Is crossfit bad for my pelvic floor?
This is a difficult question. In life we are always labelling things as good or bad. Good food and bad food. Good knee and bad knee. Good for your pelvic floor and bad for your pelvic floor. As physiotherapists we learn time and time again that every person is individual. What does this mean? Something that is “bad” for one person, is actually the “best” for another. So instead of labelling crossfit or any exercise which includes heavy lifting, jumping, skipping or high intensity for that instance as good or bad, we will discuss what you should consider when it comes to exercise and how to choose if it works well for your body or if you need to modify so it suits better
As a physiotherapist, I know that the best exercise to give someone is something that they enjoy and therefore will be compliant with. There is no point in giving someone who loves swimming, cycling exercise. Or someone who loves to get a sweat up and their heart rate pumping, gentle deep breathing exercises. If it is indicated, I will discuss with them why it is beneficial and how it could improve their health/injury/pain/discomfort etc, but a lot of the time you will give this alternative until the client is able to get back into the sport they love. This is a big reason why we have the Alter G anti-gravity treadmill at POGO Physio, because instead of getting people to run in water or do cycling to maintain their fitness when returning from injury, they can run with less gravity through their joints and still get the rush they love from running.As a physiotherapist, I know that the best exercise to give someone is something that they enjoy #performbetter @pogophysio Click To Tweet
Key times in which you should consider whether an exercise is good or bad for you includes
- During pregnancy
- After giving birth
- If you are experiencing signs of prolapse eg heavy feeling in the vagina, bulge out of the vagina etc
- If you experience leaking of urine/wind/faeces during the exercise
- If you experience pain
Lets go through each of these in more depth
1. During pregnancy
During pregnancy you have a lot of changes going on. Firstly, you have a baby growing inside of you! This puts extra downwards pressure down on your pelvic floor. You have a growing tummy to allow the baby to grow, this changes your centre of gravity and makes some exercises a bit trickier to perform. You have hormones releasing which relax the ligaments around your body, including the ligaments in your pelvic floor. Basically, there is already a lot of pressure on your body simply in the pregnancy itself, let alone with exercise on top of that. You need to consider risk vs benefit of the exercise you want to do. Eg, risk = pelvic organ prolapse, benefit = keeping cardiovascular fitness. During pregnancy you can often continue exercise you love but perform it at a lower level (eg instead of jumping squats with a weight, body weight squats are a great alternative).
2. After giving birth
If you have a vaginal delivery, you need to consider if you’ve had any tearing or stitches following labour. If you have caesarean section, you need to give your wound adequate time to heal. Either way, it takes time for your uterus to shrink down and you are also bleeding after giving birth so you do not want to go too hard to soon. A lot changes in the first 6 weeks after giving birth so it is good to give your body a break in those firs 6 weeks before you think about trying anything heavier than walking.
3. If you are experiencing a heavy or dragging feeling in the vagina, bulge out of the vagina etc
These are signs of pelvic organ prolapse. It means that your body is not transferring pressure evenly and there is too much pressure going downwards onto your pelvic floor. Your pelvic floor is made up of muscles and ligaments, and pressure downwards stretches and tensions these ligaments. These symptoms mean your body is not quite ready for the exercise yet and you need to back off. You need to be able to contract your pelvic floor whilst doing exercises and brace and breath correctly. If you are getting these symptoms it is often a good idea to see a women’s health physiotherapist for a full assessment and plan of attack to get you back to doing the exercise you love without these symptoms and possible permanent damage.
4. If you experience leaking of urine/wind/faeces during the exercise
This is similar to the point above. Tension in your pelvic floor ligaments and muscles help to maintain closing pressure of the urethra and anus. If your exercise is too heavy for you, and your muscles cannot maintain their contraction and therefore the urethra or anus opens, that is when there is leakage. Similar to above, you need to back off the exercise you are doing, and having a proper assessment is the best way to know how to build your exercise back up without having issues.
5. If you experience pain
This point is quite self-explanatory. Some people when exercising have a “no pain no gain” mindset. When it comes to exercise, you need to be in tune with your body and know the difference between “muscles working” and “injury type pain”. If something feels hard that is ok, if something feels wrong, stop, reset your posture, try again and if it feels the same, cease the exercise. Sometimes pain can be because you are fatigued, and the next time you try the exercise it will be fine. Sometimes pain can be because there is an injury, and in that case you need a proper assessment and treatment plan to tackle it.
Instead of thinking if something is good or bad for your pelvic floor, think about how you can build your strength and tolerance to be able to perform heavier exercise. The main thing physiotherapists think about in these exercises is intra-abdominal pressure. This pressure is the force within your abdomen when exercising. If it is not controlled it will push down against your pelvic floor and put you at risk of prolapse and incontinence etc. If you are having problems, it does not mean you need to give up completely. It just means you need a plan of how you are going to gradually and safely build up to what you want to do, and a physiotherapist is your best guide for this. As physiotherapists, we WANT you to keep exercising and moving! Do not fear going to the physiotherapist to be told “sorry you cannot do this”, be excited to have a plan of how you are going to get back to it the most safe way for your body.
Emily Georgopolous (APAM)
Featured in the Top 50 Physical Therapy Blog