Crossfit and the Pelvic Floor. Match made in heaven?

So, I do Crossfit. And I’m a pelvic floor physiotherapist. If you haven’t heard….these two things combined are a little controversial. When Crossfit made and released the below video, I am sure they did not anticipate the barrage of criticism that was unleashed by hundreds of enraged continence physio’s worldwide. We can be a passionate bunch….we normally only need a little poke to get started, but this was like waving a red flag at a bull. So much material to tear apart! And they couldn’t have made it easier…….Geez, they started by calling the medical condition by the wrong name! So, enough talking - if you haven’t seen it, here it is:
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Crazy? Yes. Appalling? Indeed. Now, as I referred to before, there has been a barrage of well articulated articles written by pelvic floor health professionals about everything that is wrong with this clip. Here are two of the best which I encourage you to read:

http://physiodetective.com/2013/06/27/crossfit-your-pelvic-floor-and-peeing-during-workouts/

https://pelvicguru.com/2013/06/22/dear-crossfit-and-crossfit-gynecologist-im-appalled-theres-help-for-peeing-during-workouts/

But, despite all this….I still do Crossfit. And here’s why: 

1. Nothing else motivates me to wake up at 6AM and work out.
2. I’m a sucker for group motivation and exercising with supportive friends.
3. I would not work as hard as I do if I were training by myself.
4. I don’t have to think about what I’m going to work on and design my own program each session.
5. It makes me do movements I would otherwise avoid like the plague.
6. The movements are (mostly) functional and reflect how our bodies should be able to move.
7. One of the features of Crossfit is that the workouts and movements are always varied, which reduces repetitive strain injuries, and increases your workout because you're body never gets too efficient at anything.
8. Incorporating heavy weights into my workouts increases my bone density and muscle mass which will prevent osteoporosis and fractures as I age.
9. Crossfit has a huge focus on mobility, that is joint range of motion and soft tissue compliance, these things keep me flexible and prevent loss of end of range motion which occurs with ageing and contributes to loss of function and pain.
10. Crossfit inspires me to have new goals and achieve. which gives me purpose and makes me feel alive.
11. I no longer care what the scales say because I know what my body can do, and I’m more proud of that than how it looks.

So, what about the pelvic floor?
Well, Stress Urinary Incontinence (which is the internationally accepted correct terminology) occurs when the intra-abdominal pressure above the bladder exceeds the closure pressure generated by the pelvic floor muscles and soft tissue structures below the bladder. This pressure can come from weight, from impact caused by the ground reaction force, and by bracing the abdominals. The thing is, yes these things can occur during Crossfit, but they also occur during Netball, Tennis, Soccer, Football, Dancing, Running, Jumping on the trampoline and any other activity that involves pushing your body. 

Should we accept it if we leak during ANY of these activities? No. And that’s where The Crossfit clip went so terribly wrong. Don’t accept it, treat your incontinence as you would treat any injury in your body - don’t push through it, get it assessed, scale back until you can do the movement with correct technique and no dysfunction, which in the case of the pelvic floor muscles, means no urinary leaking or feelings of heaviness. 

If you are thinking about starting Crossfit, research your choices. Choose a box that has experienced coaches, has an induction training program, that limits class sizes so technique can be monitored, and that doesn’t pressure you to add weight or intensity unless you are ready. If you are concerned about your pelvic floor function or don’t know how to control your pelvic floor muscles, make an appointment with a pelvic floor and continence physio who can answer all your questions or visit my website at womankindphysiotherapy.com.
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Enjoy your WOD!