD among elite female athletes and it is suggested that future research should adopt qualitative methods or incorporate a qualitative component.

Urinary Incontinence in Competitive Women Powerlifters: A Cross-Sectional Survey

Background

Urinary incontinence (UI) can negatively affect a woman’s quality of life, participation in sport and athletic performance. The objectives of this study were to determine the prevalence of UI in competitive women powerlifters; identify possible risk factors and activities likely to provoke UI; and establish self-care practices.

Methods

This international cross-sectional study was conducted using an online survey completed by 480 competitive women powerlifters aged between 20 and 71 years. The Incontinence Severity Index (ISI) was used to determine the severity of UI.

Results

We found that 43.9% of women had experienced UI within the three months prior to this study. The deadlift was the most likely, and the bench-press the least likely exercise to provoke UI. ISI scores were positively correlated with parity (τ = 0.227, p < 0.001), age (τ = 0.179, p < 0.001), competition total (τ = 0.105, p = 0.002) and body mass index score (τ = 0.089, p = 0.009). There was no significant correlation between ISI and years strength training (τ = − 0.052, p = 0.147) or years powerlifting (τ = 0.041, p = 0.275). There was a negative correlation between ISI score with having a pelvic floor assessment (η = 0.197), and the ability to correctly perform pelvic floor exercises (η = 0.172).

Conclusion

The prevalence of UI in this cohort was at the upper limit experienced by women in the general population. Women who had undergone a pelvic floor examination or were confident in correctly performing pelvic floor exercises experienced less severe UI.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-021-00387-7.