Relationship between foot flexibility and urinary incontinence in nulliparous varsity athletes

OBJECTIVE: To explore the relationship between urinary incontinence in elite nulliparous athletes and force absorption on impact, as assessed by foot arch flexibility. METHODS: One investigator measured medial longitudinal arch height in two gait stances (neutral and maximally dorsiflexed ankle positions) in 47 female varsity athletes representing five sports. Each athlete completed a questionnaire about urinary incontinence prevalence. We compared the change in arch height between the two gait stances with the prevalence of urinary incontinence. RESULTS: There was a statistically significant association between decreased foot flexibility and urinary incontinence; the mean percent change in arch height was 8.94 +/- 0.08% (standard deviation) in incontinent women and 13.70 +/- 0.09% in continent women (P = .03). CONCLUSION: How impact forces are absorbed may be one potential etiology for stress incontinence. An improved understanding of how impact forces are transmitted to the pelvic floor could provide important information about potential preventive interventions for urinary incontinence and other pelvic floor disorders, such as genital prolapse.