Weightlifting and pelvic floor dysfunction: the connection and safe lifting techniques
Worried about weightlifting and pelvic floor dysfunction? Learn safe lifting techniques and how to strengthen your pelvic floor while building strength.
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Strength training is one of the best ways to improve your muscle, bone, and overall health — and that includes muscles you might not think about, like your pelvic floor. If you've experienced leaking during squats or deadlifts, or been told that lifting leads to pelvic organ prolapse, you may have questions about how the two are connected.
The good news: Weightlifting can actually help strengthen and support your pelvic floor muscles. Your pelvic floor is designed to handle pressure and can adapt over time with the right training. "The key is understanding intra-abdominal pressure — the natural buildup of pressure in your belly when you brace, breathe, or lift — and using proper breathing and lifting techniques," says Alex Jones, PT, DPT, a Hinge Health physical therapist.
Read on to learn more about the relationship between weightlifting and the pelvic floor — including how lifting can work in your favor — and how targeted exercise and pelvic floor therapy can improve pelvic floor health.
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The connection between weightlifting and the pelvic floor
During heavy lifts like squats, deadlifts, or overhead presses, pressure from your deep core and diaphragm creates downward force on the pelvic floor muscles. This pressure isn't inherently problematic — your pelvic floor is built to manage it, and it can adapt and get stronger with consistent training.
Symptoms like leakage or discomfort can show up when the pelvic floor isn't yet conditioned to manage a particular load, or when breathing patterns create more downward force than your body is ready for at that moment.
During your lifting workout, breathing techniques can help keep your abdominal muscles, diaphragm, and pelvic floor working together, which supports better pressure management.
"When you take a deep breath in, the pelvic floor is supposed to relax as the diaphragm drops," says Dr. Jones. "During the exhale, the diaphragm rises and the pelvic floor gently contracts." To better support your pelvic floor during lifts, do the most effortful part of your lift on the exhale.
Your body is also able to generate more force when you exhale, so proper breathing can also enhance your lift.
Can weightlifting cause pelvic floor dysfunction?
Weightlifting alone doesn't cause pelvic floor dysfunction. However, certain factors combined with breathing patterns that don't match the demands of a lift can contribute to symptoms.
"Many times, symptoms occur not because the pelvic floor isn't strong, but because it's not firing at the right time," says Dr. Jones.
Factors that may contribute to pelvic floor symptoms include:
Pregnancy and childbirth. Carrying or recently delivering a baby is one of the biggest contributors to pelvic floor changes, which means postpartum lifters may notice more symptoms as they return to training.
Breath-holding during lifts. Holding your breath can create more downward pressure than your pelvic floor is ready to manage at that moment, which may contribute to discomfort or leakage.
Lifting more than your pelvic floor can handle right now. Doing too much too soon without gradual progression can increase intra-abdominal pressure beyond what your body is currently conditioned for.
Pelvic floor that's still building strength. If your pelvic floor hasn't yet built the capacity it needs — whether from childbirth, inactivity, or other factors — you may notice symptoms during lifting.
Core and breath coordination still developing. When your core engagement and breathing aren't yet coordinated during lifts, your pelvic floor may have to manage more pressure than it's ready for.
Remember: The goal isn't to avoid lifting — it's to lift in a way that respects and builds your body's current capacity. Your pelvic floor PT can help you figure out where you are now and how to progress from there.
Signs your pelvic floor needs attention
Certain signs suggest it may be a good idea to work with a pelvic floor PT to build strength and improve coordination. Common signs include:
Leaking urine during lifts (especially squats, deadlifts, jump ropes, box jumps)
A feeling of heaviness or pressure in the pelvic area
Sensation of something "bulging" or dropping down in the vaginal area
Pelvic pain during or after lifting
Difficulty controlling gas or bowel movements
Lower back pain that worsens with heavy lifts
If you're experiencing any of these symptoms, don't be discouraged. It doesn't mean you need to stop lifting — it means your body is giving you useful information about how to adjust your approach and build more capacity.
How movement can help pelvic floor dysfunction
The pelvic floor, like any other muscle group, responds well to targeted exercise therapy and progressive strengthening. In other words, yes — weightlifting can strengthen your pelvic floor when done with proper technique and gradual progression.
Pelvic floor exercises and modified strength training that gradually builds your capacity is the best approach — and a pelvic floor PT is your best resource for both.
"Working with a physical therapist who specializes in pelvic health can help you return to the activities you love while addressing pelvic floor symptoms," says Dr. Jones.
Exercises to strengthen your pelvic floor for weightlifting
Want expert care? Check if you're covered for our free program →- Diaphragmatic breathing
- Hooklying kegels
- Glute bridges
- Kegel squat
- Deadbugs
Remember: Building pelvic floor strength doesn't happen overnight. Consistent practice of these exercises, combined with proper lifting technique, will help you manage intra-abdominal pressure and reduce symptoms over time.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Pelvic floor physical therapy is more than just kegel exercises. Various exercises tailored to your symptoms and needs are key to getting relief. Pelvic floor PT can relieve many different pelvic issues, such as pelvic pain, painful sex, and urinary incontinence.
