Our Umi Guides complement our online courses to focus more closely on discrete topics, as guided by our community. Here you’ll find all of the e-guides we have published to date. As our community is broad and multi-generational, not everything will be relevant to you, but keep your eyes peeled as new guides are released regularly. If you have a topic you want us to cover, ping us a message and let us know.
The Umi guide to leak free lifting
If you’ve been with us for any length of time, you will know by now that it’s never too late, or too early, to address leaks. It doesn’t matter what kind of leaks you experience (urine, faecal or wind), how long you’ve been leaking for, how much or little you leak and it doesn’t matter how old you are. Leaks can happen at any age and at any time. While leaking is often correlated with having a baby, lots of women leak who have never had babies.
Any amount of leaking is very likely to be, at least, improved, if not resolved - which is the case for 70% of women - by taking a different approach to pelvic health. As the saying goes; ‘If you always do what you’ve always done, you’ll always get what you’ve always got’.
If leaks have been happening for a long period of time, it doesn’t make them less likely to resolve, it just means you need to understand the way your body is managing Intra-abdominal Pressure (IAP), revisit how you are using your pelvic floor muscles and make some tweaks. On the flip side, small leaks that only happen, for example, with exercise are unlikely to resolve on their own and have been shown to persist and increase in frequency as you age. So take these simple steps now to stop leaking and future-proof your bladder and bowel control so you can continue to live and exercise leak-free well into the future!
As always, we would highly recommend seeking the opinion of a pelvic health physiotherapist if at all possible if you are experiencing leaks. However, in the absence of that, until you are able to, or alongside your treatment, see all our top tips in this easy to implement, up-to-date, evidence-based guide. Don’t forget to head back to Essentials by Umi at any point for all the info you need on the anatomy of and how to do your pelvic floor squeezes.
What type of leaks can be improved/resolved?
In general we are referring to bladder leaks i.e. urinary incontinence (UI) as this is the most common type of incontinence to experience when lifting, but this guide can also be applied to bowel leaks. If you leak wind or stool with lifting, which many women do, then follow all of the exact same advice in this guide.
What lifting are we referring to?
Any movement or exercise that involves picking something or someone up! This can include everyday movements such as lifting kids or household objects as well as weights that you’d find in a gym environment like dumbbells, kettlebells, plates and barbells.
Why does lifting make so many of us leak?
First, a really brief science lesson. We always have pressure within our core canister. We call this IAP. IAP is required for our core to provide a stable base from which our limbs work. When we exert physical effort, our muscles contract and IAP increases. When considering an activity like lifting, the more weight we lift, the more IAP is created. This means there is more pressure down on the pelvic floor muscles.
Simply put, if the rise in IAP is greater than the strength in our pelvic floor muscles, we will leak. This could be with just one rep, or it could be the cumulative effort of a set. Our pelvic floor muscles need to be quick enough, strong enough and have enough endurance to counteract the amount of IAP we are applying to them. If they don’t, then we leak.
It happens really commonly – in a recent study 84% of women reported leaking when exercising and it’s weightlifting (along with jumping movements) that have been found to be the most common exercise activities when women experience UI. Don’t forget to check out our Umi Guide to leak-free impact if you are having leaks with any impact exercise.
If lifting makes us leak, is it bad for our pelvic floor? Should we abstain from lifting all together?
No! If you leak with any lifting, it’s just a sign that your pelvic floor muscles need some attention to improve their ability to manage the IAP/weight. In fact, abstaining from all lifting doesn’t actually help at all – what we need to do, instead, is find the weight that we can just about manage without leaking and then gradually work back up from there whilst also doing daily pelvic floor muscle squeezes (remember we have loads of information on how to do your squeezes or ‘Kegels’ in our Essentials course). This is the quickest and safest path to long-term leak free lifting.
Don’t forget that the World Health Organisation recommends that every single one of us should be doing some muscle strengthening exercises twice per week – abstaining is not an option if we want to maximise the health benefits of regular physical activity. Using resistance and/or weights during exercise is particularly vital for us as women in slowing the decline in muscle mass and bone density.
