I started doing CrossFit 8 years ago, when the sport was in its infancy and the number of athletes worldwide was only in the thousands. Flash to today, there are 13,000 CrossFit gyms in more than 120 countries, thousands of other gyms who offer CrossFit-like programming, plus athletes who workout from their own garage. When it first started, there was a lot of trial and error. Over the last 8 years CrossFit coaches and the community in general has gained an insane amount of knowledge around all the different aspects of the sport, including technical expertise in specific areas like weightlifting and gymnastics, endurance training, recovery, etc. Along with that has come a much better understanding of something else that has weighed heavily on some of us in the CrossFit community: how to stop peeing your pants.
You see, along the way, CrossFit has accumulated a large community of folks who have an issue peeing while they workout. I am one of those people. For a long time it has been a joke (see above video), that some people just pee when they workout and LOL there is nothing we can do about it but laugh. That is the perspective I have always had, that peeing while I workout is just a fact of life. However, while all of us have been laughing it off and being like “oh well”, physical therapists have been raising their hands and saying “ummm I can help with this”.
Recently I decided I would actually listen to that voice, and get my own issues checked out. See, I don’t pee during every workout, or even every time I workout. My problem is during heavy weights, primarily on the front squat, clean deadlift. Over the last year or so, however, I have noticed that the frequency of peeing my pants has increased. Someone suggested that maybe my pelvic floor was weak, and I was incensed! I was downright angry about it. I work so hard to be strong, to have strength in my core, how the heck can it be that a part of my body is so weak that it betrays me in the most humiliating way? I was frustrated, I was embarrassed, and I felt doomed to pee my pants forever.
That is when I met Dr. Alyssa George from Motion Minnesota. I started working with her a few weeks ago and I have learned A LOT during that time about pelvic floor health and what I can do to stop myself from peeing. During my first appointment with her, Alyssa did an internal and external pelvic exam to determine my pelvic floor strength, as well as the strength of my transverse abdominals. What she discovered is that my pelvic floor is actually pretty strong, however, my transverse abdominals are stronger and overcompensating to support my core every time I brace. Instead of using my pelvic floor to help me support my brace, I was bearing down on my organ system and bracing exclusively with my abs and obliques. Hence, pee.
The first step to fixing this problem has been correcting my brace. Alyssa taught me how to brace in a way that activates the pelvic floor, and connects internal and external strength so I am not unbalanced. What a revelation! It’s not easy to fix something that has become such an implicit behavior for me, but so far it has made a huge difference in keeping me in the #nopeeclub. Here is what Alyssa gave me in a handout send sent (my own words added in blue).
PERFORMING THE PELVIC BRACE
- Place your fingers on your lower abdomen just inside your pelvic bones. You should feel the low level contraction under your fingertips.
- Contract the pelvic floor (like a kegel), creating tension in the surface layer muscles that moves up to your abdomen and stop at the bikini line. This draws in and flattens the lower and side muscles of your abdomen. Imagine drawing the vagina or scrotum into the body.
- Tighten both the muscles as if you are trying to zip up a pair of pants to the bikini line.
- Imagine you are trying to fog a window with hot breath.
- Breathe into your diaphragm while you maintain the low level contraction.
- Remember, do not bulge your belly, strain or allow movement in the pelvis or back.
- If you wear a belt when you lift, think about expanding your belly with your inhale above the belt.
- When you lift, keep your pelvis braced in this way and reset your strong breath before the start of each rep.
- If you breathe out during the concentric phase of a movement (ie: standing up on the squat), don’t release the pelvic brace.
I realize that seems like a lot of steps, but after practicing for a few weeks, it has become much more natural for me. She also gave me a short list of exercises to do to prime that brace before I lift. Just this simple change in bracing was a HUGE first step for me. Immediately after my session with Alyssa, I PR’ed my back squat, and I didn’t pee at all! In fact, after one session with Alyssa I went from peeing my pants 4-5 x per week, to only leaking 1 or 2 times over the course of 3 weeks.
The next session we had together, Alyssa took a look at some of my other postural muscles and mobility. She looked specifically at my low back, where I have had some injuries in the past. In 2016 I herniated my L4/L5 and had to recover from it slowly with lots of PT help. One of the things she discovered is that my spine is much stronger than it was, but the muscles in that area are very tight and hold a lot of tension. Her theory was that at the bottom of my squat and deadlift positions, the tight muscles toward the back of my pelvic area were actually pulling on my urethra, opening it just a slight amount, letting some pee escape. The cure? Mobility. Whereas the brace was a quick fix, gaining mobility in my lower back and hips is going to be a longer process.
There are two really important reasons I wanted to address this issue before it got out of hand: organ prolapse and pregnancy issues. See, weak pelvic floor muscles can do more than just make you pee your pants. Bearing down on your organs without any strength in your pelvic floor can also push your organs down, and potentially lead to prolapse, where the uterus or bladder might actually slip out of position and cause major problems. The other is that, If I decide to get pregnant, my pelvic floor may become stretched and weak, and if I am already having issues, it may stop me from being able to stay active during pregnancy. So yes, it’s embarrassing to pee, but it’s also potentially risky for me to continue on without dealing with my pelvic floor health.
My circumstance is one of many that people might experience with pelvic floor health. I don’t actually have a weak pelvic floor, but instead I have a poor understanding of how to properly fire those muscles, and I need to teach my body how to do so without thinking about it. Some other people might have issues because they have a stretched or weak pelvic floor, or because their pelvic floor is to tight and causing pain. Either way, those issues can be dealt with and managed, and you don’t have to pee your pants. There is no shame in having this problem, and many people out there are experiencing it. In fact, since I started my own #nopee journey, a lot of folks have reached out to me and said they too want to be part of the #nopeeclub.
Are you excited to join the #nopeeclub? In March we are going to be holding a seminar at Solcana with Dr. Alyssa, all about pelvic floor health and how to fix your pee problems. Sign up will come out next week so keep your eyes peeled. In the meantime, if you are ready to get started to becoming a member of the #nopeeclub now, contact Dr. Alyssa at firstname.lastname@example.org and set up your appointment today!