How Exercise Impacts Pelvic Floor Muscles – What You Need to Know

The pelvic floor muscles are crucial yet often overlooked components of the body, playing a vital role in bladder and bowel control, core stability, and overall movement efficiency. These muscles work in coordination with the deep core to support daily activities and more intense forms of exercise. However, certain types of training, such as heavy lifting, high-intensity interval training (HIIT), and high-impact exercises, can place excessive strain on the pelvic floor, potentially exposing or exacerbating existing weaknesses.

Many individuals may experience symptoms such as urinary leakage, pelvic discomfort, or difficulty engaging core muscles during workouts, particularly if the pelvic floor is underactive or overworked. Understanding how different types of exercise affect these muscles and learning effective training strategies can help prevent issues while allowing individuals to progress in their fitness journey.

The Role of the Pelvic Floor in Exercise

The pelvic floor consists of layers of muscles that stretch across the base of the pelvis, supporting the bladder, bowel, and uterus (in women). These muscles function as part of the core, working alongside the diaphragm, deep abdominals, and back muscles to stabilise the spine and maintain internal pressure during movement. According to a study, proper pelvic floor function is essential for maintaining continence, preventing pelvic organ prolapse, and optimising core stability.

During physical activity, the pelvic floor naturally contracts and relaxes to adapt to varying loads. When functioning correctly, it helps absorb impact, maintain continence, and provide the necessary support to keep the body moving efficiently. However, excessive strain, poor technique, or an already weakened pelvic floor can lead to dysfunctions, including incontinence, prolapse, or pain, as highlighted in research, which also notes the importance of voluntary and involuntary pelvic floor muscle contractions during physical tasks.

How Different Types of Exercise Challenge the Pelvic Floor

Weightlifting & Strength Training

Lifting heavy weights significantly increases intra-abdominal pressure, requiring the pelvic floor to work harder to stabilise the body. If the pelvic floor is weak or untrained, it may struggle to manage this pressure, leading to issues such as urine leakage or heaviness in the pelvic region. An investigation suggests that improper breathing and bracing techniques during strength training can contribute to pelvic floor dysfunction, particularly in women who lift heavy weights regularly.

HIIT & High-Impact Exercises

Exercises like jumping, sprinting, and burpees create repeated forces on the pelvic floor, requiring it to act as a shock absorber. According to a report, women who engage in high-impact sports and workouts have a higher likelihood of experiencing stress incontinence due to the repetitive strain placed on these muscles. Strengthening the pelvic floor and incorporating lower-impact alternatives can help reduce unnecessary pressure while maintaining workout intensity.

Core Workouts & Abdominal Training

Traditional core exercises such as crunches, leg raises, and planks can exert downward pressure on the pelvic floor, particularly if the deep core muscles are not properly engaged. Studies indicate that modifying core training with pelvic floor-friendly movements, such as diaphragmatic breathing and controlled stability exercises, can prevent excessive stress on this area.

Signs Your Pelvic Floor May Be Weak or Overworked

If your pelvic floor is struggling to keep up with your exercise routine, you may notice:

• Urine leakage when coughing, sneezing, running, or lifting weights.
• Heaviness or pressure in the pelvic region, particularly after workouts.
• Lower back pain or difficulty engaging core muscles despite training efforts.
• Changes in bladder or bowel control, including increased urgency or difficulty emptying completely.

A study on elite female athletes’ experiences with pelvic floor dysfunction symptoms found that urinary incontinence during exercise is not uncommon, especially among those engaged in high-impact sports.

How to Protect and Strengthen Your Pelvic Floor During Training

1. Proper Breathing & Core Engagement

Many individuals unintentionally hold their breath while lifting or performing high-intensity movements, increasing intra-abdominal pressure and stressing the pelvic floor. Practicing diaphragmatic breathing—inhaling through the nose and exhaling during exertion—can help distribute pressure more evenly and reduce the risk of strain. Research supports the effectiveness of pelvic floor muscle exercise with biofeedback in improving muscle coordination and reducing symptoms of urinary incontinence.

2. Pelvic Floor-Friendly Strength Training Modifications

Instead of traditional heavy bracing, consider:

• Using moderate weights with controlled movements.
• Performing box squats or sumo squats to reduce downward pressure.
• Incorporating single-leg exercises to build strength with less intra-abdominal force.

3. Low-Impact Alternatives for HIIT Workouts

If high-impact exercises cause discomfort or leakage, substitute them with:

• Step-ups instead of box jumps.
• Low-impact kettlebell swings instead of jump squats.
• Inclined mountain climbers instead of full plank versions.

4. Pelvic Floor-Safe Core Workouts

Replace high-pressure core exercises like crunches with:

• Dead bug exercises for core engagement without excessive pressure.
• Modified planks (on knees or elevated) to reduce downward force.
• Glute bridges with proper breath control for core and pelvic activation.

When to Seek Help from a Physiotherapist

If you experience ongoing pelvic floor dysfunction despite modifying your workouts, it may be beneficial to consult a pelvic health physiotherapist. A physiotherapist can:

• Assess pelvic floor strength and function.
• Provide tailored exercises to improve muscle coordination.
• Offer biofeedback therapy to retrain pelvic floor engagement.
• Educate on breathing and core mechanics to protect against future strain. 

Exercise is essential for overall health, but understanding how different training styles affect the pelvic floor is crucial for preventing injury and dysfunction. Weightlifting, HIIT, and core training can challenge these muscles in ways that may highlight weaknesses, but with proper modifications, breathing techniques, and pelvic floor engagement, you can continue training safely.

If you experience discomfort, incontinence, or any signs of pelvic floor dysfunction, a physiotherapist can help assess and strengthen this essential muscle group. At Physiomove London, we provide expert guidance in pelvic floor physiotherapy, helping you stay strong, confident, and pain-free in your fitness journey.