Pelvic Floor Dysfunction: Crossfit Women – you don’t have to leak when you lift!

Pelvic Floor Dysfunction – Leaking with Lifting

Pelvic floor dysfunction is all too common in the women’s Crossfit community.  This community continues to increase in numbers.  Combining strength building and momentum efficient movements in order to create powerful and athletic female bodies improves an overall ability to function well.  But what about pelvic floor dysfunction?  Does someone have to experience stress incontinence, or leaking, when lifting heavy, or is there help? I am here to tell you that you can absolutely change this!

Why am I leaking when I’m lifting?

Lets look first at what the pelvic floor is and what it should be doing.

Anatomy and Function of the Pelvic Floor Muscles

The pelvic floor muscles are part of our core system.  The core includes the pelvic floor muscles, the transverse abdominis muscle, the diaphragm and the multifidus muscles.

Their function is to help keep your pelvic organs where they should be and ensure that YOU are in control of your bladder, not the other way around. They do this by balancing the intra-abdominal pressure within the abdominal wall. Simply put, when the pressure in the abdominal wall is greater than what the pelvic floor muscles can handle, there may be leakage and/or an eventual prolapse.

Why does this pelvic floor dysfunction happen?

The pelvic floor muscles need enough flexibility for movement and enough strength for support.  They really aren’t that different from other muscles in our body.Think about this scenario:

You are doing a heavy barbell biceps curl but you experience pain in your back.  Your back muscles/core muscles are not strong enough to support the amount of weight you want to lift with your biceps.  What would you do in this scenario? Likely, you would start increasing your back and core muscle strength. When you lift heavy or jump and experience urinary leakage the pelvic floor muscles are not strong enough to support the amount of weight you are lifting or the pressure it builds up with impact.

Why don’t we do the same thing in this scenario? Work on increasing the strength of our pelvic floor muscles?

Pain is definitely the driving force. Its what makes people finally head into their friendly neighbourhood physiotherapy clinic for help. But with leaking, there isn’t any pain. So, people think it isn’t a big deal.

Is Urinary Leakage, a pelvic floor dysfunction, a Big Deal?

This isn’t life threatening but it can become life changing.  A small problem often becomes a larger problem.  At first, you may leak only when doing your heaviest lifts, but over time you may notice that you are leaking when you never did before. The pelvic floor muscles are doing their best but as time rolls on and they continue to be unable to support the bladder, they will continue to weaken. With so much downward pressure, a pelvic organ prolapse may present itself.

What is a Pelvic Organ Prolapse?

Our pelvic floor muscles are designed to help support our pelvic organs; bladder, uterus and rectum for women and bladder and rectum for men. When there is too much intra-abdominal pressure, they can no longer hold our organs where they are and our organs may move downwards. A bladder prolapse is a cystocele, a uterine prolapse is a urethrocele and a rectal prolapse is a rectocele. There are different stages:

No Prolapse




Bladder (front), Uterus (middle) and Rectum (rear) are all where they should be

Stage 1: Virtually no prolapse, very slight organ displacement

Stage 2: Bladder, uterus or rectum are beginning to descend

Stage 3: Bladder, uterus or rectum may be at the entry point or slightly beyond

Stage 4: Bladder, uterus or rectum are completely outside the body

This is an all too common problem and could likely have been prevented if the information was given earlier.

Does Urinary Incontinence Cause a Prolapse?

No. People can have one and not the other.  But, too much downward pressure may lead to a prolapse and too much downward pressure with not enough support may lead to incontinence.

How can I Prevent Leaking?

  1. Posture Retraining – The way we hold our bodies dictates where and how much force or stress will travel through our bones, muscles and associated tissues. We need to learn our good postures and how to move within them
  2. Brain to Bladder Retraining – As we are learning to retrain our bladder, we must involve our brains. A few simple examples are; if we know we are about to sneeze, contract our pelvic floor muscles beforehand; before we change position, get out of our car, get up from the table, contract our pelvic floor muscles; on our lighter lifts…before standing up out of a squat, contract our pelvic floor muscles.  It sounds simple but most people either brace, push down or use only their transverse abdominis muscle by pulling in at the lower belly. The pelvic floor muscles need to pull inwards and upwards and they are often left out. If they weren’t left out, there would be a lot less leaking!
  3. Pelvic Floor Muscle Strengthening

Do I have to stop doing Crossfit?

Absolutely not! But you have to make a change or two. In the above example, if you hurt your back when lifting too heavy, you wouldn’t just return to lifting that heavy again, without any further intervention. Do the same regarding the leaking issue! You may have to lighten the load or take out box jumps at first. For example:

  • Make sure you are activating your pelvic floor muscles optimally…for this, you may need to have an assessment from a pelvic floor physiotherapist. This will ensure that you are activating with both your front and your rear passage well.
  • Work on some pelvic floor muscle strengthening exercises (2 sets of 10 reps with a 3-5 second hold, twice daily)
  • As your strength increases, challenge your pelvic floor muscles…wide legged squat, lunge with impact, small jumps, etc.
  • Notice whether or not you are actually using your glutes.  Lots of people who work out regularly do not grow any glutes; simply because they haven’t been using them during their exercises.  Place your fingers on your butt cheeks when standing…are they on? What about when you come up from a squat…are they on just at the top or are you using your glutes the whole way up to standing? Ideally, you want some tension in your buttock muscles during your day to day activities, more tension in your buttock muscles when performing exercise but never so much tension in your buttock muscles that you are squeezing your butt cheeks together. This will overwork your piriformis muscle and you definitely don’t want problems with sciatica because of that.  Just become aware of whether or not your glutes are on!

For further ideas, check out




Leave a Comment


Watch my free 5-part video series that will teach you the basics of developing a strong & healthy core!