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Do women runners report more pelvic floor symptoms than women in CrossFit®? A cross-sectional survey


Introduction and hypothesis

Women who perform high-impact activities might be at greater risk of pelvic floor dysfunction (PFD) than those participating in low-impact exercise; however, little is known about whether PFD is more common in one type of high-impact activity than another. The aim of this study was to compare the prevalence of PFD symptoms in women who engage in high-impact activity compared with CrossFit®-brand training (CF).


An online survey collected data from 1,379 women (521 runners, 858 CF) on exercise participation, parity, and PFD symptoms, via the Pelvic Floor Distress Inventory (PFDI-20). Specific questions from each PFDI-20 subscale further investigated symptoms of pelvic organ prolapse (POP), anal incontinence (AI), as well as stress (SUI) and urgency (UUI) urinary incontinence.


Symptoms of POP and AI were significantly higher in runners (POP 12.7%, AI 34.0%) than in CF (POP 7.8%, p = 0.003; AI 27.7%, p = 0.014). There was no significant difference in SUI symptoms between groups (37.0% vs 41.0% respectively, p = 0.141). Vaginally parous runners reported significantly more symptoms of POP (19.0% vs 12.2%, p = 0.023), AI (39.3% vs 27.2%, p = 0.001), and UUI (36.3% vs 29.0%, p = 0.037) than CF.


Women, particularly parous women, who participate in running, have a higher prevalence of POP and AI symptoms than women who participate in CF. This suggests that CrossFit®-brand training might not be more detrimental to PFD symptoms than other high-impact activity, such as running. This study does not conclude a pelvic floor health benefit of one exercise over another, but highlights that exercise options can be provided to women.

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Correspondence to Lori B. Forner.

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Author L.B. Forner is a private practice physiotherapist and has accepted brand ambassador fees for Procter and Gamble Australia. Authors E.M. Beckman and M.D. Smith declare that they have no conflicts of interest.

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Forner, L.B., Beckman, E.M. & Smith, M.D. Do women runners report more pelvic floor symptoms than women in CrossFit®? A cross-sectional survey. Int Urogynecol J 32, 295–302 (2021).

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  • Pelvic floor
  • Incontinence
  • Heavy weightlifting
  • Exercise
  • Pelvic organ prolapse
  • Running