Pelvic Floor Physiotherapy for the Crossfit Athlete
By now, I’m sure you’ve heard the term “pelvic floor/ health physiotherapy” floating around. Luckily, it has become more accepted in society to seek help for symptoms that have been previously dismissed such as incontinence, increased urgency/ frequency, and pain in the pelvic region. If you’ve been looking to learn more about pelvic floor physiotherapy or are curious to what it entails, please keep reading! I hope to give you an idea of what pelvic floor physiotherapy is, what an assessment may look like, and how it can help you optimize your health and performance as a Crossfit athlete!
What is a pelvic floor physiotherapist?
A physiotherapist who can perform pelvic floor assessments undergoes special post-graduate training to be able to perform not just an external, but also internal assessment of the pelvis and pelvic floor. The pelvic floor is a group of muscles that are located in the pelvis that are responsible for support, stability, sexual function, and sphincteric control. While the pelvis may be the focus, we also take into account the other joints (e.g the hips/ spine/ ribs/ knees) to best diagnose and start you on a path to resolving your symptoms.
How do I know if I have pelvic floor dysfunction?
Pelvic floor dysfunction can occur in any population, not just pre/post natal! Common symptoms of pelvic floor dysfunction include incontinence (leaking of urine, feces, or gas), pain (vulvar, testicular, hip), heaviness/ pressure/ feeling like something is “falling out”, and dyspareunia (pain with intercourse).
Pelvic floor dysfunction can cause difficulty with proper bracing during exercise, and poor bracing can also lead to pelvic floor dysfunction; thus making it very important for these athletes to acknowledge! The pelvic floor is the bottom of the “core canister”, which is compromised of the diaphragm (top), transverse abdominus (anterior/ lateral) and lumbar multifidus (posterior). Together they work to manage intra-abdominal pressure, which increases significantly during lifting, especially if using the valsalva (inhale and hold) maneuver.
Reasons for a Crossfit athlete to seek out pelvic floor physiotherapy:
Leaking- often with double unders, box jumps, or quick transition movements
Heaviness/ pressure in the pelvic region- often with heavier, deeper lifts or running
Exercise modifications or guidance in the pre/post natal periods
Difficulty with core engagement in exercises such hollow hold rocks, dead bugs
Lower back pain (while not always related to the pelvic floor, poor pressure management can lead to or exacerbate the lower back)
What does a pelvic floor assessment look like?
A pelvic floor assessment, like any physiotherapy assessment, starts with a thorough subjective history, but with more of a deep dive into bowel/ bladder habits, fluid intake, diet, and sexual health. This can all tell us a lot about your pelvic health before even doing an examination. We then look at how you move through the lumbo-pelvic region, hips, diaphragm/ ribs, and any other external assessment we deem appropriate based on your symptoms.
In regards to the pelvic exam itself, it is client guided depending on your comfort level. Consent is VERY important and continuous throughout the assessment. While an internal pelvic exam is the gold standard and provides a lot of valuable information, we can also learn a great deal from your history and external assessment, thus I would never want someone to miss out on the education that can be provided because of anxiety around the exam. Your comfort is most important!
Your treatment plan will be tailored around your goals, and at some point we will end up in the gym reviewing lifts or exercises that have historically aggravated your symptoms to ensure your confident and safe return to these movements!
While this article was tailored to the Crossfitter, obviously anyone with a pelvis is welcome!