Urinary incontinence in elite women's artistic gymnastics: A qualitative case study of athletes' perspectives and management strategies

Urinary incontinence (UI) is the most common pelvic floor dysfunction in female athletes. This condition not only causes health problems but also reduces quality of life and can limit their athletic careers. The following research questions were posed: What is the perspective of the Spanish national gymnastics team on UI? How does UI influence the performance of their sport? This study aimed to explore the perspectives of a group of artistic gymnasts regarding UI, its impact on their sport, and the strategies they use to manage it. A holistic single case design was used under an interpretive paradigm. Fifteen gymnasts (mean age 18.1, SD 3.56) were recruited from the Spanish national artistic gymnastics team through purposive sampling. Unstructured and semi-structured interviews and researchers' notes were used for data collection. Sociodemographic and clinical data were also collected (Urinary Distress Inventory Short Form, Incontinence Impact Questionnaire Short Form). An inductive thematic analysis identified two key themes: (1) Discovering urinary incontinence (subthemes: ‘onset and perception of UI’ and ‘talking about UI’); and (2) Managing urine leakage (subthemes: ‘impact on athletic performance’ and ‘strategies for addressing UI’). Our results show that UI can affect the athletic performance of female gymnasts and that they lack information and strategies for its prevention and management. These findings may help establish programs for the early detection and management of UI.