Prevalence of pelvic floor symptoms and their association with lumbopelvic and/or hip/groin pain in professional female athletes (Australian rules football and netball)

OBJECTIVES: To report the prevalence of pelvic floor symptoms and explore their association with lumbopelvic and/or hip/groin pain in professional female Australian rules football (Australian Football League Women's) and Super Netball players. DESIGN: Observational, cross-sectional survey study. METHODS: Australian Football League Women's and Super Netball players aged ≥18 years competing professionally in Australia completed a bespoke online screening questionnaire during pre-season. Questions included: demographics, pelvic health, and self-reported musculoskeletal pain/injury history. Data were analysed descriptively, and logistic regression models assessed the association between pelvic floor symptoms and lumbopelvic and/or hip/groin pain. RESULTS: (SD: 1.6); predominantly nulliparous (95.3%); and played professionally for a median of 4 years (interquartile range: 3). Urinary incontinence was the most prevalent pelvic floor symptom reported (42.1%). Other pelvic floor symptoms included: penetration pain (tampons/intercourse) (15%), urinary frequency (12.1%), bowel urgency (12.1%), nocturia (9.3%), bladder urgency (8.4%), and regular constipation (7.5%). Urinary incontinence was associated with hip/groin pain (odds ratio = 2.66, 95% confidence interval [1.03, 6.86], p < 0.05), but not lumbopelvic pain. No other associations were found. CONCLUSIONS: Although urinary incontinence had the highest prevalence, professional Australian Football League Women's and Super Netball players experience a breadth of pelvic floor symptoms relating to bladder/bowel dysfunction and pelvic pain. Therefore, pelvic health screening for female athletes should examine a broad range of pelvic floor symptoms, beyond urinary incontinence. Our findings also suggest that in female athletes, consideration of pelvic floor function may be important in hip/groin pain assessment, management, and prevention.