Prevalence and normalization of stress urinary incontinence in female strength athletes.

Mahoney K, Heidel RE, and Olewinski L. J Strength Cond, 2023 [epub ahead of print].

Full Text Freely Available

Take-Home Message

Seven out of 10 female strength training athletes report stress urinary incontinence (SUI) in some aspect of their life. However, less than 2 in 10 athletes are talking to their doctor or seeking treatment for SUI.


Highly intense physical activity can increase the chance of SUI, an involuntary leakage of urine due to increased intra-abdominal pressure. Up to 2 in 5 women may experience SUI throughout their lifetime, which can negatively impact an individual’s quality of life. Pelvic floor training can treat SUI. While female strength training athletes may be at greater risk for SUI, it remains unclear how many of these athletes experience SUI and seek treatment, as well as how they would prefer to learn about SUI.   

Study Goal

The researchers performed a cross-sectional study to assess female strength training athletes’ understanding and normalization of SUI, including how frequently female strength training athletes sought treatment for SUI. 


The researchers developed a novel survey, which was expertly reviewed, to share on various social media platforms. The survey asked respondents about demographic information, risk factors for SUI, experience with SUI, preferred sources of information about SUI, and if the respondent had sought treatment for SUI. Survey respondents were women > 18 years of age who self-identified powerlifting, weightlifting, or strongman as their primary activity.  


Among 425 respondents, 69% reported experiencing SUI in some aspects of their life. Among athletes who experienced SUI, 61% reported first experiencing SUI after they started their sport. About two-thirds of athletes thought SUI was a normal part of their sport. Only 17% of respondents indicated they had spoken to their doctor about SUI, and 9% sought treatment. Almost 30% of respondents indicated they sought advice about SUI from videos and articles on the internet, 23% spoke with friends, and 13% talked to their coach about SUI.


Overall, the results of this study indicated that SUI is common in female strength training athletes, and most see it as a normal part of their sport. However, very few athletes are engaging the healthcare system to address their SUI. It would be interesting to see this study repeated by asking athletes to complete the survey at competitions because it’s unclear if women with SUI were more likely to complete the online survey. Hence, the online survey may overestimate how many women have SUI, but the answers about engaging the healthcare system and where they seek advice are likely still informative.

Clinical Implications

Clinicians working with athletes at high risk for developing SUI should educate athletes about effective treatments. Educating strength and conditioning coaches about SUI and the available treatments may also be helpful.

Questions for Discussion

How do you talk to your athletes about SUI? Have you noticed other athletes having a high rate of SUI?

Written by Kyle Harris
Reviewed by Jeffrey Driban

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