There are very few people who have not heard about the sport CrossFit. First founded in 2000, it started to gain popularity and traction around 2007, and now there are more than 12,000 affiliated CrossFit gyms worldwide.
If you’re not familiar with the practice, CrossFit is a fitness regimen that involves constantly varied functional movements performed at high intensities. It’s a combination of traditional and olympic style lifting, high intensity interval training, plyometrics, calisthenics, gymnastics, kettlebell lifting, strongman workouts, and more. Individuals who do CrossFit are often competitive, athletic, and committed to the practice. It’s not something people take lightly. In fact, it’s more of a lifestyle than a workout.
CrossFit has received a lot of criticism for putting people at increased risk of injury compared to other sports and activities, but a recent article in the Journal of Sports Rehabilitation found that the CrossFit injury risk is actually lower than some other common forms of exercise or weightlifting. But, what about the impact on your pelvic floor? On average, at least 25% of females in the general population experience stress incontinence, or leakage with exercise, but in the CrossFit world, that number is closer to 30%.
So, here’s what you need to know about doing CrossFit, leaking when you lift, and how it impacts your pelvic health overtime.
Is CrossFit “bad” for your bladder and pelvic floor?
The all encompassing answer is, “it depends.” In general, weight lifting is actually very beneficial for strengthening your pelvic floor and increasing the support of your bladder, uterus, and other internal organs. But, strenuous exercise, especially the kind performed at high intensities with poor breathing mechanics and form, may increase stress on the pelvic floor, leading to weakness overtime. This weakness can lead to issues like leakage, pelvic organ prolapse, hemorrhoids, abdominal separation, and more. So, depending on how you’re doing it, CrossFit can either help or harm your pelvic floor. That’s why if you are experiencing problems, it’s important to work with a trained specialist, like a pelvic floor physical therapist, who can identify the cause of your issues and develop a personalized rehab program to prevent further injury (or in this case, pelvic floor issues). CrossFit in itself is not bad for the pelvic floor, but if you already have underlying issues, chances are they are going to get worse when you start lifting heavy and fast, especially if you don’t have proper technique.
What kinds of pelvic floor issues do CrossFitters experience? And why does it happen?
The most common issues that people experience when it comes to CrossFit and the pelvic floor include: stress incontinence (leakage), pelvic organ prolapse, hemorrhoids, and diastasis recti abdominis (abdominal separation). Although common, it doesn’t mean these issues are normal. In fact, they all highlight one specific problem: poor pressure management.
When you lift weights, do a double under, or perform a box jump (and plenty of other movements common in CrossFit), there is an increase in pressure in your abdominal cavity. The abdominal cavity, also known as your core, goes from the bottom of your rib cage down to the bottom of your pelvis and wraps all the way around the spine like a corset. When we have an increase in pressure, we should be able to equally distribute that pressure throughout the entire container. If there is an area of weakness, like the abdominals or the pelvic floor, more pressure may be directed in that area, leading to increased weakness and pelvic floor dysfunction. The more you lift weights and exercise with poor pressure control, the greater your chance of developing pelvic floor issues. And if you already have pelvic floor issues, more than likely they are going to get worse unless you change your strategies. What’s important to note is that this is NOT purely a problem of weakness in the pelvic floor; it’s how you are performing the movement and controlling the increase in pressure that causes problems.
Should I do kegels if I experience leakage with CrossFit?
NO! The answer to your problem will not be fixed with kegels. If you’re experiencing leakage, urgency, or heaviness in your pelvis during CrossFit, it’s not because your pelvic floor is inherently weak. It’s more an issue of controlling the increase in pressure and making sure you are not bearing down on your pelvic floor. Kegels are simply a squeeze of your pelvic floor muscles. Using a simple squeeze of the muscles to help us stop leaking when we’re lifting heavy weights at a fast pace is not going to work. That would be like bending your elbow over and over again and expecting to be able to curl 45 lb dumbbells all of a sudden. How we practice needs to be specific to the movement and it needs to be challenging enough to make a difference.
Instead of kegels, the best thing you can do is learn how to evenly distribute pressure throughout your core. This uses a combination of breath work, posture, stability training, and core strengthening. The quickest way to address this issue is to work directly with a pelvic health physical therapist who is familiar with CrossFit movements and can help you identify why you’re experiencing these issues. Self-diagnosing and self-treating can often be frustrating, time-consuming, and make your symptoms worse if you’re not doing the right things. Not to mention, it’ll eventually limit your ability to fully participate in CrossFit, which no one wants.
We are the providers who can help! Don’t let leakage prevent you from doing the things you love or going all out during your competitions. Curious to learn a little bit more about how pelvic health physical therapy can help you stop leaking during CrossFit and reach new PRs with your lifts? Schedule your FREE 10-minute consult call today ✨
Be empowered in education,
OrthoPelvic Physical Therapy