Part of Pelvic floor weakness
Lifting weights with a weak pelvic floor: what to change first
Warning signs, and when to get help
Can you lift weights with a weak pelvic floor?
Usually yes, with changes, and the changes are smaller than most people fear. What is not reasonable is carrying on exactly as before once a lift makes you leak.
The published advice splits in two here, and the split is better set out than averaged into one vague sentence. You can meet both halves of it in the same afternoon and come away thinking somebody must be wrong.
Continence Health Australia, through its Pelvic Floor First program, writes for someone whose pelvic floor is already symptomatic. Its ten-step guide says never to lift heavy weights that make you strain or make you want to hold your breath, to keep resistance to a minimum until your pelvic floor condition has improved, and to lift from waist height rather than from the floor while that is the case. It also says to breathe out with every effort and never to hold your breath or pull your stomach in strongly.
POGP, the UK group of pelvic health physiotherapists, is at the same end for one specific group. In its prolapse guide, written for women who already have a prolapse, it says activities using weights may cause too much downward pressure and suggests low-impact work in the short term, such as modified aerobics, cycling, a cross trainer, fast walking, pilates or swimming, while you build the pelvic floor up. It also makes a point the gym rarely does. The weight of the thing you lift is one part of it, and frequent or repetitive bending and lifting can be a problem in its own right. Its instructions are to tighten the pelvic floor before each lift, even a light one, and to split loads and make more trips.
UK guidance for that same group says something similar in a single line. For women with pelvic organ prolapse, NICE suggests considering lifestyle advice that includes keeping heavy lifting to a minimum, alongside weight loss if your body mass index is over 30 and preventing or treating constipation (NG123, recommendation 1.7.2). The NHS is blunter on its own prolapse page, where the things to do yourself include avoiding physical activities that put a lot of strain on the pelvic floor, naming heavy lifting, running and trampolining. That advice is written for women who have a prolapse, not for everyone who lifts.
The research reads differently. Forner and colleagues surveyed 3,934 women and grouped them by how much they lifted in training: 15 kg (33 lb) or less, 16 to 50 kg (35 to 110 lb), more than 50 kg (110 lb), or none. Symptoms of prolapse, defined as the sensation of a vaginal bulge, were reported by 14.4 percent overall, and the authors concluded that physically active women who lift heavy weights do not have a higher prevalence of prolapse symptoms.
If anything the numbers lean the other way: women lifting 15 kg (33 lb) or less were more likely to report a bulge sensation than women lifting more than 50 kg (110 lb), with an adjusted odds ratio of 2.1 (95 percent confidence interval 1.7 to 3.4). Do not read that as light weights being the problem. A survey taken at one point in time cannot tell you which came first, and the obvious explanation is that women with symptoms choose lighter weights.
Age, having given birth vaginally, a history of constipation or hemorrhoids and a family history of prolapse were all associated with symptoms. Body mass index, cesarean section, forceps delivery, hysterectomy and menopausal status were not.
Both sides are honest, and they are answering different questions. The continence and physiotherapy guidance is a management plan for a pelvic floor that is giving you symptoms today, or for a prolapse that has already been diagnosed. The survey evidence is about whether lifting is what caused the problem across a population. Knowing which question you are asking tells you which piece of advice applies to you, and if you have symptoms now, the cautious side is the one written for you.
Does lifting weights weaken the pelvic floor?
The straight answer is that we do not know, and that the evidence available leans toward no for recreational lifting.
Nygaard and Shaw's review is the most useful summary. Across the literature, mild to moderate activity such as brisk walking goes with lower odds of urinary incontinence, leaking during exercise is common in high-impact sport, and lifetime activity in middle-aged women may slightly raise the odds of stress incontinence without appearing to increase prolapse. Then two findings that sit awkwardly together: women having surgery for prolapse reported more heavy work than controls, while community women found to have a prolapse on examination reported similar strenuous activity to those without one.
The authors are blunt about why that is unresolved. Most studies are cross-sectional, most are small, and the data are insufficient to say whether strenuous activity when young leads to pelvic floor disorders later in life. Their overall conclusion is that most physical activity does not harm the pelvic floor and brings health benefits worth having.
