What every CrossFit athlete should know about leakage

At its core CrossFit is built on the idea of performing constantly varied, functional movements at high intensities. Whether you are lifting a heavy barbell, jumping rope, running, or moving through a complex gymnastics skill, CrossFit challenges strength, power, coordination, and endurance. 

As a result this requires athletes to be able to manage high levels of intra-abdominal pressure. One important component of this pressure management system is the pelvic floor. 

To better understand how this works, think of your core as an abdominal canister. This system is made up of the diaphragm, abdominal muscles, pelvic floor, and multifidus. Together these muscle groups create a coordinated, pressurized system similar to a cylinder that is called the abdominal canister. 

Intra-abdominal pressure (IAP) refers to the pressure created within the abdominal cavity. When managed effectively IAP can help provide spinal stability, support to abdominal organs, and contribute to efficient movement and force production with weightlifting, gymnastics, and metabolic conditioning. This system also has important connections to bladder and bowel function. 

As a pelvic floor physical therapist, some common things I hear from CrossFit athletes include: “I don't like double-unders because I always pee.” and, “Any time I lift heavy, I leak a little bit.”

While these experiences may be common, they are not something you simply have to accept as part of training. Urine leakage during jumping, running, or lifting can be addressed with the help of a pelvic floor physical therapist.

Leakage can occur when the demands placed on the pelvic floor exceed its current capacity or when the body has difficulty coordinating and managing intra-abdominal pressure during movement. This does not necessarily mean that your pelvic floor is simply “weak.” Strength, coordination, timing, breathing mechanics, movement strategies, and the ability to respond to different loads can all play a role.

Pelvic floor physical therapy can help identify the factors contributing to symptoms and develop an individualized plan to improve pelvic floor function, pressure management, and overall confidence with training.

The goal is not to avoid heavy lifting, double-unders, box jumps, or other challenging movements. Instead, the goal is to help your body build the capacity and coordination needed to meet the demands of the activities you enjoy.

Because at the end of the day, leaking during a workout may be common, but it does not have to be your normal.