Pelvic floor dysfunction (PFD) is a common issue among female athletes, often presenting as urinary incontinence (UI) and pelvic organ prolapse (POP). Campbell et al. (2023) reported a high prevalence of UI (70%) and POP (18%) among women engaged in elite sports and high-impact exercise. Regular pelvic floor exercises are the gold standard for managing UI and PFD (Bø, 2023). However, it remains unclear whether Saudi female athletes incorporate these exercises into their training.

Given the unique cultural context of Muslim societies, particularly in Saudi Arabia, comparing findings with Western studies is challenging due to differing societal norms and attitudes toward women's health and fitness. This study is the first to explore awareness of pelvic floor muscles (PFMs) among Muslim female athletes, providing new insights into this understudied population. The primary aim is to assess Saudi female athletes’ knowledge and understanding of PFM exercises and PFD, with a focus on their impact on athletic health and performance.

This cross-sectional study was conducted in 2024, targeting Saudi female athletes in Riyadh engaged in sports involving high-intensity activities like weightlifting, running, and jumping. A total of 79 participants were surveyed using Arabic versions of the PIKQ (UI and POP) and a PFM knowledge questionnaire. These tools assessed the participants' awareness of PFDs, with data analysed using descriptive statistics, T-tests, and ANOVA. Ethical approval was obtained, and confidentiality was maintained throughout the study.

The results showed that female athletes engaged in weightlifting have a higher level of awareness of PFD compared to the other group (p = 0.022). All the other athletes had a poor level of knowledge of PFM anatomy and its importance in the prevention of PFD. However, athletes engaged in weightlifting have significantly better PFM knowledge, p> 0.022. In terms of training frequency, it was estimated that participants who attended exercises more than twice a week will have better knowledge, but the results showed no significant difference was observed based on training frequency, p=0.352. Furthermore, it was estimated that participants who have been doing exercises for more than one year will have better knowledge of PFD, but there is no significant difference observed based on years of experience. The results are summarised in the attached image.

The study highlights a critical lack of awareness about pelvic floor dysfunction (PFD) among Saudi female athletes, with significant differences based on training type but not frequency or experience. This limited knowledge may contribute to conditions such as pelvic organ prolapse and urinary incontinence. As the first study of its kind, these findings emphasize the need for culturally tailored educational programs to integrate pelvic floor muscle exercises into female athletes' training.

This study is the first to investigate PFM awareness among Saudi female athletes, revealing novel findings and significant gaps in knowledge. Integrating PFM education into training programs is essential for enhancing athletic performance, reducing PFD prevalence, and improving overall quality of life. Future research should explore longitudinal interventions and cultural influences on PFM awareness.

Campbell KG, Batt ME, Drummond A. Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey. Int Urogynecol J. 2023 Oct;34(10):2429-2437.
Bø, K. (2023). Pelvic floor muscle training for stress urinary incontinence. Evidence-Based Physical Therapy for the Pelvic Floor-E-Book: Evidence-Based Physical Therapy for the Pelvic Floor-E-Book, 202.