Can’t Hold It – Assessment of Pelvic Floor Dysfunction in Female Professional Dancers

Prevalence of urinary incontinence and other pelvic floor-related symptoms in female professional dancers

Winder B, Lindegren K, Blackmon A. Journal of Dance Medicine and Science. March 2023; 27(1): 50-55.

Full text freely available

Take home message

Three in ten professional dancers report pelvic floor complaints. Healthcare professionals who work with these individuals should screen for urinary incontinence, educate their patients about urinary incontinence, and develop a plan to refer patients if necessary.

Background

In the general population, pelvic floor-related symptoms such as urinary incontinence (urgency or stress-related) are common diagnoses. At least 1 in 4 female athletes suffer from urinary incontinence. However, we know little about how common it is among dancers and its impact.

Study aim

The authors conducted an online survey to assess the prevalence of pelvic floor-related symptoms within the professional dance community.

Methods

The authors developed an anonymous online questionnaire on several topics, including demographics, back and hip pain, dance training and cross-training, menstruation, pelvic health, oral contraceptive use, and bowel movements. The authors shared the survey via email and social media posts. The study assessed urinary incontinence using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Their target group consisted of professional dancers of at least 18 years old who trained or performed at least 25 hours a week.

Results

A total of 208 female professional dancers between the ages of 18 and 41 completed the survey. Nearly 35% of all participants and 33% of those with no pregnancy history reported urinary incontinence. Of these participants, 32% reported urge-related symptoms, 53% reported incontinence with coughing or sneezing, and 54% reported incontinence with physical activity or exercise. The authors also found that 8% of individuals reported symptoms potentially indicative of pelvic organ prolapse, and 45% reported pain with sexual activity. The authors also assessed menstrual disorders that are evident within the population, with symptoms including irregular cycles, heavy bleeding, amenorrhea and irregularities associated with changes in exercise intensity.

Viewpoints

At least one in three professional dancers suffer from urinary incontinence. Therefore, healthcare professionals who work with professional dancers should screen for pelvic floor dysfunction. These findings are based on people who completed an online survey. Therefore, it can be difficult to say whether these figures over- or underestimate the true prevalence of urinary incontinence. Researchers could follow professional dancers over time to get a better idea of ​​how common urinary incontinence is among dancers. Despite this limitation, these are compelling data because these numbers are consistent with estimates from other female athletes and highlight the need for clinicians to be aware of urinary incontinence in this population. It would be interesting to know if this was the first time they reported symptoms, if they are actively addressing these issues, what their perception of the condition is and if these symptoms affect their performance.

Clinical implications

The prevalence of urinary incontinence among professional dancers is comparable to that among other high-level female athletes. Healthcare professionals who work with professional dancers should educate their patients about urinary incontinence and screen patients to ensure they are promptly referred to a physical therapist, occupational therapist, gynecologist, or urogynecologist if necessary.

Questions for discussion

How often do you screen athletes in your area for pelvic floor dysfunction, and how do you approach this screening process?

How comfortable are you with the referral process or with prescribing a pelvic floor exercise program for individuals reporting possible pelvic floor dysfunction?

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Written by Alexandra Bossi
Reviewed by Jeffrey Driban