I'M PISSING MYSELF
No, seriously.
I saw a video on Instagram recently of a young woman back squatting over 500 lbs. Wildly impressive. Stupidly, I went to the comments... "Wait, did she...pee?" "Are we not gonna talk about her pissing all over the place?" "If you pee when you lift it, it's too heavy for you."
Gotta love the abundance of powerlifting and pelvic floor experts in...checks notes... right, the comments on Instagram.
This is a type of stress incontinence - basically incontinence caused by stress to the urinary system. Lifting heavy, particularly when bracing with the Valsalva maneuver, creates a lot of downward pressure in the abdomen, pressing down on the bladder and pelvic floor. This mainly affects people assigned female at birth. Pregnancy and childbirth can be risk factors, but this can affect anyone, even if you've never been pregnant.
I think it's important for people to talk honestly about this, because it really is very common, and there are some options that can reduce stress incontinence, but also, sometimes when folks lift really heavy, piss is gonna happen and that's okay.
I often hear folks ask "Why don't you just pee before you lift?" Here's the thing: your bladder never empties completely. I'll admit, drinking coffee (and other caffeinated drinks) can worsen this, as caffeine is a bladder irritant. I'm not planning to give up my coffee any time soon, so we're just going to have to work around that one.
If you're struggling with stress incontinence, seeing a urogynecologist, and possibly a referral to pelvic floor physical therapy can be a major help, and can help ensure that there aren't other issues at play.
A few things that have helped me to pee less when I'm lifting:
When powerlifting, it's common to brace using the Valsalva maneuver. You basically take a big inhale, hold and brace, execute your lift, then exhale. I've been working to instead, take a big inhale, exhale a little bit, then hold and brace. That small exhale enables me to find some lift and tension in my pelvic floor. It was tricky to get adjusted to, and I breathe loud and dramatic as shit when I'm lifting, but I don't really care about that.
Using a Poise Impressa bladder support. It goes in like a tampon. "Wait, Jess, I'm very confused because you don't pee out your vagina, this makes no sense." You are correct, the Impress works similar to how a pessary would, by supporting your bladder from inside your vagina. It helps keep pressure on your urethra to prevent leaking. (Note: I'm not sponsored and don't get anything if you buy them. It's just a product that helped me. But Poise, fam, the inbox is open for partnership!)
Working to strengthen my pelvic floor. Obviously there's lots of ways to do this, but I've been working on the Strengthening Program from the Vagina Whisperer. Again, not sponsored, just sharing what I've found helpful!
And lastly, I've been wearing Poise pads on days where I'm lifting heavy and expect to probably leak. At least then I'm not soaking through my shorts. Incontinence pads are different than menstrual pads and do a better job of absorbing a higher volume of liquid.
I really want folks to understand that this is common, and NOT intentional (we aren't out here just pissing all over the place for fun). Urine leaking doesn't mean you need to stop lifting, and it also doesn't mean you're necessarily doing anything wrong. You should definitely seek advice from a qualified healthcare provider to rule out and specific medical causes. That said, it is a common problem, and not something to feel ashamed about.
And y'all, if you see a video of a peron lifting and notice they pee a little (or a lot), trust me, that lifter knows they peed and you don't need to point it out.
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