Sportphysio 2025; 13(01): 27-36
DOI: 10.1055/a-2494-1539
Focus
Vertiefung

Der weibliche Beckenboden im Sport – Teil II: Das Training für den weiblichen Beckenboden

Monika Leitner

Teil 1 zeigte die Komplexität des weiblichen Beckenbodens und die Bedeutung der Beckenboden-Gesundheit allgemein bzw. für die Leistungsfähigkeit der Athletin auf. In diesem zweiten Teil geht es um die praktische Umsetzung dieser Erkenntnisse in eine Beckenbodentraining-Strategie für die körperlich aktive Frau, v. a. bei Vorliegen einer Belastungsinkontinenz.



Publication History

Article published online:
03 February 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Antônio FI, Yamamoto G, Varette K. et al. One in four women with stress urinary incontinence who are taught „the knack“ maneuver adopt this motor pattern while coughing: A prospective interventional cohort study. Neurourol Urodyn 2023; 42 (6) 1290-1298
  • 2 von Arx M, Liechti M, Connolly L, Bangerter C. et al. From stoop to squat: A comprehensive analysis of lumbar loading among different lifting styles. Front Bioeng Biotechnol 2021; 9: 769117
  • 3 Burd NA, West DW, Staples AW. et al. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. PLoS One 2010; 5 (8) e12033
  • 4 Cacciari Lv, Dumoulin C, Hay-Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: A cochrane systematic review abridged republication. Braz J Phys Ther 2019; 23 (2) 93-107
  • 5 Christopher SM, Donnelly G, Brockwell E. et al. Clinical and exercise professional opinion of return-to-running readiness after childbirth: An international Delphi study and consensus statement. Br J Sports Med 2024; 58 (6) 299-312
  • 6 Christopher SM, Gallagher S, Olson A. et al. Rehabilitation of the postpartum runner: A 4-phase approach. Journal of Women’s Health Physical Therapy 2022; 46 (2) 73-86
  • 7 Da Roza T, de Araujo MP, Viana R. et al. Pelvic floor muscle training to improve urinary incontinence in young, nulliparous sport students: A pilot study. Int Urogynecol J 2012; 23 (8) 1069-73
  • 8 Donnelly GM, Moore IS, Brockwell E. et al. Reframing return-to-sport postpartum: The 6 Rs framework. Br J Sports Med 2022; 56 (5) 244-245
  • 9 Dos Santos KM, Da Roza T, Mochizuki L. et al. Assessment of abdominal and pelvic floor muscle function among continent and incontinent athletes. Int Urogynecol J 2019; 30 (5) 693-699
  • 10 Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 04.10.2018; 10 (10) CD005654
  • 11 Edwards K M. Considerations for the postpartum runner. Strength and Conditioning Journal 2020; 42 (1) 45-52
  • 12 Ehrhardt D. Hrsg. Praxishandbuch funktionelles Training I. 2. Aufl.. Stuttgart: Thieme; 2020
  • 13 Ferreira S, Ferreira M, Carvalhais A. et al. Reeducation of pelvic floor muscles in volleyball athletes. Rev Assoc Med Bras 2014; 60: 428-433
  • 14 Goom T, Donnelly G, Brockwell E. Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. Sports Medicine 2019
  • 15 Hartigan EH, McAuley JA, Lawrence MA. et al. Hip angles, joint moments, and muscle activity during gait in women with and without self-reported stress urinary incontinence. Journal of Women’s Health Physical Therapy 2020; 44: 107-116
  • 16 Hartigan EH, McAuley JA, Lawrence MA. et al. Pelvic floor muscle performance, hip mobility, and hip strength in women with and without self-reported stress urinary incontinence. The Journal of Women’s Health Physical Therapy 2019; 43 (4) 160-170
  • 17 Henscher U. Physiotherapie in der Gynäkologie. Stuttgart: Thieme; 2022
  • 18 Hulme JA. Solving the mystery of the pelvic rotator cuff in human function and movement: Back pain, balance, bladder and bowel health. Phoenix Publishing; 2005
  • 19 Jordre B, Schweinle W. Comparing resisted hip rotation with pelvic floor muscle training in women with stress urinary incontinence: A pilot study. Journal of Women’s Health Physical Therapy 2014; 38 (2) 81-89
  • 20 Kandadai P, O’Dell K, Saini J. Correct performance of pelvic muscle exercises in women reporting prior knowledge. Female Pelvic Med Reconstr Surg 2015; 21 (3) 135-140
  • 21 Knechtle D, Schmid S, Suter M. et al. Fear-avoidance beliefs are associated with reduced lumbar spine flexion during object lifting in pain-free adults. Pain 2021; 162 (6) 1621-1631
  • 22 Lauper M, Kuhn A, Gerber R. et al. Pelvic floor stimulation: What are the good vibrations?. Neurourol Urodyn 2009; 28 (5) 405-10
  • 23 Laycock J. Concepts of neuromuscular rehabilitation and pelvic floor muscle training. In: Baessler K, Burgio KL, Norton PA. et al. (eds) Pelvic floor re-education. London: Springer; 2008
