Displacement of the Levator Ani Muscle in Continent and Incontinent Female Athlete

Hypothesis / aims of study Physical exercise has been highlighted as a factor of primary prevention and therapeutic support of several chronic diseases [1]. In addition to this, there are many other benefits of regular exercise and training that increases cardiovascular fitness, increases muscle mass and strength, improves physical appearance and neuromuscular coordination, among others. These facts can be used to encourage sedentary women to start exercising regularly. However, exercise has been implicated as a risk factor for onset of urinary incontinence (UI). Recent studies have suggested that there is a surprisingly high incidence of UI in women who have participated in long-term high impact sports [2]. It seems that, mainly, the high impact exercises create a greater increase in intra-abdominal pressure than other athletic activities, leading to a stress urinary incontinence (SUI). For example, some studies refer that 80% of nulliparous elite trampolinists have involuntary loss of urine [3]. The ability to contract the pelvic floor muscles (PFM) is essential to maintain continence during an abrupt increase in intraabdominal pressure. The contraction exercises are the foundation of physical therapy for SUI. However, actually we cannot predict whether the muscle has the ability to contract the PFM in all their portions (puborectalis, pubococcygeus, and iliococcygeus). The aim of this study is to assess the displacement of PFM in different parts of the part of levator ani muscle, under simulated contractions in two synchronized swimming athletes, one healthy and one with SUI.