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We’ve established that women need to do weights, and heavy weights at that, however heavy lifting is a risk factor for developing pelvic dysfunction. So how do we go about loading a woman’s muscles heavy enough, without exacerbating an existing pelvic dysfunction, or contributing to the development of a new one?

This month we’re going to go through 4 simple tweaks to your programming that will allow your female client’s to lift heavy, even when they live with prolapse, stress incontinence, or another pelvic dysfunction.

Tip 1) Sit Them Down

Lifting heavy weights with someone who has pelvic dysfunction is about managing their intra abdominal pressure. Intra abdominal pressure is increased in some positions, which will differ from client to client, as well as some breathing habits. The tips we are sharing this month are by no means a “one sized fits all” solution, but you can experiment with positions, including sitting your client down to see if that helps with their symptoms.

Sitting down, rather than standing, to perform upper body exercises, will likely reduce what the client is able to lift, because they cannot recruit the muscles of their legs to assist them lift. This means the arms are taking more load, and are still heavy lifting, with less load on the torso.

Furthermore, when a client is sitting down, there’s kinesthetic feedback to the pelvis, which alone can assist some clients with their pelvic control. You can also experiment with different styles of sitting – on a fitball versus a bench. On the floor versus kneeling. If the client has control over their pelvic floor lift, and does not experience symptoms at the time of lifting or in the days following, chances are that your positioning tweak has been successful!

I had a question today about whether or not heavy lifting is safe for someone with pelvic dysfunctions and I just want to clarify that it is, under certain conditions:

  1. you know that pelvic dysfunction exists in that client
  2. you know how to manage intra-abdominal pressure

Which is what I am teaching you this month with these tips…

Tip 2) Exhale on exertion OR at the highest load point

Today we’re going to talk about different breath options for lifting heavy weights with someone with pelvic dysfunction.

The traditional breath hold for weight lifters is a breath in before starting the movement, followed by a breath hold while performing the movement. They do this to create stability in the torso. In functional pelvic floors, this also creates an upward vacuum…

Key word “functional”.

At least 1 in 3 of your female lifters will have pelvic dysfunction, if you’re coaching elite lifters, the number is 1 in 2. In a dysfunctional pelvic floor, when you hold your breath, the pressure will spill into the areas that have the lest tension – your hernia (if you have one), or your dysfunctional pelvic floor.

A method of breathing that creates the same pelvic stability is “exhale on exertion”. This is where you breath in during one part of the movement, and out during another part, effectively directing where the “spills” of pressure go. A good rule of thumb is breathing out during the “grunt” phase – the part of the movement where clients will “oomph” naturally:

  • the pull down of a LPD
  • the press up of a bench press
  • the standing phase of a squat

However, exhale on exertion won’t always work with every client or every exercise, and another strategy is exhaling at the highest load point – ie. When the pelvic floor is at it’s max stretch against gravity, or the intra-abdominal pressure is at it’s highest (which can also be different for different people and different dysfunctions).

For many women, the highest intra-abdominal load point is;

  • the mid-way point through a chin up
  • at the bottom of a squat or deadlift
  • half way down a push up

Having versatility with your breath cues will mean more women can keep lifting, even when they’re living with pelvic dysfunctions.

Tip 3) Simplify the Movement

When we are rehabilitating or training women with pelvic floor dysfunction, it often requires them to be super aware of their bodies, specifically what sensations they’re feeling in the pelvic floor region. If they’re required to think of this on top of a hundred other instructions, it can get confusing or distracting, and they may not be able to lift as much.

On the other hand, if you’re only asking them to do ONE thing, while practising awareness of their pelvic floor, they’re much more likely to succeed. For this reason, it’s one of the few occasions I do isolation work with clients – if they’ve only got to think of their biceps in a biceps curl, it leaves brain space for their pelvic floor awareness as well.

In addition, when you’re lifting with one muscle at a time, you’re generally loading the pelvic floor less too – for example, a leg extension versus a leg press. A leg press versus a back squat. A back squat versus a squat press. A squat press versus a clean and press. And so on… keep regressing the complexity of the movement, while still lifting heavy, until they’re able to lift or control their pelvic floor or pelvic symptoms at the same time.

Tip 4) Reduce Impact

Now, when I talk about reducing impact, that’s not the same as “making easier”. I have two free courses where I demonstrate the logic of “reducing impact” which you can view here: https://clarehozack.au/home/free-courses/hiit-training-for-the-post-natal-client/ and here: https://clarehozack.au/home/free-courses/five-ways-to-burpee-with-your-post-natal-client/

Reducing impact is about understanding which moment in an exercise, gravity is hurling the internal organs towards the pelvic floor, and how to slow that hurl down – whilst still maintaining the intensity of the exercise! Again, i’ve demonstrated this concept before, see below. 

Reducing impact is about:

a) knowing where the client’s pelvic dysfunctions are, and what movements exacerbate them, and

b) understanding gravity and momentum and the points in each exercise where momentum is pushing against this specific client’s dysfunctions.

For any jumping exercise, the momentum of the organs down into the pelvic floor muscle group is almost always on landing – so how do we make bounding, jumping, skipping less impact, whilst maintaining intensity? Here are some ideas:

  1. Jump on a lower box, but do more
  2. Sprint uphill, rather than on the flat
  3. Bound uphill, rather than on the flat
  4. Reduce the weight in a wall ball, or keep the weight the same and slam it into the floor instead

Do you have more ideas for me??

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