Leaking or Pelvic Pressure When Lifting Weights? How Pelvic Floor PT Can Help
Do you leak when you squat or deadlift? Feel pelvic pressure as the weight gets heavier? Or find yourself avoiding certain exercises because you're worried about your pelvic floor?
You don't necessarily need to stop lifting—and you don't have to settle for simply doing Kegels.
For women who strength train, pelvic floor rehabilitation should help you build the strength, coordination, and pressure-management capacity needed to get back to the weights and exercises you want to perform.
Check Out our What Is The Pelvic Floor and How Does It Work article.
Why Do I Leak When I Squat or Deadlift?
Squats, deadlifts, and other heavy exercises place significant demands on your trunk and pelvic floor.
As you brace and produce force, pressure increases within your abdomen. Your diaphragm, abdominal muscles, and pelvic floor need to coordinate to manage that pressure while you lift.
When your body has difficulty meeting the demands of the exercise, urinary leakage can occur.
But leaking while lifting doesn't automatically mean your pelvic floor is weak.
Strength may be one factor, but pelvic floor symptoms can also be influenced by coordination, timing, breathing, bracing, fatigue, excessive tension, or simply performing at a load that currently exceeds your capacity.
That's why doing more Kegels isn't always the answer.
What Does Pelvic Pressure When Lifting Mean?
Not every woman with pelvic floor symptoms experiences leakage.
You might instead notice pressure, heaviness, or a dropping sensation in your pelvis during or after squats, deadlifts, or other exercises.
Pelvic pressure can sometimes be associated with pelvic organ prolapse. But experiencing symptoms doesn't automatically mean you need to give up strength training.
A pelvic floor physical therapist can assess your pelvic floor function along with your breathing, strength, movement, and lifting strategy to determine what may be contributing to your symptoms.
Is Heavy Lifting Bad for Your Pelvic Floor?
Heavy lifting isn't automatically bad for your pelvic floor.
If your goal is to strength train, the solution shouldn't necessarily be to eliminate heavy exercises indefinitely.
Instead, we want to determine what your body can currently tolerate and progressively build your capacity from there.
That might temporarily mean changing:
Weight
Repetitions
Range of motion
Exercise variation
Breathing or bracing strategy
Training volume
As your capacity improves, those demands can progressively increase.
The goal isn't to make your symptoms disappear by permanently avoiding heavy lifting. The goal is to build your capacity so you can tolerate the activities you want to do.
Do I Need to Exhale Every Time I Lift?
You've probably heard that women with pelvic floor symptoms should exhale during the hardest portion of an exercise.
That can be a useful strategy for some people, particularly when initially managing symptoms. But there isn't one breathing technique that's appropriate for every person, exercise, or weight.
Heavy strength training requires you to create trunk stiffness and manage significant forces.
Instead of trying to avoid abdominal pressure altogether, we want you to learn how to manage pressure appropriately for the demands of the exercise.
A pelvic floor physical therapist who understands strength training can evaluate how you breathe and brace during movements like squats and deadlifts and help you find strategies appropriate for both your symptoms and your performance goals.
Returning to Squats, Deadlifts & Heavy Lifting
If your goal is to return to lifting, your rehabilitation should eventually include lifting.
Early treatment may address pelvic floor function, breathing and pressure management, hip and trunk strength, mobility, or other factors contributing to your symptoms.
But that's only part of the process.
As you improve, your rehabilitation should progressively look more like the training you want to return to.
That could mean progressing from a lighter squat variation back to barbell squats, gradually loading a deadlift, increasing repetitions, or eventually returning to heavier sets.
Your pelvic floor needs to be prepared for the demands you're going to place on it.
The goal isn't simply to perform exercises comfortably in a treatment room. It's to help you confidently squat, deadlift, strength train, and lift at the level that's important to you.
Pelvic Floor Physical Therapy for Women Who Lift
Leaking, pelvic pressure, or heaviness during strength training doesn't automatically mean you need to stop lifting.
It means we need to understand why you're experiencing symptoms and what needs to change to help your body better tolerate the demands of your training.
At Summit Physical Therapy, our pelvic floor physical therapists work with active women who want to stay strong, return to exercise, and continue doing the activities that are important to them.
If you're experiencing urinary leakage, pelvic pressure, heaviness, or other pelvic floor symptoms during squats, deadlifts, or strength training, schedule a pelvic floor physical therapy evaluation with our team.
Summit Physical Therapy provides pelvic floor physical therapy for women in Summit, Short Hills, Millburn, Maplewood, Chatham, Florham Park, New Providence, Springfield, South Orange, and surrounding New Jersey communities.