The health conditions linked with high-impact female sports can be grouped into two categories: those related to pelvic floor weakness and those related to overtraining.
Pelvic Floor Dysfunction
The muscles of the pelvic floor stretch between the bones of the pelvis and act as a harness for the organs within the abdomen. When the muscles are weak, pain, urinary incontinence and bowel incontinence can result. These latter two occur because the muscles fail to properly support the bowels and bladder.
In a survey of 311 female triathletes, one third of respondents reported at least one sign of pelvic floor dysfunction. Of those who exhibited such signs, 37% reported urinary incontinence (55% of those who had given birth and 23% of those who had not). Bowel incontinence was reported by 37% as well. Finally, 18% reported pelvic girdle pain.
High-impact sports are associated with pelvic floor dysfunction because they generally involve increased abdominal pressure; if the pelvic floor is not sufficiently strong to handle this pressure, symptoms of dysfunction can result.
Overtraining can cause a group of conditions knows as the “female athlete triad”: low energy, menstrual irregularities and low bone mineral density. The link between the three is the impact of overtraining on estrogen. Women who overtrain experience a reduction in estrogen levels similar to what occurs during menopause.
A quarter of the survey respondents in the above study exhibited at least one condition of the female athlete triad: 22% had low energy; 24% had menstrual irregularities; 29% had low bone mineral density.
Preventing pelvic floor dysfunction and a hypoestrogenic state requires proper strengthening of the pelvic floor, on the one hand, and a reduction of high-impact training on the other. Kegels are the exercise of choice for strengthening the pelvic floor muscles, and have the convenience of being doable just about any time, anywhere. Reducing training duration, frequency and/or intensity may be a hard sell to triathletes, but overall health is severely jeopardized by overtraining.
For more on the survey into health conditions prevalent among female triathlete, see www.sciencedaily.com.