One distinction is doing a lot of work in that paragraph. Heavy lifting done repeatedly at work, year after year, appears on Continence Health Australia's own list of what puts a pelvic floor at risk, next to long-term constipation and a long-term cough. Three sets of a barbell lift twice a week is not that. If your job involves lifting all day and you have symptoms, you are in the group the cautious advice was written for.
What happens inside when you lift
Pressure in the abdomen rises, the pelvic floor is the bottom of the container, and the amount of rise is less predictable than you would expect.
Shaw and colleagues measured intra-abdominal pressure directly, using a wireless pressure sensor placed in the vagina, in 57 women doing a set protocol of activities. Two of their findings carry into the gym. Pressure varied a great deal between individuals doing the same activity, particularly in tasks where you regulate your own effort. And coughing produced the highest single peak pressure of anything they measured, although the total pressure over time was lower for a cough than for most of the other activities.
The practical consequence is that nobody can give you a safe weight. A number that produces a modest pressure rise in one woman produces a much larger one in the next, and a cough you cannot avoid beats the peak of things you can. That is why the advice below is about how you lift rather than about a ceiling in kilograms.
What you can do is reduce the two things that push the pressure up without adding any training effect: holding your breath through the effort, and pulling the stomach in hard. Continence Health Australia names both specifically, saying that holding your breath or pulling your stomach in strongly during exercise increases the downward pressure on your pelvic floor.
What to change first: load, breathing, range
Change these in order, and give each one two or three weeks before you judge it.
One reader stops here instead. If you have had an operation in your pelvis, whether it was for prolapse or leaking, a hysterectomy, prostate surgery or anything else, your surgical team's instructions decide when lifting comes back and at what weight, and the three changes below are for when they have cleared you. What to ask them for is further down this page.
Load comes first because it is the lever with the most effect. Bring the weight down to something you can lift without straining and without wanting to hold your breath, which is the national continence test, not a percentage of your maximum. Continence Health Australia suggests starting with very light resistance, getting the technique right, and adding load only once your technique and your pelvic floor control are good. Your physio will adjust this.
Breathing is next, and it is the change people notice fastest. Breathe out through the effort and in on the way back: on a barbell lift Continence Health Australia puts it as exhaling as the weight goes up and inhaling as it comes down. Count or hum through a rep if you catch yourself holding.
Then use the pelvic floor the way you would before a cough, squeezing just before the effort and letting it go fully between sets or repetitions, which is the same approach described on the staged pelvic floor program. POGP's prolapse guide puts the same instruction as drawing up and tightening the pelvic floor before any activity that raises the pressure in your tummy, because that is what resists the downward push, and it tells women to do it before every lift rather than only the heavy ones. If the breathing part is what is defeating you, diaphragmatic breathing is where to practice it without a weight in your hands.
Range is the third lever and the one most lifters resist. For squats, deep squats and lunges, Continence Health Australia advises a narrow stance, bending the knees less than 90 degrees, and reducing the weight carried on the shoulders, because that load also presses down on the pelvic floor. A squat with ball squeeze is a useful halfway house while you rebuild, and the glute bridge lets you load the hips with your trunk supported.
One more lever is the day itself, and it is the one nobody counts as training advice. Continence Health Australia's eighth step says that when you are very tired, unwell or have low back pain your pelvic floor and deep tummy muscles may not work as well, so you are more likely to get symptoms and to hurt yourself, and that the answer is a break until you have recovered. A session moved to Thursday is not a setback.
Which lifts cause the most trouble, and what to do instead
Not every lift presses down equally, and the published list is short and specific.
Overhead work is the one named outright: exercises performed above the head place much more pressure on the pelvic floor, so leaking is more likely, and the suggested swaps are lighter weights or a forward, lateral or rear raise with dumbbells instead of a press. Loaded squats come next, through the weight on the shoulders as much as the depth. Lifting from the floor is discouraged while symptoms are active, with waist height suggested instead, which in practice means a rack pull or a box rather than a deadlift from the ground. Jumping work, including jumping lunges and power jumps, is not recommended for people with pelvic floor problems. One thing on the same list is not a lift at all: a full plank on the toes is not recommended either, and the suggested way in is to hold the pelvic floor lift with your thighs still on the floor, for up to 10 seconds at a time and then rest, before progressing to a plank on your knees.
