This changes the way I warm them up, prescribe exercises, and dictate mobility protocols for them. This change was very apparent the first time I coached a class with them that involved double unders. A few women came over, and kind of pulled me to the side and asked what they could do to substitute double unders. Of course, me, as a male who had predominately only trained tactical athletes and football players, replied "single-unders"…as they rolled their eyes, they replied, "ugh…yeah, that's not gonna work, I can't jump, I have a problem." Then, I understood. These ladies were referring to pelvic floor dysfunction.
I knew a little about pelvic floor dysfunction, but never had to talk to someone about it. So, I promised my CF Women class I would research, then write about it and link them to some resources. It also made me think about it in a military context. I am sure women in our military face this issue as well, but they just do not speak up about it like they have in crossfit. Women account for about 16% of our military, and this can really be an issue during a deployment, or military exercise. So, this is also for all my female tactical athletes, if you face this issue while jumping from a plane at 1200 ft, or during PT, then this post is for you.
THE BASICS:
First of all, lets get one thing straight--don't be embarrassed. But also, don't accept this issue. Peeing yourself during a WOD is NOT OK. Billy Madison and CF HQ are wrong. There is nothing cool about peeing your pants...
There was a crossfit video that created some controversy a year back about this issue of peeing during a workout. You can see the video HERE, and learn a little about the anatomy behind the pelvic floor.
As seen in the video linked above, some medical professionals think it is okay to pee when working out. While I am not a medical professional yet, as a believer in common sense, I disagree. If your body is reacting to something you are doing by peeing or pooping on yourself…something is probably wrong. If every time you brushed your teeth, you pooped your pants, I am sure you would try to figure out whats going on and how to stop it; and, peeing during a double under is no different.
SO WHAT NEXT?
In class, I harp on my athletes about proper setup for a braced spine (butt squeezed to set position, and belly tight to reinforce position) in everything they do for a reason…Because it matters! So, with that concept in mind, if you are having pelvic floor issues, add in setting the pelvic floor as well. In this video, Kelly explains this:
You need to retrain your body and gain awareness and control of your pelvic floor. Another great article is one from Mobility WOD instructor/Marine/physical therapist Dianna DiToro found HERE. Dianna does a great job of breaking down this issue and has some great tips to help retrain and build your pelvic floor muscles.
OTHER ADVICE:
-For people I work with, I always advocate primarily training raw (aka no weight belt). Belts give you a false sense of security if you don't know how to properly brace in the first place. As soon as you master this concept and know how to truly set position, and are pulling some serious weight (more than 300lbs) safely with perfect form, then throw on a belt. There should be no reason you throw on a belt for your first set.
-Strict Movement is King (or Queen)! I like what Dr. Danny Matta of MWOD/Athletes Potential suggests, "Train like a powerlifter until you are strong enough to control your own body." If you are having a stability problem, you need to retrain your body, and go back to focusing on strict movement. For example, if your gym is doing jerks, and you are working on pelvic floor correction, sub in strict press. Danny has a great article about hyper-mobile athletes HERE.
-Stop worrying about "task completion" and focusing so much on the clock. You need to check the ego at the door. The only way to correct movement is repetition…and more importantly-CORRECT, WELL EXECUTED REPETITION. It takes 10,000+ repetitions to learn a new skill, it will take time to fix this and other issues you may have. Crossfit and weight training are all about getting better and having a better quality of life. The only way to set yourself up for success for when you are 80 years old is to harp on technique and placing a focus on quality over quantity. In a high rep deadlift/box jump workout your back doesn't give a shit about your time. Work for a PR of technique instead of trying to just beat a time that means nothing.
-Also, you can train/track progress by testing your pelvic floor as you work on this issue. Take whatever movement is causing you to leak (double unders, box jumps, etc) and each week as you strengthen your pelvic floor see how many reps you can do before you feel start to feel that you may leak. Be patient. You are all badass women and those small, untrained, weak pelvic floor muscles need time to get to the same level as all of your other bigger stronger muscles that don't fatigue as easily.
FINALLY:
Try to treat this issue yourself first. What I love about Dr. Kelly Starrett's Mobility WOD philosophy, is that YOU should take a crack at solving issues you have first…and if that still doesn't help; then, go see a medical professional. Another great resource is Jill Miller from Yoga Tune Up. Try some of the things suggested, and see if you can correct this issue. Talk with your doctor if you are concerned, set a realistic time frame to see progress, and track your progress or lack thereof.
If you do decide that you need professional help, go see a physical therapist who a.)specializes in pelvic floor issues, and b.) agrees that peeing yourself is not ok. There are lots of physical therapists who now specialize in the pelvic floor and can help if you need it.