Members of the Hinge Health pelvic health program experience an average 67% reduction in pelvic pain and 54% reduction in urinary incontinence within the first 12 weeks. Learn more*.
Supportive weightlifting techniques for pelvic floor health
The way you breathe, brace, and move during lifts can make a big difference for pelvic floor health. Here are some tips to support your pelvic floor when you lift:
Coordinate your breathing. Exhale during the hardest part of the lift (the exertion phase). "For example, breathe out as you stand up from a squat or as you pull the barbell up in a deadlift," says Dr. Jones. Try to keep your breath flowing rather than holding it, which helps manage downward pressure.
Engage your core properly. Think about drawing your ribs toward your pelvis and gently activating your pelvic floor before initiating the lift. "This creates stability without excessive bearing down," says Dr. Jones.
Progress gradually with weight. Build strength slowly rather than jumping to heavy loads — your pelvic floor is designed to handle pressure, but it also needs time to adapt to increased demands.
Modify exercises when needed. If squatting deep leads to leaking, a modification may help. Try box squats or reduce your range of motion temporarily. If deadlifts create pressure, try Romanian deadlifts or sumo stance variations.
Listen to your body. If you notice leaking, heaviness, or discomfort during a specific exercise, try reducing the load, modifying the movement, or substituting with a different exercise while you build more capacity.
Strengthen the supporting cast. Don't neglect accessory work! "Strong glutes, core, and hips all support pelvic floor function," explains Dr. Jones.
Tips to support pelvic floor health while weightlifting
Small adjustments to your lifting routine and daily habits can support and strengthen your pelvic floor.
Address constipation. Straining during bowel movements puts repeated pressure on the pelvic floor. Stay hydrated and eat a balanced diet with plenty of fiber-rich foods.
Practice exhale-on-effort throughout the day. Notice if you're holding your breath during daily tasks such as lifting groceries, carrying laundry, or picking up kids. "Practice the same exhale-on-exertion technique as you would during weightlifting," says Dr. Jones.
Wear supportive footwear. Stable shoes with good arch support can improve your lifting mechanics and reduce compensation patterns, supporting better technique and pelvic floor function.
Warm up your pelvic floor. Include pelvic floor activation exercises like kegels in your warm-up routine before lifting.
Consider where you are in your journey. If you're postpartum, returning from time off, or dealing with active symptoms, it may help to focus on building a strong foundation first and then gradually increase intensity. "Focus on building foundational strength first, then gradually increase," says Dr. Jones.
Stay consistent with pelvic floor exercises. A variety of different muscles need to be strong for you to function (and lift) well. Just like you wouldn't skip leg day, don't skip pelvic floor work.
When to see a pelvic health physical therapist
Many people with mild pelvic floor symptoms improve with targeted exercises and modified lifting techniques. But if your symptoms are persistent, getting worse, or significantly affecting your quality of life, a pelvic health physical therapist can help.
It's also a good idea to get professional guidance if you have:
Persistent leaking during workouts despite technique modifications
Visible or palpable pelvic organ prolapse
Pelvic pain that doesn't improve with exercise modification or activity changes
Recent childbirth (especially if you're planning to return to heavy lifting)
History of pelvic surgery or significant pelvic trauma
"A pelvic health PT can perform an internal assessment, identify specific areas to work on, and create a customized plan to return you to full strength training safely," says Dr. Jones.
PT tip: Coordinate your breath
The key to supporting your pelvic floor while weightlifting is coordinating your breath with your pelvic floor. "I see a lot of people make substantial progress once they figure out how to properly coordinate breath with exertion," says Dr. Jones.
When you exhale at rest, you should feel your pelvic floor contract and gently elevate — this happens automatically as part of your body's natural breathing mechanics. During activity, that contraction still happens on its own, but adding some intentional effort to your kegel during the exertion phase can provide extra support when you need it most.
Just as important: Make sure you inhale fully during the resting phase of each movement, and avoid holding your breath. Breath-holding increases downward pressure on the pelvic floor, which can contribute to leakage, pelvic heaviness, or increased strain during lifts.
How Hinge Health can help you
If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
References
Grimes, W. R., & Stratton, M. (2021). Pelvic Floor Dysfunction. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559246
Talasz, H., Kremser, C., Talasz, H. J., Kofler, M., & Rudisch, A. (2022). Breathing, (S)Training and the Pelvic Floor-A Basic Concept. Healthcare (Basel, Switzerland), 10(6), 1035. https://doi.org/10.3390/healthcare10061035
Skaug, K. L., Engh, M. E., & Bø, K. (2024). Acute Effect of Heavy Weightlifting on the Pelvic Floor Muscles in Strength-Trained Women: An Experimental Crossover Study. Medicine and science in sports and exercise, 56(1), 37–43. https://doi.org/10.1249/MSS.0000000000003275
Wallace, S. L., Miller, L. D., & Mishra, K. (2019). Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology, 31(6), 485–493. https://doi.org/10.1097/gco.0000000000000584