Two general rules sit under all of that. Rest for a couple of minutes between sets so the pelvic floor recovers along with everything else, and where you can, do resistance work seated or lying down, which takes gravity out of the equation. If you are pregnant and past the first three months, check with your physio before exercising flat on your back, and use the seated version instead.
And the rule that outranks the list: if your symptoms are worse with a specific exercise, modify it or leave it out and replace it with another exercise for the same area. That is Continence Health Australia's tenth step, and it is better than any general ranking of lifts, because it uses your floor rather than an average one. If back pain rather than the pelvic floor is what the barbell brings on, lower back pain after deadlifts covers that separately.
What leaking, heaviness or a bulge during a lift is telling you
These three are not the same signal, and the usual mistake is treating them as one.
A leak during a lift is a timing and load problem most of the time. The floor did not get there fast enough or strongly enough at the moment pressure rose. Stop that lift for the day rather than finishing the set, and get the floor assessed before you build the weight back up, which is what the warning list at the foot of this page says as well. The fixes themselves are undramatic: dropping the load, fixing the breath, squeezing before the effort, and building the squeezes themselves in parallel.
Heaviness or dragging low in the pelvis during or after a session is a different message. It says the load is reaching the supporting tissues rather than being managed by the muscle, and it belongs in the warning list at the foot of this page rather than in a plan to push through. The same goes for a sense of a bulge or of something coming down, which needs looking at before you build the weight back.
Pain is its own category and does not fit the weak pelvic floor story at all. Pelvic pain, pain with sex or pain around the tailbone more often goes with a floor that is overactive and will not relax, and squeezing harder makes that worse rather than better.
Whichever of the three you have, the thing to record is the lift it happens on and the weight at which it starts. That one note turns a vague complaint into something a pelvic health physio can work with in a single appointment.
Lifting after birth, and lifting after pelvic surgery
If you have recently given birth, including by cesarean section, or you have a gap down the middle of your stomach muscles (diastasis recti), ask your physio, midwife or doctor first.
That line is not a formality. Lifting is the activity most likely to find the two postnatal problems that are easy to miss, and both have their own pages: postnatal core and pelvic floor for the months after a birth, and diastasis recti for the gap itself. Forner's survey found having given birth vaginally among the factors associated with prolapse symptoms, so this is not a cautious invention.
After surgery for incontinence or prolapse, or any other pelvic surgery, follow the program your surgical team gave you, including when lifting can come back and at what weight. Ask for that instruction in detail rather than taking it away as do not lift anything heavy, because it has several parts: the weight you can start from, how long the limit lasts, whether it comes off in stages, whether overhead work and lifting from the floor are treated differently from everything else, and whether anything is off the list for good. NICE asks for a review 6 months after prolapse surgery, including an examination, so if nobody has given you a date for a conversation about load, that is the appointment to use (NG123, recommendation 1.8.24).
Surgeons genuinely differ here, and how far apart they are is worth knowing before you go hunting for a number online. Read the figure in this paragraph as a survey answer belonging to the surgeons who gave it, not as a weight you have been cleared for. In a survey of physicians at a national gynecology conference in the United States, answered by 135 of the 418 attendees, 87 percent of them specialists in pelvic reconstructive surgery, 82 to 86 percent gave their patients a specific lifting restriction after minimally invasive gynecologic or pelvic reconstructive surgery, and about half limited lifting to a maximum of 10 lb (4.5 kg), with the figure shifting depending on which operation was done. The authors' own conclusion was that the recommendations they collected covered a wide range (Winkelman 2020).
That 10 lb is not a safe weight and it is not this page handing you one. It was the commonest cap in that survey, which makes it the order of magnitude to ask your own team about rather than a number that applies to you: ask whether theirs is that, or more, or less. A post-operative limit is not a pelvic floor number in the first place. It is a healing timetable for the tissue somebody repaired, which is why it arrives with a date on it and why this page's refusal to name a weight elsewhere does not apply to it.
