This article was written by one of our contributors; physiotherapist – Emma Brockwell.
Strenuous work or heavy lifting have been widely debated as a possible risk factor for pelvic floor disorders. Recent research (1,2) has identified that women who lift heavy weights report a higher prevalence of pelvic floor dysfunction (e.g. urinary incontinence). A lot more research is required to fully understand the relationship between lifting and pelvic floor dysfunction but does the evidence we currently have suggest we should stop lifting for the sake of our pelvic health?
Why you might experience pelvic floor dysfunction when you lift
When you lift weight (in fact even change position, move, breath or contract our abdominals) pressure in the abdomen increases. Your core muscles, which include your pelvic floor. then have a balancing act to perform, pressure from above needs to be met by support from below. If pressure from above is too high, or support from below too low, pelvic floor dysfunction like urinary leakage, pelvic organ prolapse, or pelvic pain might occur. If this balancing act is maintained optimally then this is likely to keep you symptom free and certainly reduce the chances of you experiencing pelvic floor dysfunction.
How to protect your pelvic health when lifting
A great place to start is by reducing excessive pressure within the core and improving support from below. You can do a variety of things to achieve this:
Reduce excessive downward pressure
- Stop holding in your tummy – so many of us do this to ‘achieve’ a flat tummy but by constantly holding in your tummy you are generating a lot of excessive pressure that even the strongest pelvic floor will eventually struggle to support. So relax, let your tummy go!
- Avoid constipation and straining – straining generates a LOT of pressure and negatively affects your pelvic health
- Maintain a healthy BMI – if you have a BMI of more than 30 this does predispose you to pelvic floor dysfunction in particular Stress Urinary Incontinence
- Breathe – when you lift try exhaling on the hardest part of the movement, this will help reduce pressure and enable a more supportive core
- Avoid bracing your abdominals and bearing down – when you lift try not to brace your tummy and push down into your pelvic floor
Strengthen your pelvic floor
The pelvic floor is just like any other muscle. It has a huge role to play in lifting. If you don’t strengthen this group of muscles then it will struggle to support the demand of the exercise you are carrying out. Check out our previous post on how to strengthen your pelvic floor.
If these tips alone do not help your symptoms then see a pelvic health physiotherapist. In many cases a bespoke treatment program is required. Your physio will assess how you manage pressure, how strong your pelvic floor really is and even modify your lifting technique so that you can go on to lift symptom free, gaining all the benefits strength training has to offer without compromising your pelvic health.
(1) Wikander L, Kirshbaum MN, Gahreman DE. Urinary Incontinence and Women CrossFit Competitors. Int J Womens Health. 2020 Dec 14;12:1189-1195. doi: 10.2147/IJWH.S278222. PMID: 33363412; PMCID: PMC7754094.
(2) Elks W, Jaramillo-Huff A, Barnes KL, Petersen TR, Komesu YM. The Stress Urinary Incontinence in CrossFit (SUCCeSS) Study. Female Pelvic Med Reconstr Surg. 2020 Feb;26(2):101-106. doi: 10.1097/SPV.0000000000000815. PMID: 31990796.