The Link Between Weightlifting and Incontinence / HARTMANN Information Centre

The HARTMANN Team

Weightlifting is an excellent way to burn calories, increase muscle mass, and build overall strength. More and more people around the world are discovering that weightlifting is a productive and enjoyable routine to add to their fitness plan. That said, when you regularly lift heavy weights for exercise, there is a chance that you will notice a weakening of your pelvic floor muscles, potentially leading to incontinence.

Incontinence, ranging from mild to severe, is a real problem that weightlifters of all ages face. In this article, we explain the link between weightlifting and incontinence and explain how you can avoid and treat it.

What Is Incontinence?

First, we need to start by defining precisely ‘what is incontinence?’ This is a medical term that refers to an involuntary, often accidental loss or leakage of urine from the bladder or faeces from the bowel (bowel incontinence). Often associated with the very young (infants), the infirm and the elderly, this is not always the case. In fact, the NHS estimates that somewhere between 3 to 6 million individuals across the UK suffer from some form of urinary incontinence, and "major faecal incontinence" affects approximately 1.4% of Britons over 40 years of age.

Incontinence can be a minor problem (just a small leak here and there) to a complete lack of bladder and/or bowel control. One of the most important factors of incontinence is the strength of the pelvic floor.

What Does The Pelvic Floor Do?

First, we need a little understanding of the pelvic floor (PF), and of muscles in general. Your pelvic floor is a group of muscles, just like your quads or your triceps. Our quads allow us to jump and squat, and to explode with leg drive in a snatch or clean and jerk. On a more practical level, they also let us sit with control and to walk down the street.

Your pelvic floor is a lot like your quads, as both are formed by layers of powerful muscles. Your pelvic floor is fantastic, but it doesn’t always get a lot of credit. By commanding its contractions, you can heighten romantic pleasure, and by flexing those muscles and your lower abdominals you can say goodbye to back pain when you sit.

The pelvic floor also allows you to control the flow of urine and waste from your bladder and bowel. And of utmost importance to weightlifters, it’s the stopper at the base of your body that allows you to maximise intra-abdominal pressure when you’re executing a lift.

Like any group of muscles, the pelvic floor needs both strengthening and stretching to be its healthiest. Our muscles need to be loose to be fast, but they also need to be tight to be strong.

The Link Between Incontinence and Weightlifting

Stress incontinence is defined as when urine leaks from the bladder during times of stress, such as when laughing, coughing or lifting heavy objects.

Weights

Which Exercises Are The Best For Strengthening The Pelvic Floor?

We asked expert personal trainer Sam Higginbotham to explain some of the best exercises for strengthening the pelvic floor. He said, without a doubt, that the answer is compound exercises.

Compound movements are so called because they use or "compound" multiple muscle groups during the exercise, which is why they are primarily used in programmes due to the fact:

  • They activate more working muscle, meaning more calories burned during training
  • They require a more significant amount of neural control and therefore can help regarding functional performance, alongside being able to maintain correct posture and overall muscle control greater than something like a Seated Chest Press, where most of the stabilising work is done for you.
  • They allow much higher loads of weight to be lifted, which in turn engages more muscle fibres, building greater amounts of muscle tissue and increases performance much quicker (e. you're going to get a lot stronger from deadlifting a bar with a lot of weight, rather than curling a few dumbbells in a chair)
  • They better represent aspects of life, so mobility and general quality of life (which is one of the main reasons people turn to training) is improved faster. A squat is more closely related to "sitting down" and "standing up" or running, you don't spend hours with your arm on the chair curling the TV remote!

As with any type of training, there are specific considerations you need to have in place, even more so with compound movements, as more muscles are used. If you do compound movements incorrectly, you can damage your body - and specifically your pelvic floor muscles!

The key points Sam believes can be applied across all movements include:

Core Stabilisation: Your core is essentially the "middle man" between your lower and upper body.