The restriction itself is less settled than the confidence it usually arrives with. None of what follows changes the instruction you were given, because only the team that operated can change that. It is here so you know the question is a live one rather than a formality, and so you can ask about it. A randomized trial of women having reconstructive prolapse surgery, 95 of whom completed the main outcome, compared being told to resume activity at your own pace with no restriction on lifting against being told to avoid heavy lifting and strenuous exercise for 3 months. Satisfaction was high in both groups, anatomic outcomes were no different at 3 months, and the unrestricted group reported fewer pelvic floor symptoms (Mueller 2017). A 2025 systematic review of 5 randomized trials, 434 women in total, found no difference in the anatomical measure out to 3 months and symptom scores that favored the liberal instruction (Cacheiro Bofarull 2025), and the 2025 Cochrane review of perioperative interventions in prolapse surgery lists restricted against liberal postoperative activity instructions among the comparisons that showed no clinically relevant difference (Shahid 2025).
Be careful how far you take that, because it is easy to take too far. Liberal in those trials meant the restriction was lifted and each woman set her own pace, not that anyone was coached back under a load and watched. Not one of them put a woman back under a loaded barbell and watched what happened, the follow-up stopped at around 3 months, and 434 women across five trials is a thin body of work for a question this consequential.
Nygaard and Shaw, the review this page leans on elsewhere, name the postoperative period as one of the stretches of life where the prospective studies have not been done. So read it as a reason not to assume the strictest figure you hear is the only safe one, rather than as permission to set your own date. Your surgeon knows which operation you had, which tissue was used and how it looked at the end, and none of that is visible from here.
What a page can give you is what to watch for, because a repair can give way, and the way it announces itself is the symptom coming back. If the bulge, the heaviness or the leaking you had the operation for returns while you are building load, or you get new pain, new bleeding or discharge, or new trouble peeing or pooing, that is the load stopping and the surgical team hearing about it, not a training problem to work around. Those are also the symptoms NICE lists for a suspected mesh-related complication, which goes to a urogynecologist, urologist or colorectal surgeon for specialist assessment rather than to a physio (NG123, recommendations 1.10.1 and 1.10.2), and the NHS asks anyone who has had vaginal mesh put in and thinks it is causing problems to speak to a GP or their surgeon.
Several of the lines in the warning list at the foot of this page say the same thing, and they are worth reading before you load the bar rather than after. The bulge, the heaviness or the leaking coming back sits at the routine level, with the surgical team rather than a physio. A fever, heavy bleeding, smelly discharge or a wound that is oozing or coming apart is a same-day call to that team, whether the operation was done for prolapse or leaking or was done in your pelvis for some other reason, such as removal of the womb or of the prostate. A newly swollen, warm or tender calf or thigh has its own line, because surgery in the pelvis raises the risk of a blood clot. And severe or sudden pelvic pain, a wound that opens up and bleeding that suddenly gets much heavier are on an emergency line, because those do not wait for a phone call. Which of those a symptom turns out to be takes a urogynecological examination, and neither this page nor a pelvic health physio can settle it for you.
If you have had prostate or other urological surgery, Continence Health Australia's advice is to wait until your surgeon has checked your healing before starting pelvic floor exercises, and the same deference applies to the weights. Returning to the gym after injury covers how to stage a return in general, and your surgeon's dates come first.
Men, lifting and the pelvic floor
Men lift and men leak, and the sources written for them are thinner, though they do exist.
Continence Health Australia publishes guidance for men on finding and using the pelvic floor, including the mirror check of the penis drawing slightly in toward the tummy and the testicles lifting as you squeeze, and a dose of a 3-second hold building to 5 to 8 seconds, 3 to 5 squeezes per set building to 8 to 10, three times a day, resting the muscle for as long as you held it between one squeeze and the next. It also names constipation and straining on the toilet as things that affect the muscles, and asks men to check weekly whether they have avoided straining. POGP publishes a separate pelvic floor leaflet for men in the UK.
What men do not have is the research. Forner's survey was in women, Shaw's pressure study was in women, and Nygaard and Shaw's review is about women. So the mechanics and the advice carry across reasonably well, and the prevalence figures do not carry across at all. A man who leaks or feels pressure during a lift has the same route as a woman does: get assessed rather than guess.
When to stop and get assessed
Stop that lift, not the gym. Then book an assessment instead of experimenting for another six months.
