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Jun 202013

Peeing during a workout. See this video. This happens — but should it?

I came across a video for peeing during CrossFit workouts on my facebook feed today. I’ve decided to completely diverge from writing about knee taping and talk about pee. The video describes it as normal, but I would say it is common, not normal.  It can happen in a repetitive workout with box jumps, jump rope or running.

It is a type of stress incontinence labeled specifically: exercise-induced urinary incontinence. It is often due to weak or slow firing pelvic floor muscles. It has been estimated that 30-40% of women have some type of urine leakage during exercise. This is a very high percentage, but is that the way it should be? Kegel exercises are often prescribed, but there has been a recent backlash in the research that they don’t work very well.

Some of the current thought on strengthening the pelvic floor include strengthening the hip/thigh adductors, strengthening both the fast and slow twitch fibers in this area, and finding what other areas are creating muscle inhibition in this area. I have followed the work of Janet Hulme, PT and have found her book helpful for patients. In addition, the use of Neurokinetic Therapy (NKT) analysis is helpful in finding the muscle imbalance pattern.

Kelly Barton has written a great blog on this for the runner.

I asked my friend Dr. Heather Rupe, OB/GYN and the author of the The Pregnancy Companion about this subject, and she had this to say: “Kegels work, but can only do so much. Genetics and childbirth can do a number on the pelvic floor. There Are some great surgical options, but you have to limit lifting for 3 months after surgery, and I doubt many hard core cross fitters would agree to that.”

I hope this gives you some reassurance, that if you are dealing with this issue, you are not alone, and there are some possible options to consider.

Dr. Mike Van Antwerp

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