Your pelvic floor plays a role in every movement you do, whether you’re deadlifting 200 pounds, running a 5K, or opening a jar of pickles. Every exercise is a pelvic floor exercise.
But that’s not to say you should be constantly engaging these muscles—or even that you need to constantly pay attention to them. Most of the time, your pelvic floor just does its thing without you knowing. And in fact, one of the most common contributors to pelvic floor dysfunction (including pelvic pain, incontinence and prolapse) is having a pelvic floor that’s constantly trying to work. When your pelvic floor muscles are constantly held tight, over time they become less responsive to the demands placed on them.
A healthy pelvic floor responds to the task at hand, lifting or engaging to support you during a challenging movement and lowering or relaxing when it’s not needed as much. Sometimes this response is automatic. Sometimes these muscles need to be turned on and off more intentionally. Regardless of whether you are dealing with pelvic floor dysfunction, it’s important to understand how these muscles work so you can make sure your current strategy is supporting the long-term function of your pelvic floor.
Your pelvic floor works differently during an exercise that has a distinct work and rest phase, such as a deadlift, versus something like running or holding a plank. It works differently when you pick up a heavy loaded bar than it does when you pick up your baby.
Following is an illustration to show how your pelvic floor works during a heavy deadlift (remembering that “heavy” is relative–it could be a 200-pound barbell or your 20-pound baby depending on where you are at). The graph indicates how much activation or lift of the pelvic floor muscles is necessary during each phase of the movement. (Note: This graph is just to help you visualize the role of your pelvic floor. There are no exact, scientific measurements here).
Pre-lift, you’ll want to take a deep inhale to allow your pelvic floor to relax as much as possible. Then immediately before you lift the bar and until you are standing (work phase), you’ll want to exhale and gently lift your pelvic floor– or as physical therapist Julie Wiebe says, “Blow before you go.” Because the weight is heavy, you will need more stability, and thus more engagement of your pelvic floor. As you lower the bar to the ground, your pelvic floor doesn’t need to work quite as hard. For many people, an appropriate strategy here is to inhale and allow your pelvic floor to relax by the time the bar reaches the ground (as shown here). However, lowering a heavy bar is still work, so If you find that you need more support, you may find that it works better to exhale and engage on the way up, inhale and relax at the top, and then exhale and engage again on the way down (not shown).
If you’re lifting something lighter (again, relative), you likely will not need to engage your pelvic floor as much. You might be able to simply exhale during the lift, and allow your pelvic floor to respond automatically to your breath. If you’re picking up a pencil, you might not need to pay attention to your pelvic floor or breath at all.
But what about all the other exercises out there that have less distinct lifting and lowering phases? Here are some more illustrations and explanations to show how your pelvic floor works in a variety of movements.
Running: Running is one of those exercises in which your pelvic floor works automatically. Thank goodness—can you imagine having to squeeze and release every time your foot hit the ground? Your pelvic floor still lifts and lowers with your breath, but you don’t have to think about it. Avoid gripping or constantly squeezing your pelvic floor and instead focus on maintaining ribs stacked over hips and feeling your breath right around your bra strap (see link “Pelvic Floor Tips for Runners” for more info).
Plank: An exercise that requires constant tension, such as a plank, is similar to running in that you don’t need to squeeze your pelvic floor nonstop. You should be breathing regularly, noticing your pelvic floor gently lift with each exhale and slightly lower with each inhale. If you feel you need more support, lengthen your exhales and gently engage your pelvic floor with more intention. If you still feel pressure at your pelvic floor, take a break.
Carrying a heavy load: Similar to holding a plank, carrying a heavy load requires constant tension. Again, you’ll want to breathe regularly, noticing your pelvic floor gently lift with each exhale and lower with each inhale. If you feel you need more support—for instance, you’re getting tired, you’re going up a step, your wiggly baby is squirming out of your arms—you can more intentionally engage your pelvic floor on your exhales. But be sure to take short inhales to give your PF muscles a chance to reset. If you constantly grip or squeeze your pelvic floor, it will tire out and be less able to support you.
Pushups: Every phase of a pushup requires tension, but the way up is typically more demanding than the way down. Your strategy may vary, but in general you’ll want to exhale and feel your pelvic floor gently lift right before you start to press your body up, until you reach the top of your push-up. This graph shows a strategy of inhaling and release a little bit (but not all!) of the tension on the way down, then exhaling and engaging on the way up. Alternatively, if you feel that you need more support you can briefly inhale at the top and exhale through both the up and down phases (not shown).
To summarize:
For movements with clear work/rest phases:
- Generally you’ll want to exhale just before and through the work phase of a movement (blow before you go). How much you actively engage you pelvic floor muscles as you exhale depends on how much support you need.
- During the less intense phase of a movement, many people find that inhaling and relaxing their pelvic floor helps them reset to prepare for the next rep. However, if you feel pressure on the inhale (like your pelvic floor is being pushed down), you may need to exhale and gently engage through this part of the movement, too. If this is the case, be sure to inhale between repetitions or between movements so your pelvic floor has a chance to reset. Do not try to squeeze your pelvic floor non-stop!
For movements with less distinct work/rest phases
- Focus on maintaining good alignment, avoid holding your breath or gripping your pelvic floor, and allow your core to work naturally.
If you’re having trouble determining whether you are engaging or relaxing your pelvic floor, I highly recommend seeing a women’s health or pelvic floor physical therapist who can get you on the right track. Once you are aware of these muscles, you can address your tendencies and best support your pelvic floor through exercise!