Healthy Pelvis, Heavy Weights: Deep Dives on Hot Topics and Navigating Common Issues in CrossFit

CrossFit, is a wildly popular branded fitness program that involves constantly varied functional movement performed at high intensity, and incorporates interval training, Olympic weightlifting, plyometrics, gymnastics, calisthenics, and powerlifting. There are now an estimated 12,500 CrossFit gyms worldwide, and a multitude of similarly-structured fitness programs also focusing on high-intensity functional fitness. Sessions are typically structured with a warmup, the practice of a skill or strength component, and then a daily workout or WOD (“Workout of the Day”). Workouts are incredibly challenging for our bodies. Yet, from challenge comes change, and there are extraordinary benefits from regular participation in CrossFit or similar exercise programs (and for more information on the benefits of strength training and high-intensity workouts, check out our recent blog post!). 

Despite so many positives, people often feel confused about strategies that are healthy and safe for their pelvic floor muscles with common CrossFit movements. Similarly, many feel frustrated from recurring pelvic floor symptoms with certain exercises, and are seeking to minimize symptoms so they can keep practicing skills and stay in the gym. Read on to learn more about how to navigate some of the most common pelvic health concerns with CrossFit (and similarly-structured programs):

Peeing with Double Unders & Jumping

Do you run to empty your bladder whenever jump rope or double unders (jumping twice before the jump rope passes under your feet) are part of a workout? You are not alone! A 2020 scientific study found that 26.1% of women reported urinary leakage during workouts, and the incidence increased with age, the number of children, and vaginal births. In simple terms, urinary leakage occurs when the pressure of the pelvic floor sphincter muscles are not strong enough to meet the force of the pressure against them (refer to our recent post for more details). Jumping rope, and double unders in particular, cause large, sudden increases in intra-abdominal pressure, and are a common cause of urinary leakage for CrossFit athletes.

Accordingly, one of the best ways to reduce leakage is to train your deep core and pelvic floor to manage and meet intra-abdominal pressure changes. Just as you might approach training your leg muscles to work harder, more efficiently, and faster by progressively increasing the weight or task complexity, your pelvic floor muscles can be trained in a similar fashion. For example, if you leak after about 15 jumps, try performing 14 jumps and doing multiple rounds of 14 jumps, stopping just before you leak. See if over time you can increase the number of jumps before you feel like you are going to leak. Setting your muscles up for success with good form also helps decrease leakage. The quickest way to make a positive change is to focus on stacking your ribs over your pelvis as you are jumping. This positional change sets your pelvic floor muscles up for success. 

Working directly with a pelvic floor physical therapist can help create an individualized plan based on your specific needs, your movement patterns, and your body. If you have unwanted leakage with jumping, reach out to us or a local pelvic PT to help you stay dry.

Pregnant and Postpartum Considerations in CrossFit

It can be safe to participate in CrossFit and similar programs while pregnant! In fact, the CDC and American College of Obstetrics and Gynecology (ACOG) recommend pregnant and postpartum people do at least 150 minutes of moderate-intensity physical activity. ACOG also iterates that if you were very active before pregnancy, as long as your obgyn approves, you can keep doing similar workouts.

Keep in mind that you may need to modify certain exercises, workout structure, or modulate workout intensity. Working closely with your healthcare team, pelvic floor physical therapist, and fitness professionals can keep you active, healthy, and part of the gym as your body goes through different seasons. Stay tuned to the blog for more information and exercise considerations for pregnant and postpartum people!

Bracing Vs. Breathing Through Repetitions

If you were trying to figure out the ‘correct way’ to breathe while lifting weights, depending on where you look, you might find totally different, and often conflicting answers! What gives, and what is the actual ‘correct way’?

Many healthcare professionals and resources, such as the Mayo Clinic website, recommend not holding your breath during weight training. They suggest we should inhale on the easy part and exhale on the hard part. For example, if you were squatting, you would inhale on the way down, and exhale on the way up.

By contrast, powerlifters and strength athletes purposely hold their breath during heavy lifts. They utilize what is known as a valsalva maneuver – or taking a big belly breath, bracing their core, and keeping their windpipe closed throughout the lift. Many casual and elite athletes use this strategy, and fitness professionals such as CrossFit coaches cue this technique because it creates increased internal pressure and rigidity of the trunk, which in turn leads to being able to lift more weight. Note that this does create a brief but significant increase in blood pressure.

With seemingly contradictory recommendations, figuring out “how to breathe” while training can be confusing for those newer to strength training, and even for the more seasoned lifter. In reality, neither breathing pattern is entirely correct or incorrect – what works best for you depends on the workout you are performing, your body, your experience, and your goals.  The truth is, you can lift much more weight with a valsalva strategy. In general, as the weight goes up and repetitions go down, more people find it beneficial to adopt a brace/valsalva maneuver. If your workout calls for a large number of repetitions of a specific exercise, it may be unnecessary and even inadvisable to hold your breath on each repetition. Similarly, for those less experienced in strength training, or for people who are mindful to avoid excessive pressure on the pelvic floor muscles – such as those in the early postpartum period, or people with pelvic organ prolapse, breathing through repetitions may be a more advantageous strategy regardless of the weight or volume of repetitions. To figure out what strategies work best for you and when, reach out to us or a local pelvic health physical therapist who can tailor techniques to meet your unique needs.