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Photo Credit: Ellen Song Photography
Many people think it is a “badge of honor” to pee or even poop yourself after a heavy lift or high
intensity event. Some go as far to say “you didn’t lift your heaviest if a mop and bucket didn’t
follow you off of the stage.” That is simply not true. In fact, it is ACTUALLY a sign of weakness,
instability, and pelvic floor dysfunction. No worries though, you can have your cake and eat it
too!
What athletes do not realize is that pelvic floor dysfunction usually boils down to two major
issues: pressure management (or breathing) and hip/pelvic stabilizer weakness. Let’s dive in:
In the pelvic health world, the best way to protect your pelvic floor is to “exhale on exertion.”
Furthermore, this would be from bottom to top of both a deadlift and squat. This would also be
any time you press or pull to ensure that you are putting pressure equally through your system
during the hardest part of the movement.
The caveat to the breathing piece is that many athletes are taught to do a valsalva maneuver (a
technique similar to holding your breath) when they are lifting. This is totally fine in order to
protect the spine! However, most people do the valsalva breathing in a way that puts ALL of
their intra-abdominal pressure on the pelvic floor. What people really need to focus on is
breathing into the lats/side rib cage more and thinking of filling up a can/cylinder (trunk and
pelvis) equally.
The majority of people we see in our clinic have a tight pelvic floor as a result of compensation
for weakness in the lower muscular chain, core, and low back. When those pelvic floor muscles
are tight, they cannot contract effectively to prevent urine and bowel leakage. Also, tight pelvic
floor muscles interfere with the delicate balance of the ball and socket joint of the hip. The femur
bone gets shoved forward, creating more tension in the hips, SI joint, and back. Combine that
with hip flexor, inner thigh, and glute weakness and an athlete can easily be injured under a
heavy load.
How do we prevent it? Lengthen the pelvic floor and make sure your hips are equally balanced
in strength! Not sure where to start? Check in with a pelvic floor physical therapist who looks at
the whole picture and has ample experience working with athletes.
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