5 MYTHS ABOUT LIFTING AND THE PELVIC FLOOR

5 Myths About Lifting and the Pelvic Floor

Have you ever heard, or been told that you should avoid heavy lifting to protect your pelvic floor? As more women are starting to embrace strength training and new research is becoming available, we’re learning some of the advice that has previously been given isn’t as evidence based as we once thought.Let's separate fact from fiction and discuss some common myths surrounding your pelvic health and strength training. 

Myth #1: Heavy lifting causes pelvic organ prolapse.

The truth: We don't have strong evidence that lifting heavy weights for exercise causes pelvic organ prolapse (POP).

While vaginal birth, age and genetics are well-established risk factors for prolapse (Haylen et al., 2016; Barber, 2016), research investigating women who lift heavy weights for exercise has found they are not more likely to report prolapse symptoms than women who lift lighter weights or do not lift weights (Forner et al., 2020), and ultrasound studies show that regular heavy lifting does not appear to compromise pelvic organ support in women who do not already have prolapse symptoms (Forner, 2025).

That doesn't mean everyone can lift without consequences, but it does mean heavy lifting shouldn't automatically be blamed.

Myth #2: If you have a prolapse, you should never lift weights again.

The truth: Having a prolapse doesn't automatically mean giving up strength training.

Many women with prolapse can continue strength training with proper guidance. The key is understanding how your body responds to load, rather than following “rules” and speaking in absolutes. Your unique symptoms, and how your body responds to load is what matters most. If lifting causes increased POP symptoms (pressure, heaviness or a vaginal bulge sensation, or urinary incontinence of any sort) your program may need to be modified but not completely abandoned.

A pelvic health physiotherapist can help you find the right exercises, as well as strategies and adjustments to your technique to manage training load and help you stay doing what you love.

Myth #3: You should always squeeze your pelvic floor before every lift.

The truth: It's not quite that simple.

You've probably heard the advice to "do a Kegel before you lift." While activating your pelvic floor can be helpful in some situations for some women, it's not a universal rule. The pelvic floor works together with your diaphragm, deep core and deep back muscles to manage pressure inside the abdominal cavity (Hodges et al., 2007; Bø & Herbert, 2013).

For some women, constantly gripping or over-contracting the pelvic floor can create unnecessary tension and increase their symptoms. Learning how to properly breathe, brace and coordinate your pelvic floor with the rest of the deep pressure system is more helpful than trying to squeeze as hard as possible before every repetition.

Myth #4: Leaking during exercise is normal.

The truth: It's common but it's not something you should simply accept.

Many women experience urinary incontinence during running, jumping, lifting, or other forms of movement. Although it is common, urinary incontinence is a sign that your pelvic floor or pressure management system may need some attention. Pelvic floor muscle training has strong evidence for improving urinary incontinence and is recommended as a first-line treatment (Dumoulin et al., 2018) You don't have to stop exercising, and you don't have to "just live with it.

Myth #5: Protecting your pelvic floor means avoiding heavy lifting forever.

The truth: Your pelvic floor benefits from getting stronger, just like the rest of your body.

Strength training improves muscle strength, bone health, balance and overall wellbeing (World Health Organization, 2020). For many women, lifting weights is one of the best things they can do for their long-term health. Rather than avoiding lifting altogether, the goal is to build strength gradually, use good technique, manage training loads and listen to your symptoms. A personalised approach is far more effective than any blanket restrictions.

The bottom line

Your pelvic floor isn't fragile.

Current evidence suggests that heavy lifting, by itself, is unlikely to damage a healthy pelvic floor or cause pelvic organ prolapse. While more long-term research is needed, particularly in women with existing prolapse symptoms, the research to date is reassuring. If you have symptoms such as heaviness, pressure, a vaginal bulge or urinary incontinence, don't assume you need to stop exercising or participating in the activities that bring you joy. Instead, reach out to a pelvic health physiotherapist who can help you continue doing the activities you love while supporting your pelvic floor. After all, our goal isn't to help women avoid movement, it's to help them move with confidence.

References

Barber, M. D. (2016). Pelvic organ prolapse. BMJ, 354, i3853.

Bø, K., & Herbert, R. D. (2013). There's not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review. Journal of Physiotherapy, 59(3), 159–168.

Dumoulin, C., Cacciari, L. P., & Hay-Smith, E. J. C. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, (10).

Forner, L. B. (2025). Towards better understanding of pelvic organ support in women who engage in recreational exercise: The effects of heavy lifting on the pelvic floor (Doctoral thesis). The University of Queensland.

Forner, L. B., Beckman, E. M., & Smith, M. D. (2020). Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: A cross-sectional survey. International Urogynecology Journal, 31(8), 1551–1558.

Haylen, B. T., et al. (2016). An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. International Urogynecology Journal, 27, 165–194.

Hodges, P. W., Sapsford, R., & Pengel, L. H. M. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and Urodynamics, 26(3), 362–371.

World Health Organization. (2020). WHO Guidelines on Physical Activity and Sedentary Behaviour.

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