  • Focus on pulling your shoulder blades back and down towards your hips to help maintain an upright chest/torso.
  • Take a deep breath in, not just to your lungs but down into your abdomen and aim to visualise filling it full of air (similar to pumping a balloon up). Once you have fully breathed in, begin to exhale forcefully and use your stomach muscles to push the air out (imagine trying to bring your belly button in towards the base of your spine). This helps to engage your deep core muscles that work together in order to provide stability and strength to the trunk or lower part of your back/abs during lifting movements.
  • Once the initial breathing cycle has been made, continue to breathe in and out while maintaining that tension in your stomach (as if you're forcing air into a pressurised tank).
  • Squeeze your glutes together firmly; this is because your hip sits in quite a free-moving position at the base of your spine and along with your core muscles, it needs to be braced in position to prevent it tilting or shifting during the movement.
  • With your legs, try to imagine pushing your feet into the floor and "twisting" them away from each other, as if you're trying to turn your feet away from each other. This, in turn, will help to rotate your femur (thigh bone) and rotate the kneecaps, which begins to build torque along the hip joint and secure the leg in place (think back to whenever you see someone sit down/stand up/jump and their knees seem to cave in or bend out off track - this is because there is no torque or tension created in the hip joint).

Controlled Breathing - As with any movement, when you are contracting the muscles regularly - and over a prolonged period - you will inevitably build up pressure within the body. So it is essential to develop a stable and consistent rhythm of breathing to make sure you place the weight in right areas at the right time.

  • Breathe IN during the "loading" phase of any movement (i.e. when you bend DOWN during a squat or lower the weight DOWN in a deadlift, bring the bar DOWN to your chest during a bench press etc.). This provides plenty of air for both the working muscle, alongside giving you support when your body is experiencing the highest amount of load.
  • Breathe OUT as you perform the movement and contract your muscles (i.e. standing UP during the squat or pulling the weight UP in a deadlift).
  • This also helps you to maintain proper control over your respiratory system, the worst thing you can do when performing high-intensity movements along with heavy load is to lose control of your breathing, you lose that, you lose control over the movement in general.

Break The Movement Down - With compound movements being made up of a combination of smaller bodily functions, the best way to work on perfecting your form and lifting correctly is to break down the movement in to manageable patterns (i.e. a deadlift can be broken down in to an initial leg press, to lift the weight off the floor, followed by a hip extension to bring the glutes forward towards the bar and standing up fully)

  • The deadlift also utilises muscles in the upper back to retract the shoulder blades, in the glutes to help keep the knees in track with the ankles and hips and deep core muscles to provide stability for the trunk of your body.
  • One way to improve your performance and make sure going forward you avoid issues with any lift, is to break down the individual components and use isolation movements to help improve these areas, working on control, thereby improving the overall lift when you perform the compound movement (i.e. crunches/plank to begin building your deep core muscles, face pull/high seated row to help focus on stabilising your shoulder blades when under increasing load).

Practice With a Light Load - Don't overestimate your abilities! It is worthwhile beginning with a lightweight to make sure you understand the basics and can apply them dynamically when working with weight and under pressure before increasing the weight you follow (you don't think about running marathons until you can tie your shoe and walk out the door). Focus on the basics and the improvement will come naturally.

You can get in touch with Sam here: samuel@bramhallpersonaltrainer.co.uk

Compound Lifts Explained

Now that you have Sam’s tips above, you are ready to apply them across three types of compound lifts detailed below (based on the advice of Nick from Lep Fitness).

Remember, before trying any of the compound lifts detailed below, it is imperative that you warm up properly. A warm-up aims to increase body temperature so that muscles and joints move more freely and you lower the risk of injury. If you want to tick all boxes, do some mobility drills after your cardio. Foam rolling exercises like mountain climbers and body weight squats can be a great way to warm up and get your muscles firing correctly before any vigorous training.

