Here’s What You Need To Know…

1. Ladies, peeing during workouts or physical activity is not normal, and shouldn’t just be brushed off as a part of life. There’s a way to fix it.

2. Developing strong pelvic floor control and function involves more than just practicing your kegel exercises every day! This is an old school thought that needs to die, especially if you want to stop peeing during workouts!

3. Incorporating your diaphragm and breathing patterns with challenging positions such as front planks, side planks, squats and core rotation are the staples of any athlete’s urinary incontinence corrective program.

4. There’s no shame in correcting your pelvic floor function and changing the way you move, workout and live. The only shame is letting this dysfunction continue and get worse over time. Lets make the change!

Even A Little Peeing During Workouts Isn’t Acceptable!

Being a Physical Therapist somehow hardwires clam shell exercises and glute bridges into our professional DNA when it comes to women’s health and pelvic dysfunction. By all means, if you can’t do a single leg bridge, you have some strength and stability issues — but to truly work the pelvic floor, you must get functional and a bit creative! But before we move on, remember, the cure for pee pants during workouts isn’t all about the kegels as you’ve been told. It’s a little more complicated than that.

A strong pelvic floor is not only essential for women wanting to lift heavy, but for all women who want to enjoy life! While it’s awesome that the Crossfit world is bringing awareness to pelvic floor issues, simply saying it’s okay and bragging about peeing during double-unders is not a solution. It’s a crime, and it’s doing women everywhere a disservice. It’s not normal to pee yourself, EVEN JUST A LITTLE. The pelvic floor should be strong and stable like the rest of your body. Women are giving up on what they love because of their weak pelvic floors and the healthcare professionals in their lives are telling them to do more kegels. That course of treatment is outdated and ineffective, and here’s why.

The Problem With Urinary Incontinence Treatment

Western medicine is great at honing in on an area of treatment, but as we’ve learned with the knee, standard treatment protocol nowadays is to look at the foot and hip first, because it’s rarely the knee itself that’s the cause of the problem. The integration of comprehensive kinetic chain treatment for the knee took 10 years or more to hit mainstream PT. Let’s do it faster with the pelvic floor. For years, kegels were thought to be the first and ONLY line of defense for pelvic floor issues. Not only is that simply not true but it’s flat out wrong. Unfortunately, the message to women is still to do your kegels, and if you aren’t getting better then you aren’t doing enough kegels, making women feel horrible about themselves. Let’s beat a dead horse a little more because that works. Yelling at your patient for not doing enough quad sets for their knee pain just seems ridiculous. So, let’s take the time to look at the kinetic chain and be rock stars with treatment!

In order to lift heavy weights, accomplish dynamic movements, and excel in extreme sports with a strong pelvic floor, we need to be integrative. The pelvic floor is not a stand-alone muscle; it interacts with the muscles above and below it to create optimal functioning. That’s why kegels alone often do not work for people, no matter how diligently they do them: they’re only targeting one piece of a much larger puzzle. Now, just because I’m saying kegels should not be your only line of defense for pelvic floor weakness doesn’t mean you should throw out the baby with the bathwater.

What About The Kegel Exercise?

The occasional kegel exercise can be beneficial, but you need to be sure you’re doing it correctly. The common description is to stop the flow of urine, but a more accurate description is trying to draw in a tampon. Graphic, I know, but very accurate. As you lift or draw up your pelvic floor, you should also feel the lower part of your abdominal wall lifting or tightening too. These two are impossible to separate, hence why trunk alignment is so important for pelvic floor function.

The second half, and probably the most important part of doing a kegel, is relaxing or fully lengthening the pelvic floor muscles. All muscles require lengthening before they can fully contract, and when someone is weak they tend to hang on for dear life, which in the long run makes them weaker. This happens to the pelvic floor by constantly holding a low level of tone making it impossible to get a full contraction. This is why deep squatting it so awesome: it gets length to the pelvic floor without taking much effort.

But again, kegels are only part of the battle. Let’s get integrative and see what we are missing when it comes to the pelvic floor, starting with the diaphragm. Here are the three most effective methods to cure your workout pees, and exercises to strengthen your pelvic floor for good!

#1 Develop Your Diaphragm

The diaphragm is the top to your core, making it a formidable ally in your quest for stability and strength. Proper diaphragm function turns on your pelvic floor. If the diaphragm does not function correctly, the pelvic floor won’t either. They work together like a piston system.

A great diaphragm starts with a great inhale. When you lift heavy stuff, you develop strong paraspinal (back) muscles out of necessity to protect your spine. If your paraspinals become a little too hyper-vigilant, they will not relax to allow proper diaphragm expansion. Therefore, we need to shut down your paraspinals (don’t worry, they will kick back in when you pick up that heavy barbell and eventually learn to have a little more balance with the diaphragm).

A plank with relaxed hips, while focusing on breathing is a challenging exercise for the diaphragm. I love this exercise because you get increased core strength and the ability to focus on your pelvic floor, all while training your diaphragm.

The Front Plank

Front Plank Coaching Cues:

Start on your hands and knees, and then lift your knees so you end up in a push up position with relaxed legs.

Tuck your chin – keep your head up and in-line with your body.

Relax your quads and hip flexors (you need strong scapula for this).

Keep your shoulders away from your ears and your weight forward over your hands. Do not push backwards.

Elbows pointed toward your toes.

Tuck your butt slightly from your core, not your glutes (basically making sure your lower abs are working).

from your core, not your glutes (basically making sure your lower abs are working). Do not let your lower back drop down when you blow into the balloon.

Do not let your head drop down when you blow into the balloon.

Focus on drawing in (contracting) your pelvic floor muscles as you exhale and relaxing out on the inhale.

If this is too hard, drop down to your hands and knees and start there.

Don’t do this exercise if you suffer from diastasis recti

Paraspinals still tight? Try this exercise to loosen things up and get you ready for glute activation. This PRI squat really promotes diaphragm expansion and pelvic floor response. Be sure to breathe in the same way as detailed above: Inhale: pelvic floor relaxes Exhale: pelvic floor draws up

The Full PRI Squat