Alert: This is gonna be the first of a few posts, because there’s a looooot of information out there about this topic and I don’t want to immediately lose you by sheer word count. I want to lose you the right way: you being bored.
Let us proceed.
I wanna get a few things straight before I dive into this very riveting topic about pee, pelvic floors, and pressure management:
- Growing and birthing a human is a damn miracle and all women should be given a lifetime achievement award.
- Sometimes we experience incontinence at 70 years old because of natural wear and tear, and sometimes we experience it at 20 years old because we’re strong and active but misled on how to stay safe through said activity. It just be like that sometimes.
- Peeing or leaking during exercise or exertion is common, but it is not normal. (I wrote about this last year some re: pregnancy, peep it.)
But contrary to popular belief, peeing while you workout (or sneeze or cough or generally exist) isn’t some rite of passage, or badge of honor for lifting heavy ass weight. It’s actually a sign of poor pressure management and/or a weak pelvic floor (which is different than pelvic floor dysfunction), and — gasp! — this issue isn’t exclusive to women who birth humans (though they are the leaders of this pack); both men and women of all shapes and sizes and fitness backgrounds can experience symptoms of a weak pelvic floor — and those symptoms can be caused by a whole heap of things.
So what exactly is a pelvic floor and what is it responsible for and why should I care holy crap you’ve said the words “pelvic floor” so many times get to your point? Our pelvic floor is comprised of a hammock or dome-shaped group of muscles and ligaments located within the pelvis, and beyond bladder/bowel control and supporting women’s bodies during pregnancy and birth, our pelvic floor is responsible for working with the rest of your core to stabilize and protect your spine during everyday life, as well as exercise. So when we experience weakness in our pelvic floors we see incontinence as a common symptom — but as active humans who run and jump and push and pull and throw weight around, we may also be putting our spines at risk with our weak little muscle hammocks.
So, how do you know if you have a weak pelvic floor? Let’s run through a quick checklist. Do you regularly pee or leak when you:
- Sneeze, cough, or laugh
- Jump (single unders/double unders, box jumps, etc.)
- Run (either during sprint sessions or long distance)
- Lift heavy weight or max out a lift
- Perform an explosive movement where you have to land at the bottom of a squat (cleans, squat snatches)
Among quite a few other more severe/personal symptoms. If you said yes to any of those bullets, you may have a weak pelvic floor. And guess what? It doesn’t go away on its own and — similar to all the other muscles in our bodies — if we don’t use them, we lose them. Just like we have to rehab a knee after ACL surgery, we have to treat this as a weakened body part and treat it with a rehab program.
Okay, tell me how.
I’d argue that the best thing we can do to help identify or mitigate pelvic floor problems — or even solve some that already exist — is to first see a pelvic floor physical therapist.
Yes, that is a real thing.
These therapists help you uncover the what and why of your pelvic floor weakness. They zero in on when it happens most, what you can do to prehab (“prehab” in that they are preventative exercises/measures given if, say, you are trying to get pregnant or are currently pregnant), rehab those muscles, and give you tactical ways to better manage your breath and internal bracing/pressure during workouts. I’ve been seeing the folks at Sullivan Physical Therapy and highly recommend them.
If seeing a medical professional is not in the cards for you right now, or you feel like you want to try some exercises on your own first, OR you aren’t necessarily experiencing weakness and you just want to be preventative — let’s set up a time to meet so we can walk through your symptoms and figure out a training plan to get those muscles right, and get ‘em tight.
You know where to find me.
Stay tuned for the next installment of this series, coming at some point, where we’ll talk about breathing strategies during heavy lifts and high intensity workouts in order to better manage the pressure in our core/midline and not dump all the work on our pelvic floors.