Pelvic floor discomfort, pressure, or urinary leakage during squatting is surprisingly common among strength athletes. When symptoms show up—especially as the barbell gets heavier—it’s easy to assume:

“I need to brace better.”
“My core isn’t strong enough.”
“I’m going too heavy.”

Sometimes those things matter. But sometimes, they aren’t the whole story.

For some athletes, the better questions are:

• Is your squat position allowing you to manage pressure effectively?
• Are your breathing and bracing strategies supporting the demands of the lift?
• Do you have the strength and power needed to move efficiently through the hardest part of the squat?

As a physical therapist who works with strength athletes, I often help athletes experiment with their squat position, bracing strategy, and training variables to find an approach that allows them to continue lifting while reducing pelvic floor symptoms.

Your Squat Position Can Influence How You Manage Pressure

There isn’t one “perfect” squat position for everyone.

Small changes in bar position, torso angle, and stance width can affect your mechanics and how you manage the load. What works well for one lifter may not work for another.

Your anatomy, mobility, strength, training history, and individual movement strategy all matter.

Bar Position Matters

A higher bar position places the bar closer to the neck and typically requires a more upright torso than a lower-bar squat.

For some lifters, maintaining that upright position may also be accompanied by greater lumbar extension during the descent.

But this isn’t universally true.

Every athlete has different proportions, mobility, strength, and movement strategies. If your current setup seems to contribute to pelvic floor symptoms, experimenting with a slightly lower or hybrid bar position may be worth considering.

A more posterior bar position can change the torso angle required to keep the bar balanced over the midfoot, potentially allowing you to find a position that feels stronger and more sustainable.

The goal isn’t to make everyone squat low bar.

It’s to find the bar position that works best for your body.

A Little Torso Angle Isn’t Necessarily a Bad Thing

One common misconception is that you need to stay as upright as possible during a squat.

You don’t.

Some forward torso inclination is a normal part of squatting, and the amount you need depends on your anatomy, bar position, stance, and goals.

Rather than forcing an artificially upright position, the goal is to find a torso angle that allows you to stay balanced, maintain control, and effectively manage the demands of the lift.

In other words, don’t chase the “perfect-looking” squat.

Find the squat position that allows your body to manage the load well.

Stance Width Can Matter, Too

Stance width is another variable worth exploring.

For some athletes, a slightly wider stance gives the hips more room to move and makes the bottom of the squat feel more comfortable and controlled.

Changing stance width also changes hip mechanics, which may influence how an athlete experiences and manages pressure during the lift.

Again, there’s no universal stance width that prevents pelvic floor symptoms.

The right stance is the one that works with your anatomy, mobility, strength, and symptoms.

Bracing for Heavy Squats: Think Pressure, Not “Push Down”

When pelvic floor symptoms occur during lifting, one of the first things athletes often hear is:

“Brace harder.”

But a stronger brace isn’t necessarily a better brace—especially if “bracing harder” feels like actively bearing down or pushing pressure toward the pelvic floor.

Instead, think about creating 360-degree pressure and tension throughout the trunk.

During heavy lifting, athletes often use a Valsalva maneuver to increase intra-abdominal pressure and create trunk stiffness. That pressure helps stabilize the body so it can efficiently transfer force during the lift.

The goal isn’t to intentionally force all that pressure downward.

It’s to create and maintain pressure throughout the trunk while coordinating your breathing, abdominal muscles, and pelvic floor with the demands of the movement.

For someone experiencing pelvic floor pain, heaviness, pressure, or leakage, learning how to coordinate breathing, bracing, and pelvic floor function under load can be an important part of physical therapy.

What If It’s a Strength and Power Problem—Not Just Pressure?

Sometimes pelvic floor symptoms aren’t simply a bracing problem.

Strength and power may be part of the picture, too.

Some athletes struggle to produce enough force to efficiently get out of the bottom of a heavy squat. As the load increases, that sticking point becomes even more obvious.

If you struggle to accelerate out of the bottom, you may spend more time grinding under a heavy load. For an athlete already experiencing pelvic floor symptoms, that may be another training variable worth evaluating.