The clearest reasons to get seen are a leak during a lift, from the first time it happens rather than after it has settled into a pattern, any sense of heaviness, dragging or a bulge, pain anywhere in the pelvis with lifting, and a lift you have already dropped the weight on twice without the symptom changing. A pelvic health physio or physical therapist can examine how your floor contracts and relaxes, which is the one piece of information no page can give you, and then set the load you can start from.
The warning list at the foot of this page is a different matter and comes before any of the above. The lines that need emergency care are about the nerves at the base of the spine and about a bladder that will not empty at all. A new soft lump at the belly button, along the middle of the tummy or at a cesarean scar that bulges when you cough or strain goes to a doctor, because a hernia and a gap can be there together. If you have had an operation in your pelvis, for prolapse or leaking or for anything else, several of those lines are written for you rather than for a pelvic floor nobody has operated on, and they route you to your surgical team rather than to a physio, with one emergency line for the pictures that do not wait for a phone call and one for a calf or thigh that could be a blood clot. Red flags in physiotherapy explains why we keep that list separate, and the gym and lifting section covers the other injuries that bring lifters to a physio.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: numbness, tingling or altered feeling around or under your genitals, between your inner thighs, or around your bottom (anus), for example it feels different when you wipe after using the toilet. Call emergency services or go to an emergency department straight away. This can be a sign of pressure on the bundle of nerves at the base of the spine (cauda equina syndrome), which needs emergency treatment.
- Emergency: you suddenly cannot control your bladder or bowels at all. The same applies to new leaking of pee or poo, new trouble starting to pee, not being able to feel yourself peeing, not noticing when you need to poo, a new change in how your genitals feel during sex, or new trouble getting an erection or ejaculating, if it comes with back pain, sciatica, or pain, tingling, numbness or weakness in one or both legs. Call emergency services or go to an emergency department straight away. These can also be signs of cauda equina syndrome.
- Emergency: you cannot pee at all, especially if your lower tummy feels full and painful. Call emergency services or go to an emergency department straight away.
- Emergency: a lump at or near your belly button, along the middle of your tummy or at your cesarean scar, together with pain that is severe or came on suddenly, not being able to poo or pass wind at all, vomiting blood or vomit that looks like coffee grounds, or suddenly becoming confused. Call emergency services or go to an emergency department straight away, and do not try to push the lump back in yourself.
- Emergency: since any operation in your pelvis, including an operation for prolapse or for leaking, removal of the womb (hysterectomy) or removal of the prostate gland, you have pain in your tummy or pelvis that is severe or came on suddenly, a wound from the operation that opens up, bleeding that suddenly becomes much heavier or that soaks a pad within an hour, or you feel faint, dizzy or breathless, your heart is pounding, or you feel very unwell. Stop lifting and call emergency services or go to an emergency department straight away, and do not drive yourself.
Get help today
- A soft lump at or near your belly button, along the middle of your tummy or at your cesarean scar that gets bigger when you cough or strain, or that gets smaller or disappears when you lie down. This can be a hernia, so see your doctor, and see one even if you already know you have a gap, because the two can be there together. If the lump becomes painful or tender, if it used to flatten when you lay down and now stays up, or if you have a bloated tummy, you feel or are being sick, you are constipated, or you have a high temperature or feel hot, cold or shivery, get medical help straight away, the same day, for example at urgent care or an emergency department, and do not try to push the lump back in yourself. If the pain is severe or came on suddenly, or you cannot poo or pass wind at all, call emergency services or go to an emergency department straight away.
- Same day: blood in your pee, which may look pink, red or dark brown, even a small amount, even once, and even with no pain. Get medical advice the same day. It needs checking even if it goes away.
- Same day: since an operation for prolapse or for leaking, you have a fever or feel hot, cold or shivery, heavy bleeding from your vagina or blood clots, discharge that smells, a wound from the operation that is oozing or whose edges are coming apart, or pain in your pelvis that is new or getting worse quickly. Stop lifting and contact your surgical team, or the ward you went home from, the same day, and if you cannot reach them get medical help the same day anyway, for example at urgent care or an emergency department. These can be signs of an infection or of bleeding from the repair. If the pain becomes severe or comes on suddenly, a wound from the operation opens up, the bleeding suddenly becomes much heavier, or you feel faint, dizzy, breathless or very unwell, call emergency services or go to an emergency department straight away rather than waiting for a call back, and do not drive yourself.
