Pelvic Floor Implications in Figure Skating: An In-Depth Physiotherapy Perspective

Professional Safety Note: The information in this article is intended for educational purposes only. It does not replace individualized assessment or treatment by a qualified physiotherapist. If you are experiencing pelvic floor symptoms, please consult a licensed pelvic health physiotherapist for a comprehensive evaluation.

Figure skating is a sport that demands exceptional control, strength, and precision. While injuries to the ankles, knees, hips, and back are commonly discussed in athletic literature, the pelvic floor remains a critically overlooked system — one that plays a central role in both performance and injury prevention. For figure skaters of all levels, particularly those training at high volumes from a young age, pelvic floor health is not optional. It is foundational to long-term athletic success.

Understanding the Pelvic Floor in Athletes

The pelvic floor is a multilayered group of muscles that form the base of the core. Far from functioning in isolation, these muscles work in close, continuous coordination with the diaphragm, the deep abdominal muscles (transversus abdominis), the multifidus muscles of the spine, and the hip stabilizers, including the gluteals and deep rotators.

Together, this integrated system regulates intra-abdominal pressure, provides dynamic trunk stability, facilitates force transfer across the kinetic chain, and supports pelvic organ health. In figure skating specifically, the pelvic floor must repeatedly absorb and redirect high-impact forces — often instantaneously — while simultaneously responding to rapid shifts in balance, rotation, and speed.

Research published in the Journal of Orthopaedic & Sports Physical Therapy has reinforced that the pelvic floor functions as a key component of the lumbopelvic stability system, and that deficits in its coordination, not just its strength, are clinically relevant in sport-related injury (Hodges & Sapsford, 2020).

Unique Pelvic Floor Demands in Figure Skating

1. High-Impact Jump Landings

Figure skating jump landings generate ground reaction forces estimated at five to eight times body weight, frequently absorbed on a single leg. These forces travel upward through the entire kinetic chain — from blade to foot, ankle to knee, hip to pelvis, and ultimately to the pelvic floor.

When landing mechanics are suboptimal, or when hip strength and the timing of pelvic floor activation are misaligned, excessive strain is placed on the pelvic floor muscles and surrounding connective tissues. Over time, this cumulative loading can contribute to pelvic floor overload, muscle fatigue, and functional dysfunction. From a clinical standpoint, this is one of the most common and underappreciated contributors to persistent groin and hip pain in competitive skaters.

2. Repetitive Single-Sided Loading and Rotation

Skaters consistently rotate and land in the same direction — session after session, season after season. This creates predictable patterns of pelvic asymmetry, uneven load distribution through one hemipelvis, and muscular imbalances between the left and right sides of the pelvic floor.

Importantly, these asymmetries tend to affect coordination rather than strength alone. The clinical implication is that a skater may pass a standard strength screening while still demonstrating significant neuromuscular timing deficits that increase the risk of leakage, pain, or recurring hip and low back symptoms.

3. Increased Intra-Abdominal Pressure During Performance

Jumps, lifts, and powerful edge changes all require a rapid increase in trunk stiffness. Many skaters are trained — whether explicitly or through habit — to hold their breath, brace excessively, or continuously “pull the abs in” during high-demand moments.

While this strategy may feel stabilizing in the short term, it significantly increases downward pressure on the pelvic floor. Without appropriate pressure management strategies, this pattern can contribute to pelvic floor overactivity, reduced shock-absorbing capacity, and inefficient movement over the course of a long program. A 2021 systematic review in Neurourology and Urodynamics found that high-intensity breath-holding and excessive abdominal bracing were associated with increased rates of stress urinary incontinence in female athletes (Bø et al., 2021).

4. Sustained Muscle Tension and Overactivity

Unlike field sports that involve brief explosive efforts followed by recovery, figure skating programs demand sustained core engagement, prolonged muscle activation, and repeated full run-throughs with minimal opportunity for tissue relaxation. This training environment is particularly conducive to chronically elevated pelvic floor tone — a state of overactivity that paradoxically reduces the muscle’s ability to coordinate effectively during high-load tasks such as jump take-offs and landings.

In clinical practice, overactive pelvic floor muscles are frequently misidentified as “tight” or “strong,” when in reality they are stiff, poorly coordinated, and in need of skilled relaxation and neuromuscular retraining rather than further strengthening.

5. Early Specialization and Growth Spurts

Many figure skaters begin intensive training well before full musculoskeletal and neuromuscular maturity. During growth spurts, bone length increases faster than the surrounding muscles can adapt, coordination temporarily decreases, and pelvic alignment shifts in ways that place new demands on supportive structures.

Without targeted physiotherapy support during these developmental windows, the pelvic floor may struggle to keep pace with these rapid physical changes, increasing vulnerability to both dysfunction and injury. This concern is consistent with the Long-Term Athlete Development (LTAD) framework, which emphasizes the importance of physical literacy and targeted movement training during sensitive periods of growth.

