Up for the tackle? The pelvic floor and rugby. A review

Abstract

The pelvic floor and its associated disorders are a unique and often overlooked aspect of women's rugby. This review discusses relevant biopsychosocial considerations specific to the pelvic floor and rugby. Pelvic floor disorders can present at any time across the female lifespan but are more prevalent during pregnancy and postpartum. This is due to the substantial physiological and anatomical changes experienced during pregnancy and vaginal childbirth. Consequently, pelvic floor disorders can impact a player's ability to perform, maintain engagement with, or return to, rugby due to symptoms. Players need to be informed, supported, and guided through focused pelvic floor muscle training to condition the muscles and 'ready' them for the varied demands of rugby. Health and fitness professionals should understand the risk of pelvic floor disorders across the female lifespan and screen players for symptoms when supporting them to maintain or return to rugby. Rugby players who are symptomatic of pelvic floor disorders should be signposted to specialist services and/or resources to manage their symptoms. Once engaging in rugby training, ongoing evaluation of player load tolerance and implementation of individualized strategies to support managing rugby-related loads to the pelvic floor should be considered. Finally, surveillance and research focusing specifically on rugby players and pelvic floor function are needed.

Keywords: female athlete; genital hiatus; incontinence; lifespan; perinatal; return to sport.

FIGURE 1

The female pelvic floor muscles and hiatal areas [Adapted from Cheng et al. (2023), Hiatal failure: effects of pregnancy, delivery and pelvic floor disorders on level III factors, International Urogynaecology Journal].

FIGURE 2

Getting Pelvic Floor ‘Ready’ for Rugby. *These recommendations are based on exercise prescription principles and research on the general population. Research specific to women's rugby players across all ages and levels is needed to better inform this population.