- Same day: since an operation in your pelvis for any other reason, for example removal of the womb (hysterectomy) or removal of the prostate gland, you have a fever or feel hot, cold or shivery, heavy bleeding, discharge that smells, a wound from the operation that is oozing or whose edges are coming apart, or pain in your pelvis that is new or getting worse quickly. Stop lifting and contact your surgical team, or the ward you went home from, the same day, and if you cannot reach them get medical help the same day anyway, for example at urgent care or an emergency department. These can be signs of an infection or of bleeding. If the pain becomes severe or comes on suddenly, a wound from the operation opens up, the bleeding suddenly becomes much heavier, or you feel faint, dizzy, breathless or very unwell, call emergency services or go to an emergency department straight away rather than waiting for a call back, and do not drive yourself.
- Same day: since any operation in your pelvis, a calf or thigh that is newly swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that feels different from normal muscle soreness. Stop lifting and get medical advice the same day, because surgery in the pelvis raises the risk of a blood clot (deep vein thrombosis). If you are also short of breath or have chest pain, call emergency services.
Book an appointment
- Within a few days: any bleeding from your vagina after your menopause, including spotting or pink or brown discharge, even if it is only a small amount, only happened once, or came on during or after sex. Book an appointment with your doctor within a few days. Bleeding after the menopause is usually not serious, but it has to be checked, because it can be a sign of cancer, and cancer found early is easier to treat.
- Routine: a bulge or lump you can feel or see inside or coming out of your vagina, or a feeling of heaviness or pressure in your lower tummy or vagina. Book an appointment with your doctor. This can be a sign of pelvic organ prolapse, and pelvic floor exercises are often part of the treatment once it has been checked.
- Routine: since an operation for prolapse or for leaking, the bulge, the heaviness or the leaking you had it done for has come back or is getting worse, or you have new pain, new bleeding or discharge from your vagina, or new trouble peeing or pooing. Stop building the weight up and book an appointment with your surgical team rather than waiting for your next routine review. A repair can give way, and after mesh surgery these are also the symptoms a specialist checks the mesh for. Which of those it is takes an examination, and it is not something this page or a physiotherapist can tell you.
- Routine: leaking urine, or a feeling of pressure or heaviness low in your pelvis, that starts during a lift. Stop that lift for the day rather than finishing the set, and book an assessment with a pelvic health physio before you build the weight back up, sooner if it happens again in a later session or you feel a bulge or something coming down.
Common questions
Can I lift weights with a weak pelvic floor?
In most cases yes, with changes. The national continence advice is not to lift loads heavy enough to make you strain or hold your breath, and to keep resistance low until the pelvic floor has improved, which is a change of load rather than a ban on lifting. The research side is reassuring about lifting in general: in a survey of 3,934 women, those lifting more than 50 kg (110 lb) did not report more prolapse symptoms than other women (Forner 2020). If you leak, feel heaviness or feel a bulge during a lift, that is the point to get assessed rather than to push on.
Does lifting weights weaken the pelvic floor?
There is no good evidence that it does, and there is not enough evidence to rule it out either. Nygaard and Shaw reviewed the field and found most activity is not harmful to the pelvic floor, with two findings that pull in opposite directions: women having surgery for prolapse reported more heavy work than controls, while women found to have a prolapse on examination in the community reported much the same strenuous activity as women without one. They also say the data are insufficient to tell whether strenuous activity when young leads to pelvic floor disorders later. Heavy lifting at work, repeated over years, is listed as a risk factor by Continence Health Australia, which is not the same thing as a few sets in the gym.
Is lifting heavy weights bad for the pelvic floor?
It depends entirely on whether your pelvic floor is giving you symptoms now. If it is, the cautious advice applies and the load comes down for a while. If it is not, there is no trial telling you a number to stay under, and the pressure studies cannot give you one: when intra-abdominal pressure was measured inside the body during a set of activities, pressures varied widely between people doing the very same task, and coughing produced the highest single peak of all (Shaw 2014). A page cannot tell you your safe weight. An assessment can tell you what your floor does under load.