Some use leaking when lifting as a badge of honour, does leaking when lifting mean I am just pushing my body hard in a good way? I see professional lifters leaking, so is it really that bad?
It’s true, you won’t find a professional weight lifting competition without a mop and bucket but that doesn’t mean leaking when lifting is something to celebrate!
Just because leaking has become accepted in pro weightlifting circles, it doesn’t mean it’s OK. It is a sign that the IAP you’re creating is over-powering your pelvic floor function. If you ignore it and do this often enough, it may well just weaken your pelvic floor and lead to more problems.
It is important to remember men are less likely to leak simply because they have a longer urethra and aren’t quite as prone to pelvic floor muscle weakness in the same way women are (no pregnancy, no menopause etc.).
The truth is that the weightlifting world has been dominated by men for so long – techniques were designed for men - and with so many coaches in the field being male, women are taught to follow the same techniques. We are on a mission to help female athletes understand that they can perform at a high level, but in a way that is more protective of their long term pelvic health.
Should I consciously engage my pelvic floor when lifting?
Sometimes, but not forever! We ideally want the pelvic floor muscles to act automatically, contracting the right amount to respond to the amount of IAP being generated. It is very common for people to end up over-clenching their pelvic floor muscles when doing a conscious squeeze during a movement and/or not relaxing them sufficiently. Imagine having to squeeze and relax for a whole set of heavy deadlifts! It would be really hard. This in itself can lead to problems, with the muscles becoming fatigued and/or inflexible.
Should I use a pad/leak protection underwear?
Pads/leak protection underwear that are specifically designed for urinary leakage can absolutely be a useful adjunct when you are trying to achieve leak-free lifting and many women use them for a while, but they are not in themselves a solution.
What can I do straight away to reduce leaking with lifting?
There are 4 crucial interventions that have been proven to decrease excessive pressure/increase pelvic floor functioning during lifting:
Relaxing you tummy muscles
Continuing to breathe
Relaxing the pelvic floor muscles
Aiming for a BMI below 30
Relaxing your tummy muscles – the more we can relax our tummy when exercising the better. Our bodies will automatically activate our tummy muscles to the required amount. Consciously bracing, over-activating or clenching them can be detrimental. If you have a tendency to hold your tummy in, as you have learnt to ‘brace’ then try to stop this when you lift. If you feel self-conscious of your tummy (as unfortunately many women do), wear a looser top while exercising. This might be helpful in allowing you to break the tummy-sucking habit.
Continuing to breathe – If we are trying to influence the pressure system, then breathing plays an important role. Remember that closing the glottis and breath-holding (valsalva) can lead to an increase in IAP, and that IAP is already going to be increasing because of the heavy lift and muscle contractions required to perform it. The IAP produced during an inhalation breath-hold has been shown to be significantly greater than an exhalation breath-hold or an inhalation-exhalation. Maintaining breathing during exercise will allow the pelvic floor to remain flexible and therefore to provide the bottom up support we need during a lift. If you are prone to breath-holding with a lift, consider whether you really need to hold your breath, or whether it is something that has become a habit.
There’s also evidence to support that breathing out with the effort when lifting is the method of breathing that results in the least amount of excess IAP without affecting force generation (ie you’ll still be able to lift the same amount of weight but crucially whilst lessening excess pressure on your pelvic floor).
Relaxing the pelvic floor muscles – it has been shown that normal support within the pelvic floor is flexible and not rigid. Despite many women instinctively clenching their pelvic floor through fear of or experiencing leaking, doing so during exercise actually makes us more likely to leak. Before beginning a lifting session and even between sets, many women find it helpful to use some strategies to relax the pelvic floor such as; ribcage breathing, deep squats, relaxing your shoulders and jaw, unclenching your butt cheeks and inner thigh stretches.