This is one situation where accommodating resistance, such as bands or chains, can be useful.

How Banded Squats Can Help Build Strength and Power

With a banded squat, resistance changes throughout the movement.

At the bottom: Less external resistance from the bands
As you stand: Resistance progressively increases

This allows an athlete to work on producing force and maintaining good technique through the bottom of the squat while progressively increasing the challenge as they move into stronger portions of the range.

As you stand, the increasing resistance demands continued force production from the quads, glutes, and other supporting musculature.

Instead of simply grinding through your sticking point, you can practice accelerating out of the hole and continuing to produce force throughout the lift.

Banded squats aren’t a universal solution for pelvic floor symptoms. But for the right athlete, they may be a useful training modification while building the strength, power, and confidence needed for heavier squatting.

Pelvic Floor Symptoms Don’t Automatically Mean You Need to Stop Squatting

Experiencing leakage, pressure, heaviness, or pain during squatting doesn’t automatically mean you need to give up the barbell.

And the solution isn’t always as simple as “brace harder.”

Depending on the athlete, treatment and training modifications might include:

• Changing bar position
• Adjusting stance width
• Finding a more appropriate torso angle
• Improving breathing and pressure management
• Building strength through the bottom of the squat
• Developing power and rate of force production
• Using bands or chains to modify resistance
• Retraining trunk and pelvic floor coordination under load
• Temporarily adjusting training intensity or volume while symptoms improve

The right strategy depends on why you’re experiencing symptoms in the first place.

That’s why an individualized assessment matters.

Pelvic Floor Physical Therapy for Strength Athletes

The goal of physical therapy isn’t simply to make your symptoms disappear.

For strength athletes, it’s also about understanding why those symptoms are happening and developing strategies that allow you to continue training while building the capacity your body needs.

You shouldn’t automatically have to choose between your pelvic floor and your barbell.

If you’re experiencing pelvic floor pain, urinary leakage, heaviness, pressure, or discomfort during squatting or strength training, a pelvic floor physical therapist can assess your individual mechanics, breathing and pressure-management strategies, strength, and training demands.

At Physio Room, we work with strength athletes to address pelvic floor symptoms while keeping their goals—including squatting, strength training, powerlifting, and weightlifting—at the center of their physical therapy plan.

Ready to lift with more confidence? Schedule a pelvic floor physical therapy assessment and let’s find a strategy that works for your body and your training goals.

Written by Dr. Jessie Czarnecki PT, DPT, OCS, CSCS, Cert. DN | Physio Room

The post Pelvic Floor Pain When Squatting: How to Lift Without Pain, Pressure, or Leakage appeared first on Physio Room.

Returning to running after having a baby can be an exciting milestone—but it involves more than simply lacing up your shoes and hitting the pavement.

Pregnancy, childbirth, and postpartum recovery can affect your core, pelvic floor, strength, coordination, and ability to manage pressure. A thoughtful return-to-running plan can help you rebuild strength and confidence while reducing the risk of symptoms and setbacks.

Why the Pelvic Floor Matters When Returning to Running

Your pelvic floor is a group of muscles that supports your bladder, uterus, and bowel. These muscles work closely with your deep abdominal muscles, diaphragm, and hips to stabilize your pelvis and manage pressure during movement.

Running is a high-impact activity. With every stride, your body must absorb and manage force efficiently. Your pelvic floor and core need to respond to these changes in pressure while coordinating with your feet, hips, and spine.

After pregnancy and childbirth, these systems may need time and intentional training to regain strength, endurance, and coordination—even if you otherwise feel like you have recovered.

Signs You May Benefit From Pelvic Floor Physical Therapy

You don’t need to be experiencing symptoms to benefit from a postpartum pelvic floor assessment. However, the following signs may indicate that your body needs additional support before or during your return to running:

• Urinary leakage during or after running
• Urinary urgency or frequent trips to the bathroom
• Heaviness, pressure, or a dragging sensation in the pelvis
• Pelvic, hip, or low back pain
• Abdominal weakness, coning, or difficulty coordinating your core
• Feeling unstable or weak while running, jumping, or changing direction
• Difficulty increasing your running distance without developing symptoms
• Uncertainty about whether your body is ready for impact

These symptoms may be common, but they are not something you simply have to live with after having a baby.