Does weight lifting strengthen the pelvic floor?
Not in the way the squeezes do. Nothing in the lifting literature shows that loading the body generally trains the pelvic floor specifically, and the evidence for pelvic floor strength sits with the long holds and quick squeezes done on their own. So treat them as two separate jobs: the squeezes build the floor, and the lifting is what you are protecting while you do it. Continence Health Australia suggests using the pelvic floor before and during a lift and relaxing it fully between sets or repetitions.
References
- Forner LB, Beckman EM, Smith MD. Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey. International Urogynecology Journal. 2020;31(8):1551-1558. https://doi.org/10.1007/s00192-019-04163-w
- Nygaard IE, Shaw JM. Physical activity and the pelvic floor. American Journal of Obstetrics and Gynecology. 2016;214(2):164-171. https://doi.org/10.1016/j.ajog.2015.08.067
- Shaw JM, Hamad NM, Coleman TJ, et al. Intra-abdominal pressures during activity in women using an intra-vaginal pressure transducer. Journal of Sports Sciences. 2014;32(12):1176-1185. https://doi.org/10.1080/02640414.2014.889845
- Winkelman WD, Erlinger AL, Haviland MJ, Hacker MR, Rosenblatt PL. Survey of Postoperative Activity Guidelines After Minimally Invasive Gynecologic and Pelvic Reconstructive Surgery. Female Pelvic Medicine and Reconstructive Surgery. 2020;26(12):731-736. https://pubmed.ncbi.nlm.nih.gov/30707119/
- Mueller MG, Lewicky-Gaupp C, Collins SA, Abernethy MG, Alverdy A, Kenton K. Activity Restriction Recommendations and Outcomes After Reconstructive Pelvic Surgery: A Randomized Controlled Trial. Obstetrics and Gynecology. 2017;129(4):608-614. https://pubmed.ncbi.nlm.nih.gov/28277355/
- Cacheiro Bofarull A, Philip CE, Francis G, et al. Postoperative Activity Restrictions After Reconstructive Pelvic Surgery. Urogynecology. 2025;31(3):266-275. https://pubmed.ncbi.nlm.nih.gov/39689229/
- Shahid U, Haya N, Baessler K, et al. Perioperative interventions in pelvic organ prolapse surgery. Cochrane Database of Systematic Reviews. 2025;7:CD013105. https://pubmed.ncbi.nlm.nih.gov/40693510/
- Continence Health Australia. 10 step guide to putting your pelvic floor first. Pelvic Floor First. https://www.pelvicfloorfirst.org.au/pages/10-step-guide-to-pelvic-floor-friendly-exercise.html
- Continence Health Australia. Barbell workouts. Pelvic Floor First. https://www.pelvicfloorfirst.org.au/pages/barbell-workouts.html
- Continence Health Australia. Pelvic floor exercises for men. https://www.continence.org.au/living-with-incontinence/pelvic-floor-exercises/pelvic-floor-exercises-for-men/
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pelvic floor muscles. https://thepogp.co.uk/patients/pelvic_health_advice/pelvic_floor_muscles.aspx
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pelvic Organ Prolapse: a guide for women. POGP 2020, 2023. https://thepogp.co.uk/Resources/9/pelvic_organ_prolapse_a_physiotherapy_guide_for_women
- National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management (NICE guideline NG123). Published 2 April 2019, last updated 24 June 2019. https://www.nice.org.uk/guidance/ng123
- NHS. Urinary incontinence: 10 ways to stop leaks. Page last reviewed 15 June 2023. https://www.nhs.uk/conditions/urinary-incontinence/10-ways-to-stop-leaks/
- NHS. Pelvic organ prolapse. Page last reviewed 3 July 2025. https://www.nhs.uk/conditions/pelvic-organ-prolapse/
- NHS. Hysterectomy: recovery. Page last reviewed 11 October 2022. https://www.nhs.uk/tests-and-treatments/hysterectomy/recovery/
- NHS. Postmenopausal bleeding. Page last reviewed 24 September 2026. https://www.nhs.uk/conditions/post-menopausal-bleeding/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-22.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.