  • 24 Leitner M, Moser H, Eichelberger P. et al. Pelvic floor muscle activity during fast voluntary contractions in continent and incontinent women. Neurourol Urodyn 2019; 38 (2) 625-631
  • 25 Leitner M, Moser H, Eichelberger P. et al. Evaluation of pelvic floor muscle activity during running in continent and incontinent women: An exploratory study. Neurourol Urodyn 2017; 36 (6) 1570-157
  • 26 Leitner M, Moser H, Taeymans J. et al. Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: A systematic review. Int Urogynecol J 2015; 26 (11) 1587-98
  • 27 Luginbuehl H, Lehmann C, Koenig I. et al. Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence: A randomized controlled trial. Int Urogynecol J 2022; 33 (3) 531-540
  • 28 Luginbuehl H, Baeyens JP, Taeymans J. et al. Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence: A systematic review. Neurourol Urodyn 2015; 34 (6) 498-506
  • 29 Luginbuehl H, Greter C, Gruenenfelder D. et al. Intra-session test-retest reliability of pelvic floor muscle electromyography during running. Int Urogynecol J 2013; 24 (9) 1515-22
  • 30 Marques A, Stothers L, Macnab A. The status of pelvic floor muscle training for women. Can Urol Assoc J 2010; 4 (6) 419-24
  • 31 Matheve T, De Baets L, Bogaerts K. et al. Lumbar range of motion in chronic low back pain is predicted by task-specific, but not by general measures of pain-related fear. Eur J Pain 2019; 23 (6) 1171-1184
  • 32 Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc 1998; 46 (7) 870-874
  • 33 Moore IS, James ML, Brockwell E. et al. Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women. Br J Sports Med 2021; 55 (22) 1286-1292
  • 34 Morton RW, Sonne MW, Farias Zuniga A. et al. Muscle fibre activation is unaffected by load and repetition duration when resistance exercise is performed to task failure. J Physiol 2019; 597 (17) 4601-4613
  • 35 Moser H, Leitner M, Eichelberger P. et al. Pelvic floor muscle activity during jumps in continent and incontinent women: An exploratory study. Arch Gynecol Obstet 2018; 297 (6) 1455-1463
  • 36 Nygaard IE, Shaw JM, Bardsley T. et al. Lifetime physical activity and pelvic organ prolapse in middle-aged women. Am J Obstet Gynecol 2014; 210 (5) 477.e1–12
  • 37 Peschers UM, Voduŝek DB, Fanger G. et al. Pelvic muscle activity in nulliparous volunteers. Neurourol Urodyn 2001; 20 (3) 269-275
  • 38 Radlinger L, Bachmann W, Homburg J. Rehabilitative Trainingslehre. Stuttgart: Thieme; 1998
  • 39 Riemsma R, Hagen S, Kirschner-Hermanns R. et al. Can incontinence be cured? A systematic review of cure rates. BMC Med 2017; 15 (1) 63
  • 40 Romero-Franco N, Molina-Mula J, Bosch-Donate E. et al. Therapeutic exercise to improve pelvic floor muscle function in a female sporting population: A systematic review and meta-analysis. Physiotherapy 2021; 113: 44-52
  • 41 Sapsford RR, Hodges PW, Richardson CA. et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn 2001; 20 (1) 31-42
  • 42 Saraceni N, Kent P, Ng L. et al. To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review with meta-analysis. J Orthop Sports Phys Ther 2020; 50 (3) 121-130
  • 43 Sousa M, Viana R, Roza TH. et al. Effects of a pelvic floor muscle training in nulliparous athletes with urinary incontinence: Biomechanical models protocol. In: Tavares J, Natal Jorge R. (Eds) Computational and Experimental Biomedical Sciences: Methods and Applications. Lecture Notes in Computational Vision and Biomechanics. Springer: Cham.; 2015. 21. 83-90
  • 44 Tamaki T, Oinuma K, Shiratsuchi H. et al. Hip dysfunction-related urinary incontinence: A prospective analysis of 189 female patients undergoing total hip arthroplasty. Int J Urol 2014; 21 (7) 729-31
  • 45 Toigo M. MuskelRevolution: Konzepte und Rezepte zum Muskel- und Kraftaufbau. Berlin, Heidelberg: Springer-Verlag; 2014
  • 46 Tuttle LJ, DeLozier ER, Harter KA. et al. The role of the obturator internus muscle in pelvic floor function. Journal of Women’s Health Physical Therapy 2016; 40 (1) 15-19
  • 47 Verbeek JH, Martimo KP, Karppinen J. et al. Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database Syst Rev 2011; (6) CD005958
  • 48 Viereck V, Gamper M. Urinary incontinence. In: Rittweger J. (eds) Manual of vibration exercise and vibration therapy. Springer Nature Switzerland; 2020: 329-335
  • 49 Wang Z, Zhu Y, Han D. et al. Effect of hip external rotator muscle contraction on pelvic floor muscle function and the piriformis. Int Urogynecol J 2022; 33 (10) 2833-2839