1. To Pee Or Not To Pee? Dr. Lauren Croal
WOD & Wine
Women’s Workshop Series
Badger CrossFit

2. To Pee Or Not To Pee? What is stress urinary incontinence?
Review the “Core”
Pain
Why do people pee with activity?
How breathing affects the pelvic floor
Not all about the “kegel”
Treatment

3. Stress Urinary Incontinence
“Unintentional loss of urine…when physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder.”
-Mayo Clinic
“Occurs when your bladder leaks urine during physical activity or exertion. It may happen when you cough, lift something heavy, change positions, or exercise.”
-National Library of Medicine

4. Core Layers of the Abdominal Core Superficial: Rectus Abdominis
External and Internal Obliques
Deepest Layer: Transverse Abdominis
Stabilizes spine and pelvis

5. Pain You may have NO pain at all OR you may have or have had Abdominal
Buttock
Low back
Pelvic
You may not present with pelvic pain
Be aware that abdominal pain, pelvic pain, buttock pain and low back pain can all be symptoms of incompetent pelvic floor
If you were previously treated for abdominal, buttock, or low back pain and the pelvis was not addressed – seek treatment!

6. Why? Incompetent pelvic floor muscles Nerve related
Overactive pelvic floor muscles
Deficient lower extremity function
Non-skillful movement patterns
Incompetent pelvic floor muscles – fascial injury, tear, avulsion
Nerve related – nerve entrapment, tight musculature
Overactive pelvic floor muscles - hypertone
Deficient lower extremity function – poor load dissipation
Non-skillful movement patterns – motor control imbalance

7. Optimal Breathing Diaphragm and pelvic floor muscles are synchronized
Increased abdominal pressure (lifting/exercise) leads to greater force on pelvic floor
Incompetent pelvic floor leads to urinary incontinence
with inhale (descend) and exhale (ascend)
When you increase intraabdominal pressure – hold core muscles tight while performing lifts and exercising the pelvic floor has to withstand the pressure in the abdominal cavity and prevent descending. If the pelvic floor is incompetent to do so or the intraabdominal pressure is too great – urine will leak out

8. A word about “kegels” >50% of women perform them incorrectly
Can worsen pelvic pain conditions

9. Treatment
Figure out what is the cause of your stress urinary incontinence
Assess posture, breathing, mobility and strength
Treat the WHOLE YOU for optimal function and performance
Not black and white like last talk

10. Questions? Dr. Lauren Croal 11702 W North Ave Wauwatosa WI 53226
Free Consults
Direct Access (no referrals needed)
In network with most major insurance companies
Dr. Lauren Croal
11702 W North Ave
Wauwatosa WI 53226