Stress Urinary Incontinence is a serious health issue - but you wouldn't know that from a video released by CrossFit recently. Last week I wrote about their attempt at promotion - a YouTube video of women working out so hard during CrossFit training that they wet themselves. An interviewer in the video even misleads women about what the condition is called, labelling it Exercise Induced Urinary Leakage.
The video attracted widespread condemnation from physiotherapists and doctors specialising in continence issues. A Sydney physiotherapist, Antony Lo, wrote a helpful response here. Despite this, the owner of the CrossFit Mode in Adelaide, James Newbury, insists that I and the experts have got it all wrong. Apparently being a CrossFit instructor who has female participants makes him an expert in women's health. In an email, Mr Newbury explained to me; "with more research you would have found out there is a difference between the medical condition you speak of [he's referring to Stress Urinary Incontinence here] and what is actually happening to these women.
"You can have a weak pelvic floor and you can also have a strong pelvic floor that will still give the same result [urinary leakage]. If your core are not [sic] contracting (in time) or in the correct sequence then the result can be the same. This is not a result of CrossFit being too intense and unsafe. This happens to many women even with a laugh or a sneeze. And because of the video, my members have since come to me and said the same thing. It has actually aloud [sic] more women to be open about the issue and find ways to combat it, eg, pelvic stimulation via pilates or yoga.''
My original piece never said CrossFit generally was too intense or unsafe. I said all training programs were open to abuse by some people, and Crossfit was no exception. I said the video was irresponsible and its messages unsafe because they were inaccurate. I expressed disappointment that CrossFit would use such an unsafe promotion, in case women believed some of the rubbish the presenter talks about. If a company wants to shed light on an issue, why not report on it accurately? And how can the video be interpreted as anything but degrading when women are shown mopping up their own urine? Who is supposed to find this funny? The women watching? Maybe my expectations of humour are too high.
Mr Newbury is entitled to his opinion. But his comments are in fact wrong. I don't say so; a Specialist Continence and Women's Health Physiotherapist, Shan Morrison, does. Also the Director of Women's and Men's Health Physiotherapy, Ms Morrison said she had ''no idea'' what Mr Newbury was talking about.
"What these women are experiencing is urinary stress incontinence,'' she says. "Whether the pelvic floor muscle is weak, strong or has poor timing - leaking urine is evidence of underlying pelvic floor dysfunction which is only going to worsen with further high intensity training and no treatment. Yes it can also happen with coughing, laughing and sneezing - which is what will happen to these women in the future - the urine loss will occur with activities other than exercise - unless they seek help.''
Here's hoping Mr Newbury isn't offering his advice to his class participants.
Ms Morrison also said there was no evidence that yoga or Pilates fixes stress incontinence, adding that the term pelvic stimulation used by Mr Newbury was inaccurate terminology. Pilates or yoga may engage the pelvic floor muscles, she said, but participating does not treat urinary stress incontinence or pelvic floor dysfunction. "It requires thorough and individualised assessment and management by a physiotherapist with specific training in pelvic floor rehabilitation,'' she said.
She said any exercise that caused participants to leak urine should be modified and the participant should seek help. Continuing to overload the soft tissue structures of the pelvic floor could lead to long term, irreversible damage. At no point does the CrossFit video make this point. As I said in my piece last week, for this reason CrossFit can not possibly be praised for drawing attention to an important health condition otherwise neglected. The video offers no reliable or accurate information.
But Mr Newburn insists. "You have actually had a dig at a video that has actually brought light to the situation and made a lot of women feel like they are not alone," he wrote to me. But I'm not arguing that CrossFit should never have made a video about the condition. I do, however, think it is ridiculous CrossFit tackled the issue inaccurately and with pornographic overtones. Using sleazy music and comments from women like ''we're just putting out'' indicates they do not see women's health issues worth of being addressed seriously of helpfully.
''They are actually doing all the women with this condition a huge disservice by joking about it, as we know that only 1 in 10 sufferers seek help,'' Ms Morrison said. "There is strong evidence that shows up to 85 per cent of women with the condition can be successfully treated by continence and women's health Physiotherapists." At no point does the presenter in the CrossFit video say the condition is treatable or point women to resources for help. He does not point out that women can be strong, healthy - and not wet themselves in the process. The CrossFit promotion glorifies incontinence - a broken body - as a sign of strength.
How Mr Newbury can claim the video sheds light on anything - apart from CrossFit's view that women wetting themselves is just so funny and makes them so much hardcore than other women - is not clear. But I'll pass on his offer to try out one of his classes sometime.
- Melissa Davey is a health and medical journalist with the Sydney Morning Herald and completing a Masters of Public Health at the University of Sydney.
- Daily Life
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