Pelvic floor dysfunction is a common yet rarely discussed issue in the sports world. One of the most prevalent conditions is urinary incontinence, affecting about one in three women across all sports. In high-impact disciplines like gymnastics, trampoline, weightlifting, and powerlifting, the incidence can be as high as 80 percent.

Belinda Cox, Gymnastics NSW Trampoline head coach and high-performance manager believes more awareness is needed.

"Pelvic health education has been non-existent in our current traditional education courses," she told ABC News. To address this gap, she and her team have been working with pelvic floor physiotherapists to educate athletes, coaches, and parents on how to prevent issues before they arise and manage them effectively if they do.

For elite trampoline athlete Imogen Florian, 23, encouraging open conversations about pelvic health is essential for supporting younger athletes.

"It's super important for our younger athletes coming through the ranks to feel more comfortable within themselves and being able to communicate any issues surrounding incontinence or pelvic health with their teammates, their coaches," she said. Without these discussions, she warns, participation in sports may decline, as has been seen in previous years.

Research from Monash University senior physiotherapy lecturer Jodie Dakic highlights how serious this issue can be. In a study of 4,500 Australian women experiencing pelvic floor symptoms while exercising, half reported that their condition led them to stop physical activity altogether.

"If we think about how important it is for women to be active and exercising for their health, and also all the work that we're putting into trying to engage women and girls in sport … this is a really big, previously unrecognised barrier that we need to make sure we're supporting women to overcome," Dakic said. Even for those who continue training, their performance, participation, and overall enjoyment of sport may be affected.

Common symptoms include urinary leakage, frequent urges to urinate, pelvic pain, or chronic constipation, yet many athletes remain silent.

"In elite athletes, less than 10 per cent have told anyone within their support team about their symptoms," Dakic said. Despite how widespread these issues are, they are not inevitable. Solutions such as targeted pelvic floor exercises, physiotherapy assessments, bladder training, and dietary adjustments can help. Even short-term modifications to training can prevent symptoms from worsening and allow athletes to continue their sport without discomfort.

While weak pelvic muscles are often linked to pregnancy and childbirth, overactive pelvic floors can also be a problem. Cox is working to dispel myths within gymnastics coaching.

"We're working really closely with coaches, from high-performance coaches all the way down to our grassroots coaches to really make sure that they're aware of what is going on, that when the girls ask to go to the bathroom, that we don't stop them," she said. She also stresses the importance of hydration, pushing back against outdated advice to restrict fluids as a way to manage symptoms.

"In fact one of the biggest myths is the fact that we think that the girls don't have strong enough pelvic floor. We know now, through working with the physios, that it's the opposite, that the girls are hyper-mobile and in fact, are actually sometimes too strong in their pelvic floor. So we need to teach some exercises and work with the physios to learn how to relax better."