Know your exercise: abdominal curls, incorrect pelvic-floor muscle training and urinary incontinence

This study examined pelvic-floor muscle activity and bladder position during abdominal exercises.

Researchers concluded that a large proportion of women were unable to correctly perform pelvic-floor muscle training. In addition, abdominal curls were found to increase strain on the pelvic-floor, and may contribute to urinary incontinence.

Pelvic-floor muscle training is often the first, and most commonly used, treatment for stress urinary incontinence. It is important that the timing and intensity of pelvic floor muscle activation is done correctly. Previous studies have reported that incorrect pelvic floor muscle activation can worsen symptoms of stress urinary incontinence. Some types of exercise have also been found to increase the risk of involuntary urine leakage. This study examined pelvic-floor muscle activation, as well as bladder position, during abdominal exercises.

Ninety women (with and without urinary incontinence) were asked to perform abdominal curl exercises and pelvic-floor muscle contractions during an ultrasound exam. Muscle activity and bladder position were assessed by ultrasound. Participants also completed a questionnaire on urinary function and symptoms.

As identified by ultrasound, 25% of women were unable to correctly perform a lifting pelvic-floor muscle contraction. There was no difference in the performance of pelvic-floor muscle training between women with and without urinary incontinence. Only 70% of women with stress urinary incontinence contracted the pelvic-floor muscle correctly. However, being able to correctly contract the pelvic-floor muscle was not associated with a reduced risk of urinary incontinence.

Ultrasound also revealed that the base of the bladder was pushed downward (onto the pelvic-floor) during abdominal curl exercises in all women (100% of cases). Over time, this strain has the potential to cause pelvic-floor weakness and increase the risk of urinary incontinence. Women who experienced childbirth in the past showed increased base-of-bladder motion during abdominal curls.

Abdominal curl exercises may be a risk factor for stress urinary incontinence. In addition, pelvic-floor muscle training is often performed incorrectly, which may contribute to increased symptoms or treatment failure.

Consult with a professional on how to correctly perform physical activities to strengthen pelvic floor.