Aiming for a BMI below 30. Although the use of BMI as a marker of overall health is controversial, the research consistently supports that a BMI over 30 is detrimental to the function of our pelvic floor. The higher your BMI, the higher IAP will be even at rest, meaning the pelvic floor muscles have to work harder to meet the demand during activity. This is not a call for you to restrict your dietary intake, and perhaps one to discuss with your own healthcare professional. Further, it is often the case that women with high muscle mass measure at the higher end of the BMI scale. The relevance of BMI here is therefore in relation to your pelvic floor muscle function, and whilst you increase its strength, consider the role your own BMI plays in this.
Shall I go for a wee right before I lift? Won’t that help with reducing leaks?
It may for some feel as though it helps and acts as psychological reassurance, however, our bladders are never fully empty or dry so for many women it does not actually help reduce leaking. Going to empty your bladder ‘just in case’ for any reason can actually get the bladder into bad habits and is not advised. It is good practise to only empty our bladder when we are being told to go by our body’s signals and with a good amount of urine to pass. This will become easier to adhere to once your pelvic floor strength is improved.
It’s also important to note here that fluid intake is crucial before, during and after exercise. Please do not restrict your fluid intake before or during exercise, this will not help with leaks. Remember also that, in the meantime, there are specific bladder leak pads (disposable or reusable) and underwear available, please do not use sanitary products for bladder leaks.
What else do I need to do?
Along with implementing the above 4 interventions, it’s vital that you start doing daily pelvic floor muscle squeezes (not forgetting to fully let go in between each one) as soon as possible. Check back to module 3 in Essentials for the full lowdown on how to do your squeezes, how to check if you’re doing them correctly, what position to do them in and how many you need to do (start with at least 8 reps, three times per day).
Your daily habits will have an impact on your recovery from leaking when lifting, for example your toilet habits – it’s crucial that you avoid straining on the toilet when opening your bowels. Check back to module 6 in Essentials for the optimal pooing technique.
This next one is controversial – ditch the belt! Or at the very least loosen it off. If you are lifting heavier weights and are accustomed to wearing a weightlifting belt, the tighter you wear the belt, the greater the rise in IAP and therefore the harder the pelvic floor has to work. And this is even before you start lifting weights (i.e. at rest), which as we have discussed is only going to increase your IAP even further. Belts are NOT proven to reduce injury risk and your body will be much more resilient if you get confident lifting without one, as well as leaking far less! Belts were only ever intended for (men originally) lifting above your 90% max lifts anyway, so bear that in mind before you reach for yours.
If you know the load that makes you symptomatic i.e. causes you to leak during the activity, reduce the weight by 50% and build back up from there, using the tips we have suggested above. So if you are leaking with a 50kg deadlift, drop the weight back to 25kg, then increase the load in increments of 5kg using your adjusted strategies. It goes without saying that you will need to ensure sufficient rest between sets. Another approach may be to reduce sets and reps, if the issue is one of lack of endurance.
If only one particular lift is problematic and you are working to get it leak free, consider other variables that might impact your symptoms, such as the time of day you’re training or when in your workout you are performing it. You might consider performing it at the start of your workout, once warmed up, while you’re less fatigued, and build from there.
How long will it take to become leak free?
This depends on your current baseline. Put simply, the weaker your pelvic floor muscles are, the longer it will take to strengthen them up. This means that lessening the leaks can take anywhere from a few weeks until up to a year. On average it takes 3-6 months.
It feels as though I only leak at certain times of the month, does the menstrual cycle effect leaking?
Yes it can. Naturally our hormones fluctuate and they can have effects on muscle physiology - mainly flexibility and endurance. This is not a detrimental thing or anything to be avoided, but it might help you to understand your body more. It’s still really important to adhere to the advice in this guide, as then once your pelvic floor is able to perform better, you wont notice hormonal fluctuations by means of leaks. If you think this applies to you, like we recommend all women do anyway in Essentials, be sure to track your cycle (check back to Essentials for our advice on this) and log your leaking to gain better understanding. Did you also know that our menstrual cycle is thought to actually naturally aid weight lifting ability in the first half of our cycle?