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Why do you pee during CrossFit?

Posted on Jun. 27, 2013 ( comments)

What was MultiCare urogynecologist Dr. Danielle Price’s first thought when she saw the new Internet video circulating that highlights women who pee during extreme CrossFit workouts?

“I see all of those people doing heavy lifting and think of their poor pelvic floors!” exclaims Price.

The video in question was posted earlier this month and had more than 120,000 views in less than a week.

In it, women at The CrossFit Games are asked whether they’ve ever peed during a Cross Fit workout. The answer is overwhelmingly ‘yes.’ Interviews are intercut with shots of puddles next to CrossFit equipment.

But why?

Price says the video depicts what is known as ‘stress incontinence’ – when pressure on the bladder results in leakage. The urethra (tube you urinate through) is unable to keep urine in the bladder, due to weakened pelvic floor muscles (due to child birth, stroke, or other factors). Seen to some degree in about 30 percent of women, stress incontinence may be caused by laughing, sneezing, coughing or exercise.

During CrossFit, participants rotate through a mix of aerobic exercise, body weight exercise, gymnastics and Olympic weight lifting – any of which can add sudden pressure to the pelvic floor and cause embarrassing leakage.

Although many people associate exercise-induced leakage with jumping (and really, what lady hasn’t experienced an oops or near-oops moment during a particularly enthusiastic set of jumping jacks?), it can be caused by any motion that transmits pressure to the pelvic floor. This can be caused by the sudden, traumatic pressure of a jumping motion, or the prolonged strain of heavy lifting.

Peeing during exercise is not going to hurt you, says Price, but it may be embarrassing and bothersome. And the good news is, you don’t have to suffer through it.

Possible treatments include physical therapy and both surgical and non-surgical options. The first step is to work on Kegel exercises to strengthen the pelvic floor muscles. If you’re unsure whether you’re doing them properly, ask your primary care provider to observe you doing one at your next regular appointment. No need to be embarrassed, says Price – your routine annual exam is the perfect time to bring it up.

How to perform a Kegel:

First, as you are sitting or lying down, try to contract the muscles you would use to stop urinating. You should feel your pelvic muscles squeezing your urethra and bottom. If your stomach or buttocks muscles tighten, you are not exercising the right muscles.

When you've found the right way to contract the pelvic muscles, squeeze for 3 seconds and then relax for 3 seconds.

Repeat this exercise 10 to 15 times per session. Try to do this at least 3 times a day. Kegel exercises are only effective when done regularly, and will be more effective when combined with a regular fitness routine to keep back and abdominal muscles strong as well. The more you exercise, the more likely it is that the exercises will help.

Dr. Danielle Price is a urogynecologist certified by the American Board of Obstetrics and Gynecology. She sees patients who require medical or surgical treatment for various pelvic floor disorders, including bladder control issues, fecal incontinence, pelvic organ prolapse, chronic pelvic pain and trauma associated with childbirth. To make an appointment, call 253-301-5120.

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