How Pelvic Floor Physical Therapy Can Help

A postpartum pelvic floor physical therapist can assess how your body responds to the demands of running and create an individualized plan based on your symptoms, needs, and goals.

1. Assess Your Pelvic Floor

A pelvic floor assessment can evaluate muscle strength, endurance, coordination, relaxation, and your ability to respond appropriately to increases in pressure.

Importantly, pelvic floor rehabilitation isn’t always about making the muscles stronger. Some postpartum runners have weak pelvic floor muscles, while others have muscles that are overly tense or have difficulty relaxing.

Your treatment plan should be based on what your body needs.

2. Rebuild Core and Hip Strength

Your pelvic floor doesn’t work in isolation. Your diaphragm, deep core, hips, and pelvic floor work together to provide stability and manage the forces created during running.

Postpartum rehabilitation may include exercises that target:

• Deep abdominal strength
• Glute and lateral hip strength
• Adductor strength
• Pelvic floor strength and coordination
• Single-leg stability
• Trunk and pelvic control

The goal is to build a strong foundation that can handle the demands of running.

3. Improve Pressure Management

One of the most important parts of postpartum rehabilitation is learning how to coordinate your breathing, core, and pelvic floor during movement.

Rather than constantly bracing your core or squeezing your pelvic floor, you want these muscles to respond appropriately to the task. This coordination becomes especially important during higher-impact activities such as running, jumping, and sprinting.

4. Gradually Reintroduce Impact

Returning to running should be a progression—not a single event.

Before increasing your mileage, your body should have an opportunity to gradually build its tolerance to impact. Your progression may include:

• Walking
• Strength training
• Single-leg exercises
• Hopping and jumping
• Running-specific drills
• Walk-run intervals

A physical therapist at Physio Room can help determine the right progression based on your strength, symptoms, training history, and goals.

5. Return to the Running You Love

Your return to running should be centered around your goals.

You may want to run a few miles around the neighborhood, return to your favorite trail, train for a marathon, or simply feel confident chasing your kids. Whatever running looks like for you, postpartum rehabilitation can help you work toward it safely and confidently.

You don’t need to rush your recovery—and you don’t need to avoid running indefinitely.

You Deserve Support During Your Postpartum Recovery

Your postpartum body has been through a tremendous amount of change. Returning to running is an opportunity to rebuild strength, confidence, and connection with your body—not to “bounce back” to who you were before pregnancy.

If you’re experiencing leaking, pelvic pressure, pain, weakness, or uncertainty about returning to running, pelvic floor physical therapy can help identify what your body needs and create a plan to get you back to the activities you love.

At Physio Room, we specialize in helping women return to the activities they love feeling stronger, more confident, and more connected to their bodies.

Written by Dr. Brooke Malloy, PT, DPT, OCS, CSCS, Cert. DN | Physio Room

The post Postpartum Return to Running: How Pelvic Floor Physical Therapy Can Help appeared first on Physio Room.

If you’re pregnant (or recently postpartum) and have felt a sudden, sharp, almost electric pain shooting through your vagina or pelvis, you may have heard it called “lightning crotch.”

This type of pregnancy pelvic pain is common — but that doesn’t mean it should be ignored.

While the name may sound dramatic (or even dismissive), the sensation is very real and often uncomfortable. It’s also not something you need to simply tolerate.

Let’s break down:

• What lightning crotch actually is

• Why it happens

• How pelvic floor physical therapy can help

• What you can do at home to feel more comfortable

What Is Lightning Crotch?

“Lightning crotch” is a non-medical term used to describe a sudden, sharp, stabbing, or electric-like pain in the:

• Vagina

• Cervix

• Pelvis

• Rectum

It often comes on quickly and can stop you in your tracks.

