As a pelvic floor PT, I get a lot of questions from patients about lifting. Whether it’s their children or getting back into the gym, I am constantly being asked how lifting impacts your pelvic floor. Let’s start with what exactly your pelvic floor is doing when you lift something. When we lift, pressure increases in our abdomen, pushing down on our pelvic floor and out through our belly. One of the main jobs of the pelvic floor is to control this pressure. Your pelvic floor is not just a one man (or woman) show though, it is part of a team. This team is made up of your diaphragm, inner core, pelvic floor, and back muscles and is called the pelvic cannister. We need a balance of pressure throughout all parts of the pelvic cannister. If there is too much pressure or weakness in this system, you may end up with bulging, pelvic or abdominal pressure, leaking, or pain. One important thing to note here is that it’s not just about the strength of these muscles. They need to be able to engage and support you, however, they also need to lengthen and relax. One place where things can go awry is if a muscle is clenching or unable to lengthen. This will throw the whole pressure system off and cause more problems. This is where lifting gets a bad reputation. When this system is working properly though, lifting -even heavy weights – can be safe and a great way to help strengthen this system. Here are some tips to keep you lifting safely:
- Don’t hold your breath. When you hold your breath, your pelvic floor tends to clench. This will throw off that pressure system and can lead to prolapse, leaking, pain, or abdominal separation.
- Prep your lift with a deep breath in. This applies to lifting anything – a baby, a barbell, a basket of laundry or groceries. You want a breath that expands in 360 degrees. Your ribs, back, and belly should all move outward slightly. You should not notice much movement in your chest and shoulders.
- Perform your lift on an exhale (a good tip to remember this is “exhale on exertion”). As you exhale, gently hug your belly button in towards your spine and perform a small lift through your pelvic floor (kegel). Make sure you are not clenching here. Exhaling like you are blowing through a straw as you lift can help ensure you are not clenching.
If in doubt, reach out to a pelvic floor specialist. If you have tension in your pelvic floor or scarring from a c-section, abdominal surgery or perineal tear during childbirth, this may limit your ability to properly lengthen and engage the muscles of the pelvic cannister. If you are trying these recommendations and still experiencing pressure, leaking, or pain that’s a good sign an evaluation is in order.
