Journal Club Episode 1: Pelvic Floor Training in Rhythmic Gymnasts

Welcome to Journal Club! I’m Dr. Rachel Selman, DPT, CSCS, CPSS, a physical therapist who focuses on pelvic floor health. You may know of my PT practice from Instagram. Here on YouTube, my Journal Club is a monthly series looking a little deeper at peer-reviewed, published journal articles to see what’s new and surprising in the research about pelvic floor dysfunction and treatments. In this video, we’ll look at a study examining pelvic floor training in rhythmic gymnasts. Study Summary: Pelvic Floor Training in Rhythmic Gymnasts We’ll consider a study titled "Pelvic floor muscle training by competitive rhythmic gymnasts at regular training sessions did not reduce urinary incontinence". The Study Design This cluster randomized control trial included over 200 rhythmic gymnasts across 23 clubs. The intervention group performed one set of 8–12 near-maximum pelvic floor contractions during their warm-ups for eight months, while the control group continued with their usual training. The Findings There was no statistically significant difference in the prevalence of urinary incontinence or how bothersome the athletes felt it was between the two groups. Notably, however, most athletes in the intervention group perceived an improvement in their pelvic floor function, creating a discrepancy between subjective feelings and primary outcome measures. Clinical Implications and Interpretation I think these results do not suggest pelvic floor strengthening is ineffective for athletes, but rather that a generalized approach may be insufficient. Specificity of Demand Rhythmic gymnastics involves high-impact, dynamic movements like jumping and rapid changes in direction, which place unique demands on the pelvic floor. The intervention—a simple, isolated contraction—did not match the functional demands of the sport. Adapting Clinical Practice I’ll plan to progress beyond isolated contractions in my own practice. Future approaches include: Integrating breathing and pressure management as part of a larger system. Exposing the pelvic floor to functional loads, speed, fatigue, and impact. Ensuring the exercise intervention increasingly mirrors the actual demands of the athlete's specific sport. Conclusion I talk about how a study showing no significant effect is not a failure but an opportunity to refine research questions. The core lesson is to use research not just to confirm existing beliefs, but to deepen understanding of dosage, specificity, and how to better match interventions to an athlete's unique problems. ABOUT RACHEL SELMAN Dr. Rachel Selman, DPT, CSCS, CPSS, is the author of Floor It and a nationally recognized physical therapist, strength and conditioning coach, sport scientist, and educator focused on pelvic health, sports medicine, rehabilitation, and athletic performance. She was named the National Strength and Conditioning Association (NSCA) 2026 Personal Trainer of the Year and is certified by the Titleist Performance Institute (TPI). She has published two research papers on pelvic health and offers continuing education coursework for physical therapists, sports medicine professionals, and other providers. Dr. Selman trains and treats athletes at her clinic, Synthesis Physical Therapy, in Charlotte, North Carolina and champions pelvic health for athletes on Instagram @dr.rachelselman. Learn more at synthesisperform.com. Floor It: Using the Pelvic Floor to Power Athletic Performance Explore my groundbreaking guide to leveraging your pelvic floor for stronger sports performance. https://8020books.com/product/floor-it/ Dr. Selman’s physical therapy clinic: https://synthesisperform.com/ Dr. Rachel Selman on Instagram:   / dr.rachelselman   See pelvic floor exercises on Dr. Selman’s Synthesis App: https://synthesis.mvt.so/ #pelvicfloor #pelvicfloorexercises #pelvicfloordysfunction #pelvicfloorpt #kegelexercises #pelvicfloorworkout