Purpose: The purpose of this review is to analyze evidence-based research in an effort to answer the PICO question: In young, nulliparous, athletic females with stress incontinence, is lumbo-pelvic strength training and neuromuscular re-education to the pelvic floor as effective as strengthening of the pelvic floor through kegels alone, in decreasing frequency of Stress Urinary Incontinence (SUI)?

Background: It is now understood that Stress Urinary Incontinence (SUI) is highly prevalent in female athletes, however the mechanism of this pathology is not well understood. At this time there is a paucity of literature regarding interventions for SUI in young female athletes. Therefore, the focus of this case report is to explore the current research investigating the best interventions for highly active nulliparous females suffering from SUI, and to bring awareness to the need for further clinical trials.

Case Description: The patient is a 26 year-old highly active nulliparous female who presents to physical therapy with an acute onset of stress urinary incontinence during exercise.

Methods: A literature review of three databases was searched regarding the PICO question.

Discussion: Interventions addressing down-training of overactive pelvic floor muscles and strengthening of lumbo-pelvic stabilizers decreased episodes of SUI in the patient.

Key words: Hypertonic, pelvic floor, physical therapy, running, athletes, nulliparous, stress incontinence, and overactive pelvic floor



Document Type


Degree Name

Doctor of Physical Therapy (DPT)

Level of Degree


First Advisor

Deborah Doerfler PhD, DPT, OCS