The effect of high impact crossfit exercises on stress urinary incontinence in physically active women

Abstract

Aims The impact of CrossFit (high energy and intensity exercise) on SUI has not been well described. This study evaluates the incidence of SUI in physically active women, and examines specific exercises that can increase SUI. Methods A cross‐sectional study was conducted in women from four CrossFit centers and one aerobic center for comparison. Participants were surveyed regarding baseline demographics, activity levels, severity, and frequency of leakage during CrossFit exercises as well as preventative strategies against SUI. Participants were stratified based on age, body mass index, types of exercises, parity, delivery, and compared using Mann Whitney‐U and Chi square. Results This study had 105 CrossFit (mean = 36.9 years) and 44 aerobic (mean = 29.0 years) participants. Fifty women reported SUI during exercises, while none of the aerobic women reported SUI during exercise. The top three CrossFit exercises associated to SUI were double‐unders (47.7%), jumping rope (41.3%), and box jumps (28.4%). CrossFit women with a history of parity had significantly more episodes of SUI with box jumps, jumping rope, double‐unders, thrusters, squats without weights, squats with weights, and trampoline jumping (P < 0.001). The top preventative strategies were emptying the bladder before workouts, wearing dark pants, and performing Kegel exercises during workout. Vaginal delivery (OR 4.94) and total incontinence symptom severity index (OR 1.45) were both significant predictors of SUI during exercise (P < 0.05). Conclusion There is a significantly higher risk of SUI during CrossFit exercises associated with previous pregnancy and vaginal delivery but also in nulliparous women. In general, women participating in CrossFit have been applying preventative measures for protection of SUI during exercises.

Urinary incontinence in a fitness club setting—is it a workout problem?

“…In the present study, no changes were observed in proportions or severity of UI across the first year of fitness club membership. Most women perceived the symptoms to be slight, and the prevalence of UI was lower than has been reported in the general female population [ 2 ] as well as other studies of women participating in different sports and exercise classes [ 8 , 15 , 16 ], including a study of young nulliparous women (20–25 years) attending gyms [ 14 ] and group fitness instructors [ 7 , 13 ].…”

“…Much research has focused on UI in athletes, including group fitness instructors [ 7 , 8 , 13 ]. A few studies have also reported the prevalence of UI among regular exercisers, including young women who participate in high-impact and high-intensity exercise [ 14 – 16 ]. However, there is a lack of knowledge about beginner recreational exercisers in a fitness club setting.…”

Physical Activity and Stress Incontinence in Women

“…The hammock hypothesis suggests that urinary symptoms, such as SUI, occur when the increase in abdominal pressure exceeds the threshold of the urinary sphincter [19–21]. This hypothesis also supports beliefs that SUI is related to muscle fatigue, evidenced by more frequent leakage later in the day and with more exercises [11].…”

“…Increased intrabdominal pressure is thought to fatigue muscles of the pelvic floor as they balance forces. Therefore, when the downward force from the abdomen is not balanced by the upward force from the pelvic floor muscles, stress urinary continence can occur [11]. This is similar to the mechanism explaining how childbirth damages pelvic floor muscles, and therefore this process is often thought to be the cause of SUI among nulliparous females [2].…”

Impact of quarantine due to COVID-19 on female urinary incontinence during exercise in CrossFit practitioners: an observational study

“…Recent studies have shown that the prevalence of UI in CrossFit practitioners is around 30%, with skipping rope the most related to this event [6,7]. The etiopathogenesis of this condition is related to the increase in intra-abdominal pressure that is not balanced by the contraction of the pelvic muscles [8].…”