Heavy lifting may produce strain on the pelvic floor muscles (PFM) due to high increases in intraabdominal pressure (1), but knowledge of impact of weightlifting on the PFM is lacking. Therefore, the aims of this study were to investigate acute effects of heavy weightlifting on the PFM in strength-trained women and whether general strength in whole-body exercises were correlated with PFM strength.

Nulliparous women between 18-35 years who regularly performed weightlifting and were able to lift their own bodyweight x 1.2 in squat and 1.5 in deadlift were included in this experimental crossover study. They participated in baseline evaluations (questionnaire/measurements of background characteristics and urinary incontinence, 1 repetition maximum (1RM) tests in squat and deadlift) and one test day where they were randomized to start with 60 minutes weightlifting (4 sets of 4 repetitions at 75-85% of 1RM in squat and deadlift) or seated rest of 60 minutes. Vaginal pressure measurements of PFM resting pressure, strength and endurance (Figure 1) and sEMG-measurements of PFM resting activity were performed before/after weightlifting and rest. ICIQ-UI-SF were used to assess prevalence of urinary incontinence (2).

Fifteen powerlifters, 14 CrossFit exercisers, 14 recreational exercisers and 4 Olympic weightlifters were included (N=47). Twenty-two (46,8%) reported any type of urinary incontinence. The most common type was stress urinary incontinence, reported by 19 (40,4%). Only 3 of the participants reported minor urinary leakage during the training session. No statistically significant differences were found when comparing the change in PFM resting pressure, strength, endurance and resting activity after heavy weightlifting and rest (Table 1). There were no statistically significant correlations between PFM strength and maximum (1RM) or relative strength (1RM/bodyweight) in neither squat nor deadlift.

Our results imply that heavy weightlifting of whole-body exercises is well tolerated by the PFM in healthy, nulliparous women with experience in strength training. Since pelvic floor dysfunction is common among female powerlifters and Olympic weightlifters (3), long term effects of heavy weightlifting and lifting above 85% of 1RM should be further investigated. Our sample included healthy, nulliparous women with no or mild pelvic floor dysfunctions. Studies comparing effects of heavy lifting on the pelvic floor in women with and without dysfunction or nulliparous vs. parous women are therefore of interest. Strength in whole-body exercises was not correlated to PFM strength, implying that targeted strength training of the PFM is necessary to improve PFM strength.

We found that heavy weightlifting, including squat and deadlift of 75-85% of 1RM, had no immediate effect on the PFM compared to rest in strength trained, nulliparous women. PFM strength was not correlated with either maximal strength or relative strength in squat and deadlift.

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Skaug KL, Engh ME, Frawley H, Bo K. Prevalence of Pelvic Floor Dysfunction, Bother, and Risk Factors and Knowledge of the Pelvic Floor Muscles in Norwegian Male and Female Powerlifters and Olympic Weightlifters. J Strength Cond Res. 2022;36(10):2800-7.

Continence 7S1 (2023) 100999
DOI: 10.1016/j.cont.2023.100999