Pelvic Floor

Pelvic Floor: what is it?

Stretched between the pubic bone at the front and the tailbone at the back, the pelvic floor is a layered set of muscles most clients have never consciously contracted. It has three jobs: holding the pelvic organs in place, controlling the openings that pass through it, and contributing to trunk stability. That third role is what puts it into a strength coach's scope, because it forms the base of the same pressure system as the diaphragm and transverse abdominis. When a client braces for a heavy lift, the pelvic floor is part of what makes the brace work, whether they know it or not.

Why it matters in strength training

Intra-abdominal pressure is what stiffens the trunk under load. It requires a roof, walls and a floor: the diaphragm, the abdominal wall, and the pelvic floor. If any of the three cannot manage the pressure, the system leaks somewhere, and in the case of the pelvic floor that can be literal.

This is why coordination matters more than raw strength. The pelvic floor should contract with the rest of the brace during effort and relax fully between efforts. A pelvic floor held permanently tight is as much of a problem as a weak one, and it is a common finding in clients who have been told to squeeze all the time.

Signs a coach should notice

You are not diagnosing anything. You are noticing signs that mean the client should see a pelvic health physiotherapist, and adjusting the program in the meantime.

• Leaking urine during jumping, running, heavy lifting or coughing, at any age.
• A sensation of heaviness or pressure in the pelvis during or after training.
• Holding the breath and bearing down hard on every heavy rep.
• Persistent pelvic, groin or low back pain that training does not change.
• A recent pregnancy, birth or pelvic surgery with no clinical clearance yet.

What a coach can do

Breathing and bracing instruction is squarely within scope, and it is often the highest-value thing you can offer. Teaching a client to breathe into the lower ribs, to brace without bearing down, and to exhale through the hardest part of a rep changes how much pressure hits the pelvic floor, without any specialist knowledge.

Load management is the second lever. Reducing impact temporarily, moving from bilateral jumping to single-leg landings, choosing supported positions for heavy work, and building back up as symptoms allow lets a client keep training while the situation improves. Stopping training entirely is rarely the right answer and is usually not what the physiotherapist wants either.

The postnatal client

Returning to training after birth is one of the most common situations where this comes up, and the practical rule is simple: clearance first, progression second. Once the client is cleared, rebuild in the same order as any other deconditioned client, starting with breathing and low-load trunk work, then loaded carries and hinges, then impact.

Impact is the piece that usually gets rushed. Running and jumping load the pelvic floor rapidly and repeatedly, and returning to them before the trunk and hips can manage that load is the most common reason symptoms appear. Building strength and single-leg control first, then reintroducing impact gradually, is both safer and faster in the end.