This sensation is most common during pregnancy — especially in the second and third trimesters — but it can also occur postpartum or beyond pregnancy, particularly when pelvic floor dysfunction or unresolved pregnancy pelvic pain is present.

While it’s often attributed to the baby’s position or growth, lightning crotch is typically related to irritation or compression of pelvic nerves, most commonly the pudendal nerve or nearby nerve branches.

Why Does Lightning Crotch Happen?

Several changes during pregnancy and postpartum can contribute to these symptoms, including:

• Increased pressure from the growing uterus or baby

• Hormonal changes affecting joint and tissue stability

• Pelvic floor muscle tension or overactivity

• Postural changes as the body adapts to pregnancy

• Changes in how the pelvis and hips move and load

Importantly, lightning crotch is not always caused by weakness.

Many people experiencing this pain actually have tight, overworked, or irritated pelvic floor muscles that are struggling to adapt to the demands placed on them.

How Pelvic Floor Physical Therapy Can Help

At Physio Room, pelvic floor physical therapy addresses the root causes of lightning crotch and pregnancy pelvic pain, rather than simply reassuring you that it’s “normal.”

Our approach blends pelvic health with performance-based physical therapy so you can continue moving well during pregnancy and beyond.

A pelvic floor physical therapist can:

• Assess pelvic floor muscle tone, coordination, and mobility

• Identify nerve irritation and contributing movement patterns

• Address muscle tension, trigger points, and connective tissue restrictions

• Improve hip, pelvic, and core support without excessive bracing

• Modify daily movements, exercise, and posture to reduce symptoms

Treatment may include:

• Hands-on therapy

• Guided exercises

• Breathing strategies

• Movement retraining

• Individualized education

The goal is to restore mobility, improve efficient strength, and help you continue doing the activities you care about— whether that’s daily life, exercise, or weightlifting.

When pressure on irritated nerves is reduced and pelvic floor muscles can relax and function efficiently, symptoms often become less frequent — or resolve altogether.

What You Can Do at Home

While hands-on care is often helpful, there are also strategies you can try at home.

1. Prioritize Pelvic Floor Relaxation

Focus on down-training rather than strengthening.

Think about allowing the pelvic floor to soften and drop, rather than tightening or clenching.

Try:

• Slow diaphragmatic breathing

• Inhaling into your ribcage and belly

• Imagining tension releasing through the pelvic floor during the inhale

2. Change Positions When Pain Hits

If lightning crotch occurs:

• Sit or lie on your side

• Avoid prolonged standing

• Avoid asymmetrical positions

• Gently shift weight or posture instead of pushing through the pain

3. Support Your Pelvis

You can reduce strain by:

• Using a pregnancy support belt (if recommended)

• Sitting with your feet supported

• Avoiding slouching or perched positions

• Being mindful of single-leg activities like stairs, dressing, or getting in and out of the car

4. Avoid Overdoing Kegels

If you’re experiencing lightning crotch, repetitive Kegels may actually worsen symptoms.

A pelvic floor physical therapist can determine whether your body needs:

• Strength

• Relaxation

• Coordination training

You Don’t Have to Power Through This

Lightning crotch may be common, but common does not mean something you have to live with.

Pregnancy pelvic pain is often a sign that your body needs support — not that you should push through it.

Sharp pelvic or vaginal pain during pregnancy or postpartum is not a rite of passage, and it’s not something you need to dismiss as “just part of it.”

Supportive, effective treatment exists.

Ready for Support?

If you’re experiencing lightning crotch or ongoing pregnancy pelvic pain, pelvic floor physical therapy can help — and you don’t have to wait until postpartum.

At Physio Room, our pelvic floor physical therapy combines hands-on care with performance-based treatment to support:

• Mobility

• Strength

• Confident movement during pregnancy and beyond

Whether your goal is daily comfort, staying active, or continuing strength training, we meet you where you are.

If something doesn’t feel right, trust that instinct. You deserve care that prioritizes long-term health, movement, and performance — not just getting through pregnancy.

Written by Dr. