In our active Boulder County community, we have observed an increase in the number of women participating in high intensity exercise such as CrossFit. The topic of pelvic health and CrossFit has been under discussion in recent years, prompted by reports of competitive female athletes experiencing urine loss due to stress urinary incontinence during CrossFit competitions.

Much of the debate around CrossFit and the pelvic floor has to do with increased intraabdominal pressure with heavy lifting or strenuous exercise and how this might ‘overstress’ the pelvic floor contributing to conditions such as stress urinary incontinence (SUI) and pelvic organ prolapse. Involuntary loss of urine with exercise occurs when the pressure in your abdomen exceeds the closure pressure of the muscles and supportive tissues of the pelvic floor. The ability to maintain continence related to a number of factors including pelvic floor muscle strength and coordination as well as passive soft tissue supports.

A 2016 study (Middlekauff et al AJOG) investigated differences in key measures of pelvic organ support in 18-35 year old women who had never given birth and were either habitual CrossFitters or women who were non-strenuous exercisers. The authors also investigated the immediate effects a single exercise session in each group on the pelvic floor and pelvic organs.

The authors found that there was no difference in vaginal support or pelvic floor muscle strength between the habitual CrossFitters and non-vigorous exercisers prior to exercising indicating that regular participation in vigorous exercise may not have detrimental effects on the pelvic floor. Participation in either a 20-minute CrossFit workout (deadlifts and push press @ 80% 3RM, push ups, burpees and sit-ups) OR a 20-minute self-paced walk both resulted in similar but small decreases in vaginal resting position (decreased pelvic organ support) and vaginal resting pressure (increased muscle fatigue) . No change was observed in pelvic floor muscle strength between groups following exercise.

Research remains sparse in the area of high intensity exercise and pelvic health. This study calls into question the conventional wisdom that heavy lifting or high intensity exercise has negative impacts on the pelvic floor. To learn more from one of the pelvic health specialists at MEND, please reach out to us here.