Can You Handle the Pressure? How To Breathe When You Lift Weights.

You may be starting a new workout routine, or trying a different method of exercise like lifting heavier weights (as you should), and you are noticing something is not right “down there.” Whether it’s increased pressure during or after the workout, peeing during a lift, feeling a strong urge to pee even if you just went, or even pain! These are common things people experience, but are not normal. This can be improved with a team approach with coaches and medical professionals such a pelvic health physical therapist communicating about the goals of the client, but then understanding physically where there may be a breakdown in handling the load/pressure in our core. 

When we begin lifting heavier weights, especially 80% of our one-rep max or larger, it is imperative that we create sufficient core stiffness to support our spine, pelvis, and equal pressure in the abdomen. If we cannot generate this stability with our breath and coordination, we can be at risk for putting undue pressure on the pelvic floor muscles, low back, and SI joints. Since I am in the business of helping us preserve our body for vitality, I want to go over breath strategies to implement to move your best. Here are three breathing strategies, in order from beginner to advanced, to try to get your core working its best when lifting weight. 

1. Free Breathing: This is simply not holding your breath while performing a movement or moving a load. It is common when we are learning a movement that thinking about breathing goes out the window, but if we can stay present with our breath, it can actually enhance our experience physiologically and mentally.               
2. Exhale with Exertion: https://www.youtube.com/watch?v=9QbqNYUylyY This may sound like common sense, but coordinating our breath with lifting the load is one of the best ways to get the assisting action of our core/pelvic floor. This works well with light to moderate resistance. You can continue to implement this strategy with heavier weight but if you’re noticing imbalances, pain/strains, pressure or bulging in the pelvis, we need to modify the weight or breath technique! Here are 3 examples:
   1. Squat - INHALE to lower, EXHALE to stand up 
   2. Bench Press - INHALE to lower the bar to chest, EXHALE to press bar away 
   3. Deadlift - INHALE to lower and hinge at hips, EXHALE to stand and drive hips forward.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
3. Breath Hold: https://www.youtube.com/watch?v=KWvSQ1Rkpac When we lift heavier weights when we are training for strength & power, it may be beneficial to hold our breath throughout the lift for sufficient spine stiffness and equal pressure across our core to move the weight. A frequent pitfall is to hold your breath and bear down as you perform the lift (a.k.a. valsalva). This will put undue pressure on different structures like your spine, discs, anterior abdominal wall causing hernias, or the pelvic floor leading to pelvic floor dysfunctions. Here is an example of how I set up the breath hold.
1. Deadlift - in the starting position gripping the bar and locking in the shoulders, INHALE into the ribs & brace the core, HOLD the breath, pick up the weight to stand, put down the weight to starting position, EXHALE the air and begin again. 
2. Disclaimer!!! Note how I mentioned heavy weights for power and strength and powerlifters. Do not confuse using a breath hold for everyday activity. 

Learning to be aware of your breath in all activities is my goal as a pelvic floor physical therapist so that you can not only perform at your best, but also reduce the risk of hurting yourself. If you are having trouble with implementing these strategies or are experiencing symptoms keeping you from training, we can help you at our clinic in Decatur! 

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In health, 

Dr. Krystal PT, DPT, CMTPT, RYT-200