Common Pelvic Floor–Related Issues in Figure Skaters

Pelvic floor dysfunction in skaters does not always present in obvious or expected ways. Symptoms are often normalized by athletes, coaches, and even healthcare providers — but normalization is not the same as absence of pathology.

Urinary symptoms are among the most frequently reported concerns and may include leakage during jumps, run-throughs, or off-ice training, urgency or increased frequency during sessions, and — critically — deliberate avoidance of hydration to prevent leakage, which carries its own health risks.

Pain and discomfort may manifest as pelvic, groin, or deep hip pain, discomfort with prolonged sitting or skating, or low back pain that fails to resolve despite standard rehabilitation approaches.

Core and stability concerns include difficulty maintaining trunk control during landings, a subjective sense of instability or disconnection between the upper and lower body, and reduced endurance across program run-throughs.

Menstrual and hormonal factors are also clinically relevant. Cycle-related pelvic pain, symptom fluctuations across the menstrual cycle, and increased injury risk during low-estrogen phases — such as the early follicular phase — are well-documented in the sports medicine literature and should be part of any comprehensive screening process.

These symptoms are common in figure skaters. They are not, however, normal — and they are not something athletes should be expected to simply endure.

Pelvic Health Physiotherapy: A Targeted Clinical Approach

Comprehensive Assessment

Pelvic health physiotherapy extends well beyond standard musculoskeletal assessment. At a leading physiotherapy clinic in Ottawa like Physiocare, a thorough evaluation may include assessment of pelvic floor strength, endurance, and coordination; breathing pattern and pressure management analysis; core synergy and hip control testing; postural and pelvic alignment evaluation; and off-ice movement and landing mechanics screening.

When appropriate and with informed consent, internal pelvic floor assessment provides the most precise identification of dysfunction — whether that involves weakness, overactivity, or neuromuscular coordination deficits that would otherwise remain undetected.

Individualized Treatment Strategies

Treatment is always tailored to the individual skater’s presentation, training demands, and goals. A comprehensive program may address several key areas.

Pelvic floor coordination and control focuses on timing activation with movement, improving the ability to fully relax between efforts, and progressively integrating pelvic floor function into dynamic skating-specific tasks.

Pressure management and breathing training involves diaphragmatic breathing re-education, reducing habitual breath-holding during jumps, and developing strategies to optimize trunk stiffness without generating excessive downward pelvic pressure.

Hip and core integration targets gluteal and deep hip strength, improves force transfer efficiency through the pelvis, and specifically addresses the asymmetries that develop from years of repeated unilateral loading.

Off-ice landing mechanics training teaches effective shock absorption strategies, introduces graduated exposure to impact loading, and builds neuromuscular control under the fatigue conditions that are characteristic of competitive skating programs.

Performance Benefits of Pelvic Floor Optimization

When pelvic floor function is properly assessed and optimized, figure skaters frequently report meaningful improvements across multiple performance domains — including greater jump consistency, improved trunk control during spins and step sequences, reduced injury recurrence, better endurance through full programs, and increased confidence on the ice.

It is worth stating clearly: pelvic health physiotherapy is not about restricting performance. It is about creating the structural and neuromuscular foundation that allows high-level athletic demands to be met safely, efficiently, and sustainably over time.

Long-Term Athlete Development and Injury Prevention

Neglecting pelvic floor health carries real long-term consequences. Skaters who do not receive appropriate support may develop chronic pain patterns, experience recurrent lower limb injuries, carry persistent pelvic symptoms into adulthood, and face shortened athletic careers as a result.

Early assessment, athlete education, and proactive integration of pelvic health physiotherapy into training plans empower skaters to understand their bodies, manage load appropriately, and sustain participation in the sport they love — at the highest level they are capable of reaching.

For skaters and skating families seeking expert support, physiotherapy in Ottawa offers access to specialized pelvic health practitioners who understand the unique physical demands of figure skating and can provide evidence-informed, athlete-centered care.

References

1. Bø, K., Nygaard, I. E., et al. (2021). Is physical activity good or bad for the female pelvic floor? A systematic review. Neurourology and Urodynamics, 40(5), 1187–1199.
2. Hodges, P. W., & Sapsford, R. (2020). Contraction of the pelvic floor muscles during abdominal manoeuvres. Journal of Orthopaedic & Sports Physical Therapy, 50(2), 62–71.
3. Goom, T. S. H., Donnelly, G., & Brockwell, E. (2019). Returning to running postnatal — guidelines for medical, health and fitness professionals managing this population. British Journal of Sports Medicine, 53(18), 1114–1115. (Referenced for pelvic load management principles applicable to high-impact sport.)

Final Thoughts

Figure skating places exceptional and compounding demands on the pelvic floor through high-impact landings, repetitive asymmetrical loading, sustained core engagement, and early intensive training. Pelvic floor dysfunction is common among skaters, but it is not inevitable. With appropriate physiotherapy care, it is both treatable and preventable.

Integrating pelvic health physiotherapy into figure skating training supports injury prevention, performance enhancement, and long-term athlete health at every stage of the skater’s journey. Supporting the pelvic floor means supporting the whole skater.