Exploring the connection between the hip and pelvic floor in women with exercise-induced urinary incontinence: integrating clinical hypotheses with current evidence.

Symptoms resulting from pelvic floor dysfunction, specifically urinary incontinence (UI), are more prevalent in female athletes than in those who do not exercise. However, female athletes do not often demonstrate the well-accepted impairments commonly associated with UI, such as pelvic floor weakness or atrophy. Additionally, factors such as greater exposure to impact, hormonal fluctuations caused by low energy availability and age-associated changes across the lifespan may negatively affect the passive tissues of the pelvic floor that are necessary to maintain continence. While high-level evidence supports the use of pelvic floor muscle training in the treatment of UI in the general population, there is mixed evidence for its use in the athletic population. To meet the needs of athletes, clinicians have adopted a more regionally interdependent model of care for UI, which relies heavily on hypothesized anatomical and functional synergies of the pelvic floor and the hip. This commentary aims to reconcile existing disparities between current clinical practice trends and available research in this area.