Influence of Powerlifting and Weightlifting on Female Pelvic Floor Dysfunction: Systematic Literature Review

The participation of women in sports such as powerlifting and weightlifting has grown over the years, and there is no consensus on the role of exercises in pelvic floor disorders (PFDs). We aimed to identify and summarize the current evidence on the impact of powerlifting and weightlifting on PFDs.

A systematic literature search was conducted on databases with no language restriction, from inception to 20 January 2024. We included observational studies or randomized controlled trials investigating female athletes in powerlifting or weightlifting providing information regarding the impact of these sports on pelvic floor structures. Studies on CrossFit trainers, nonfemale athletes, age <18, and congress abstracts were excluded. Two researchers independently performed the data extraction and quality assessment. The risk of bias was assessed using the Risk Of Bias In Non-randomized Studies-of Interventions. The main outcomes were the prevalence of PFDs in women practicing powerlifting or weightlifting, the factors associated with PFDs, and exercise related to urinary loss.

Of the 221 articles found, 5 studies with 1,809 participants were included in the qualitative synthesis. The prevalence of urinary incontinence (UI) in powerlifters ranged from 41.0% to 48.8% and in weightlifters from 36.6% to 54.1%. The main associated factors were age, parity, and body mass index. Deadlift was the exercise most commonly associated with UI (42.5%), followed by squats (36.3%). High loads and repetitions, along with competitions, were associated with UI.

This systematic review reveals a clear connection between PFD, particularly UI, and the engagement of women in powerlifting and weightlifting.