Below are a handful of compound lifts and some tips to help you execute them:

  • Squats - One of the things that can help make the movement more fluid is to use either a squat ramp or some plates under your This makes the distance to travel on the way down less and allows you to focus more on working the quadriceps muscles. Alongside this make sure to perform the exercise slowly, taking 3 seconds on the lowering phase and 2 seconds on the lifting phase. Like with all of the major compound lifts take your first few sets lightly and build up to a weight that pushes you but that doesn't sacrifice technique.
  • Pull-Ups – This is another fantastic exercise, both close grip and wide grip pull-ups will strengthen the back, and biceps. Before going into full pull-ups you can build up by using an assisted pull up machine. Even if you are able to complete 10+ full pull-ups I'd still recommend warming up on an assisted machine. Make sure to engage your lats and keep your shoulder pinned back. Exhale as you lower yourself down for each rep.
  • Deadlifts - Instead of doing conventional deadlifts, which can place a lot of stress on the lower back muscles and cause the shoulders to round forwards (leading to bad posture) I'd recommend instead using a trap bar. The trap bar handles are higher so you don't have to bend down as far. Also as you use a hammer grip it encourages your shoulders to be in a neutral position and is a much healthier way of deadlifting. Leave your ego at the door, warm up properly and slowly increase the weight as you build confidence and your body adapts over time.

More Tips From The Experts


We reached out to Nick at Lepfitness.co.uk, and here’s what he told us about how to strengthen your pelvic floor and prevent stress incontinence:

  • Warming up is key - Before performing any of the major compound lifts, make sure you warm up properly. I'd recommend 5-10 minutes of low-intensity cardio - a medium paced walk on a treadmill would be perfect, or 5 minutes on a fitness bike.
  • Foam rolling - After warming up you could then add in some foam rolling to ensure that you loosen off any tight muscles. You should target areas like the glutes, hips, hamstrings and thighs, especially before doing any of the major compound lifts such as squats, pull-ups, deadlifts, and clean and jerk.
  • Rest and relaxation - Once you've done your big lifts make-sure to get plenty of rest and good I'd recommend static stretching for at least 20 minutes after each session. Hold each stretch for 60s. You could also do some more foam rolling, especially if you've done lots of reps and built up lactic acid, and a soft tissue sports massage is always a good idea.
  • Food - In terms of food you need protein, at least 30g (potentially 50g, depending on your goal) within the post 2 hour workout window. Food like chicken, turkey, mince, eggs, salmon and protein shakes do a good job at helping muscles to repair so that you can recover and train again sooner.

Matt from Mattswaz.co.uk provided us with the below tips:-

  • Setup - Face the bar. Grab it tightly with a medium grip. Put it on your upper-back by dipping under the bar. Raise your chest.
  • Unrack - Move your feet under the bar. Unrack it by straightening your legs and step back slowly. Lock your hips and knees.
  • Squat -  Take a big breath and Squat down. Push your knees out while moving your hips down and back. Keep your lower back neutral. Squat down until your hips are below your knees or at a 90-degree angle.
  • Squat Up - Squat back up. Keep your knees out and chest up. Lock your hips and knees at the top. Breathe out.
    Breathe in on the lowering phase and out on the upwards phase. Gradually and incrementally increase the weight. Ensure correct form every time.

What Else Can You Do To Help Control Incontinence?

If you are experiencing incontinence due to weight lifting (or any other reason), you do not need to be ashamed. Try some of the compound lifts described above, and consider trying pelvic floor exercises. These simple exercises are specifically designed to strengthen the pelvic floor, and you can do them at any time – some people do pelvic floor exercises while brushing their teeth, or their morning commute, or while watching TV.

You can also find many modern incontinence products on the market that will keep your clothing and skin clean and dry in the event of any leakage. These are not your grandparents ‘adult diapers’ – they are hidden beneath even tight work out clothing, and wick away moisture from your skin.

Summary

If you are struggling with stress incontinence caused by heavy weightlifting, you don’t have to suffer in silence. By following these tips above and taking this expert advice, you can stop this problem dead in its tracks.

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