Pelvic Floor Health and Strength Training: How to Support Your Pelvic Floor at the Gym by Kathryn Melvin Women's Health APA Physiotherapist

When it comes to fitness, many people focus on building muscle strength, improving cardiovascular health, and increasing flexibility. However, one often-overlooked aspect of physical health is pelvic floor strength. The pelvic floor plays a crucial role in supporting various bodily functions, including bladder and bowel control, sexual health, and core stability. Unfortunately, this area of health is sometimes neglected, especially when it comes to exercising at the gym. In this post, we will explore how to support your pelvic floor during gym workouts and highlight the latest research and Australian guidelines to help guide your approach.

Understanding the Pelvic Floor

The pelvic floor consists of a group of muscles, ligaments, and tissues that form a supportive hammock-like structure at the base of your pelvis. These muscles support vital organs such as the bladder, uterus (in women), bowel, and rectum. A healthy pelvic floor allows for efficient control over urination, bowel movements, and sexual function. It also plays an important role in stabilising the core during exercise, providing balance and preventing injury.

The Impact of Exercise on the Pelvic Floor

Many types of exercise, particularly those involving high impact or heavy lifting, can place strain on the pelvic floor muscles. Activities like running, jumping, or lifting heavy weights can increase intra-abdominal pressure, which, if not managed correctly, can lead to pelvic floor dysfunction.

Research over the last few years highlights that pelvic floor dysfunction is relatively common, particularly among women. For example, studies indicate that between 25% and 45% of women experience urinary incontinence, with higher prevalence rates during or after pregnancy and childbirth (Bø et al., 2020). However, pelvic floor issues are not limited to women. Men can also experience pelvic floor dysfunction, particularly after prostate surgery or due to age-related changes.

Key Guidelines for Supporting Your Pelvic Floor in the Gym

1. Strengthen Your Pelvic Floor Muscles with Targeted Exercises

One of the best ways to support your pelvic floor during exercise is to perform regular pelvic floor exercises. These exercises, often referred to as Kegel exercises, involve contracting and relaxing the pelvic floor muscles. Research shows that strengthening these muscles can help improve bladder control, reduce the risk of prolapse, and support overall pelvic health (Dumoulin et al., 2021). In addition to Kegels, consider working with a physiotherapist who specialises in women's health or pelvic floor rehabilitation. They can guide you in performing the exercises correctly and incorporate pelvic floor training into your broader fitness regimen.

2. Be Mindful of Your Breathing During Exercise

Incorporating proper breathing techniques can significantly reduce the strain placed on your pelvic floor during exercise. When lifting weights or performing high-intensity activities, people often inadvertently hold their breath, increasing pressure on the pelvic floor. To avoid this, aim to breathe out during the exertion phase of the movement (such as when you lift or push) and breathe in when the movement is less demanding (when lowering or resting). The principle of "core bracing" is commonly used in weightlifting, but it’s important to modify this for pelvic health. Instead of holding your breath and tightening your core in a way that increases pelvic floor pressure, use a gentle breathing technique that allows you to maintain both abdominal and pelvic floor stability.

3. Caution with High-Impact Activities If You Have Existing Pelvic Floor Issues

If you are experiencing symptoms of pelvic floor dysfunction, such as urinary incontinence or pelvic organ prolapse, it may be necessary to limit high-impact exercises like running, jumping, or exercises that cause excessive jarring. It may be necessary to replace high-impact activities with low-impact exercises like swimming, cycling, or walking, which put less strain on the pelvic floor (Royal Women's Hospital, 2020). If you are cleared by a health professional, gradually reintroducing high-impact activities with appropriate pelvic floor exercises can help rebuild strength and prevent further injury.

4. Modify Exercises to Protect the Pelvic Floor

In the gym, certain exercises can place excessive pressure on the pelvic floor, especially if performed incorrectly. For instance, heavy squats and deadlifts can increase intra-abdominal pressure, potentially leading to pelvic floor issues if proper technique is not maintained. It is vital to ensure you are engaging the pelvic floor muscles during these movements and not letting them "relax" or disengage under heavy loads. Using a lighter weight, focusing on your form, and engaging your core can make these exercises safer for your pelvic floor. Additionally, exercises that involve a neutral spine (e.g., bridges, bird dogs, and planks) can promote pelvic floor health without excessive pressure.

5. Focus on Core Stability

While the pelvic floor is part of the core, it is essential to understand that it works in harmony with other core muscles, including the abdominals, back, and diaphragm. Australian guidelines recommend a focus on dynamic core stability training to enhance overall support for the pelvic floor during exercise (Physiotherapy Australia, 2021). Exercises like Pilates and yoga can help activate and strengthen the entire core, including the pelvic floor.

6. Seek Professional Advice If You Experience Symptoms

If you are experiencing symptoms such as urinary incontinence, pelvic heaviness, or pain during or after exercise, it is important to seek advice from a pelvic health physiotherapist. They can help assess your pelvic floor strength and guide you in safe, effective exercises.Many women and men unknowingly live with pelvic floor dysfunction because they don’t know where to turn for help. Don't let stigma prevent you from getting the support you need.

Conclusion

Supporting your pelvic floor while working out is essential for long-term health and well-being. Incorporating pelvic floor exercises, using correct breathing techniques, and being mindful of high-impact movements will help prevent pelvic floor dysfunction and injury. Additionally, remember to listen to your body and modify your exercise routine as needed, particularly if you experience symptoms of pelvic floor dysfunction. By taking proactive steps to care for your pelvic floor, you can enhance your gym performance and overall health, ensuring a strong foundation for both fitness and daily life.

References

Bø, K., Stær-Jensen, J., & Mørkved, S. (2020). 'Pelvic floor muscle training in the management of female stress urinary incontinence and pelvic organ prolapse', Neurourology and Urodynamics, 39(4), pp. 1074-1086.

Dumoulin, C., Hay-Smith, E. J. C., & Dorey, G. (2021). 'Pelvic floor muscle training for the management of pelvic organ prolapse: A systematic review', Cochrane Database of Systematic Reviews, 2021(6), CD003019.

Physiotherapy Australia (2021). 'Guideline for management of pelvic floor dysfunction'. Physiotherapy Australia. [online] Available at: https://physiotherapy.asn.au [Accessed 6 December 2025].

Royal Women’s Hospital (2020). 'Pelvic floor health: Keeping it strong'. The Royal Women's Hospital, [online] Available at: https://www.thewomens.org.au [Accessed 6 December 2025