When we hear the word ‘pelvic floor’ often what comes to mind are things like ‘pregnancy’, ‘postnatal recovery’, ‘pelvic organ prolapse’ or ‘kegels’. We think ‘women’ and we think ‘childbirth’; but the pelvic floor plays a much bigger role in our day-to-day lives, especially our lifting lives than people realise - and this includes men.
Yep, I did just say the word ‘men’. Often people don’t associate the word ‘pelvic floor’ with the word “men” or they only associate it with men in their later stages of life when incontinence or POP may becoming a topic of interest. But the thing is, we all have pelvic floors and they all play a role in our integrated core, supporting our internal organs, creating a solid brace when we go to lift heavy things (I’m looking at you deadlifts and squats), as well as controlling our urinary and bowel functions.
In FFS Gyms, we pride ourselves on our Strength & Conditioning Programmes. Head of Performance, Coach Ciaran Ruddock, spends a lot of time planning and researching our 8-week S&C programmes to ensure that our members are getting stronger and more resilient over time.
The key thing here is - more resilient. Have you ever been in the situation when you go to get a PB on a deadlift or squat, you lose your brace in your core and next thing you know you have a lower back niggle that is at you. Or ladies, do you dread doing plate hops, skipping, or box jumps for more than 10 seconds in the fear of having a bit of urinary leakage? Both of these scenarios are common amongst the athletic community (see meme below) but neither should be considered normal (nor should it be made a joke of, just FYI).
I’m not here to judge, I have suffered from both of Lower Back Pain and Urinary Stress Incontinence but it wasn’t until recently that the penny dropped that my pelvic floor might be the missing piece in the puzzle. A cross-sectional study by Bush et al. in 2014 found that women who reported with chronic back pain “have an increased odds of having SUI (stress urinary incontinence) and concluded that it is “important for all trunk muscles, including the pelvic floor muscles, to function in coordination with one another for postural control and for prevention of pain and dysfunction”. The research on pelvic floor dysfunction in men is limited as research has focused mostly on women and there is an assumption that symptoms can go unreported amongst men. Nevertheless, it is estimated that 3-11% of males suffer from urinary incontinence (Nitti, 2001) and this gets more prevalent with age. The Continence Foundation of Australia lists ‘lifting heavy’ as a contributing factor to weakening of the pelvic floor muscles, so it is important that males know how to train it properly to make sure they are building resilience and overall health.
What I want to address in this blog post is the second point - creating a solid brace when we got to lift heavy things.
What is the pelvic floor and why does it matter for lifting heavy?
Let’s take a step back - The pelvic floor is a dome-shaped group of muscles that sits like a sling at the bottom of your pelvis. It connects to your pubic bone at the front, tail bone at the back, and the bottom of your pelvic bones. Its role is to support your internal organs, maintain continence and assist in defecation and childbirth.
Dome-shaped you say? Sounds familiar? That is because there is another muscle that is dome-shaped and that is your diaphragm, which sits at the top of your abdomen at the bottom of the ribs.
The diaphragm and pelvic floor are both part of your ‘core muscles’. We need to think of our core as more than just abs, it made up a multitude of muscles such as your diaphragm at the top, pelvic floor at the bottom, transverse abs at the sides, multifidus at the back and rectus abdominous at the front. These muscles need to be able to co-contract and work together (as you can see in the gif below) to be able to create a strong and stable trunk. This is particularly important during heavy lifts such as your deadlifts, squats, and bench.
Source: Jenny Burrell
Most of us are familiar with the ‘brace’ - the deep breath, ‘tighten your tummy like you are going to get punched’ breathing that we do at the start of a heavy lift. This (also known as the Valsalva Technique) creates intra-abdominal pressure that acts as a natural corset around your spine. However, this corset is only as strong as its weakest link. Your pelvic floor is one part of this corset and if it is not contracting optimally (either from lack of strength or over-fatigued from being constantly contracted) then there is a risk that you are not bracing and lifting as optimally as you could.
Once I started going to a pelvic floor physiotherapist and learned how to relax and contract my pelvic floor correctly, I was advised to start adding this into my lifting, specifically on movements like my squats and deadlifts as this would help with my lower back pain. Now, it took a little while to get and I had to drop back the weights a little at the start, but my god am I more resilient for it. Since I started adding this into my lifting, I haven’t had a blow out back spasm. Sure I can get a bit of a fatigued lower back from time to time but I am much more mindful in creating a total and integrated brace when I lift and it has paid off. I am not saying that learning how to incorporate pelvic floor engagement in your lifts is going to fix all of your problems, but it is a technique that is worth learning and trying out for yourself.
For our FFS Members, Aoife, Kathryn and I will be hosting a workshop on January the 18th 2020 where we will discuss the above in a lot more detail as well as have a practical element to the workshop where you will learn to incorporate correct breathing, bracing and pelvic floor engagement during your lifts.
A final note for those with Stress Urinary Incontinence (SUI)
Stress Urinary Incontinence (SUI) It is often treated like a ‘taboo’ subject or something that us ladies (and some gents) just have to put up with, but that is 100% not the case.
If you run to the loo before a HIIT class to make sure your bladder is empty before you start exercising, have to wear a sanitary pad ‘just in case’, or completely avoid certain exercises for fear of leaking urine, then it sounds like you may have SUI.
As I mentioned above, the pelvic floor muscles can be dysfunctional either due to them being weak (untrained PF muscles), being on a stretch due to postural issues, being hypertonic (which means they are overactive and an unable to relax which is essential for correct contractions), or they can be damaged (say from a vaginal birth or assisted vaginal birth). All of these can be contributing factors to an inability to contract your pelvic floor correctly.
If this is happening, then things like plate hops, box jumps, plyometrics, or skipping can be our worst nightmares due to the worry of some urinary leakage occurring. If this is the case for you, I would strongly recommend going to see a pelvic floor physiotherapist who specialises in this area, as they are qualified to help diagnose what the cause is and work with you to address your specific problem.
If you would like a recommendation on what physiotherapists to visit then email me at firstname.lastname@example.org or come and speak to me, Aoife, or Kathryn at our FFS workshop.
Find Out More
Below are some resources that you may find useful for further reading:
FFS S&C Core Workshop is taking place on the 18th of January 2020 - sign up via your FFS App or add yourself to the waitlist.
Not a member or can't make this worksop, then register your interest for a future workshop by emailing email@example.com.
Email Sinead at firstname.lastname@example.org
Find Sinead on Instagram at @sineadbrophy