Could Your Workout be Wrecking Your Pelvic Floor?

Picture it. You’re on your last set of squats, the playlist is hitting hard, but you’re hitting harder. You suck in a huge breath, clamp your jaw like you are about to deadlift a Corolla and grind out rep four.

Then it happens. Warm wetness between your thighs. You blink, thank the heavens you wore black leggings and waddle to the nearest bathroom.

Welcome to the most common secret in the health realm. The leakage that’s shamed but shared with almost half of female gym bunnies, so if this has happened to you? You’re not alone.

But, here’s the thing. It’s usually not the running or even the heavy barbell causing it.

It's what you're doing with your breath.

All pressure, no plan

Here’s how your core works. You lift something heavy and the pressure inside your abdomen spikes – that’s what keeps your spine safe. Where does all that pressure go? It goes down and straight onto a muscle group nobody ever taught you to use.

So, if you hold your breath, clench and push, it all lands on your pelvic floor. If that floor isn't switching on in time, something gives. Usually a leak, but over time that leak can turn into heaviness or dragging, especially after birth and throughout perimenopause when the tissues are changing anyway.

In the Core Restore Co clinics, we see it every week. Women aren't bracing correctly. They're bearing down. Breath held, belly pushed out, pressure going straight to the pelvis, on every single rep. Think of this as the fitness equivalent of flooring the accelerator with the handbrake firmly on – and it’s going to create some serious damage to your proverbial car.

Defying gravity, not the gym

First things first. Please don't stop lifting. Strength training is the star of the show when it comes to bone health, metabolism and mood, and those benefits matter more for women as estrogen drops. Monash researchers surveyed more than 4500 Australian women with pelvic floor symptoms and 46 per cent had quit exercising because of them. That's exactly the pelvic floor plot twist we're trying to avoid.

And your breath hold isn't the villain either. Holding your breath under a genuinely heavy weight is not a mistake… it's reflex. Past about 80 per cent of your maximum it’s something that happens automatically, and skilled lifters lean on it. The problem isn't the breath hold. It's holding your breath on a warm up set, on every rep, on the days your pelvic floor has nothing left to give.

So, here’s where to start. Begin by exhaling on the effort. Breathe in through your nose to prepare, then breathe out through your mouth as you stand up from the squat, press the weight skyward or leave the ground for a jump; focus on gently lifting your pelvic floor as you exhale. Blow as you go, as the physios say, which is slightly less catchy than “Shake It Off” but considerably drier.

Leaking is intel, not a life sentence. Your body is telling you it needs support, but know that there are always options for treatment – you don’t have to live with it. At Core Restore Co, that treatment often means Emsella, which contracts your pelvic floor thousands of times while you sit fully clothed, plus Emsculpt, for the deep core sitting above it. Twenty eight minutes, no sweat and nobody watching you do your Kegels wrong.

Breakout | Bracing or bearing down? Here’s your 60 second check

1. Lie on your back, knees bent. Breathe in and let your belly and pelvic floor soften.
2. Breathe out through pursed lips, like blowing out one very determined birthday candle and gently lift your pelvic floor as if you are holding in a fart.
3. Repeat 10 times, then give it a go standing with a light weight, exhaling as you lift.

Key signs you’re bearing down? Leaking, a heavy or dragging feeling, a belly that domes outward or a breath you are holding on rep two of twelve.

See a pelvic health physiotherapist, women's health clinician or reach out to the team at Core Restore Co.

Heather Foord (DipPil, BComms, BHSc, MWM, MSex.) is a women’s health clinician and the founder of Core Restore Co, winner of the Sexual Health category in the 2026 Prevention Health & Fitness Awards. The Core Restore Co clinics use Emsella and Emsculpt for pelvic floor and deep core rehabilitation across five NSW locations. corerestore.co

References

Dakic, J. G., Cook, J., Hay-Smith, J., Lin, K.-Y., Ekegren, C., & Frawley, H. C. (2022). Pelvic floor symptoms are an overlooked barrier to exercise participation: A cross-sectional online survey of 4556 women who are symptomatic. Physical Therapy, 102(3), pzab284. https://doi.org/10.1093/ptj/pzab284

Dominguez-Antuña, E., Diz, J. C., Suárez-Iglesias, D., & Ayán, C. (2023). Prevalence of urinary incontinence in female CrossFit athletes: A systematic review with meta-analysis. International Urogynecology Journal, 34(3), 621-634. https://doi.org/10.1007/s00192-022-05244-z

Prevett, C., & Moore, R. (2024). Nuances of the Valsalva manoeuvre and bracing with regard to resistance training performance and its effects on the pelvic floor. Journal of Pelvic, Obstetric and Gynaecological Physiotherapy, 134, 31-41.