If I had to pick ONE THING to help a woman protect her pelvic floor, I’d teach her how to lift.

Almost everyone has been taught the proper body mechanics for lifting (i.e. “lift with your legs, not with your back”). This technique is important to help protect the spine, but it overlooks the importance of protecting the pelvic floor.

Here’s why it’s critical to think of the pelvic floor when lifting: anytime you move from a squat position to a standing position — especially if you’re holding something — pressure is going to increase inside your abdomen.

You know that feeling of strain that happens as you pick up something heavy?

Sometimes you even hold your breath? (Spoiler alert: Don’t hold your breath!)

That strain equates to STRESS on the pelvic floor.

The strain/increase in pressure pushes down on your pelvic organs (i.e. your intestines, bladder, uterus, etc.), and they, in turn, press downward on your pelvic floor muscles. This is a problem if you’re dealing with a pelvic floor that’s already weak and overstretched, for example after you’ve had a child or two (or more). Even if your pelvic floor is strong and perfectly healthy, it’s important to prevent excess strain as a preventative measure against future problems such as incontinence and pelvic organ prolapse.

Lifting is something we do every day, multiple times per day. Every time you pick up your baby, your pet, your purse, a weight at the gym — or even something as small as a piece of paper off the floor, you’re risking strain on the pelvic floor muscles. So here’s how to lift correctly, keeping back health in mind as well:

  • Stand close to the item you’re preparing to lift.
  • Bend at the knees and hips, keeping your back straight.
  • Squat down, and bring the item close to your body.

Here’s the part that helps protect your pelvic floor…

  • Gently contract the pelvic floor muscles (do a “kegel”) and HOLD, and then exhale (breathe out) as you stand up. Exhale loudly! Really go for it!

The reason this helps is threefold:

  1. Contracting the pelvic floor muscles protects from below by acting as a brace to keep the pelvic organs supported and held in place despite the increase in intra-abdominal pressure.
  2. Exhalation — particularly a fairly strong/forceful exhalation — protects from above because the breathing diaphragm (a dome shaped muscle at the top of your abdominal cavity, just under your lungs) naturally moves upward when you breathe out. The action of the diaphragm moving upward helps prevent an excessive increase in intra-abdominal pressure (as can happen when you hold your breath), thereby helping to prevent downward pressure on the pelvic organs and pelvic floor.
  3. A strong, forced exhalation also activates the deep abdominal muscles, helping to protect and support your spine.

The way people normally lift, with their breath held (thus, the breathing diaphragm held low and fixed) and without thinking of their pelvic floor muscles (so they’re most likely not strongly contracted) is a recipe for pelvic floor muscle strain. This, done over and over throughout a lifetime, is a recipe for pelvic floor muscle disaster.

Please remember this ONE THING for the sake of your pelvic floor:

When you prepare to lift, engage your core muscles! Do a gentle kegel and HOLD, then exhale as you stand up.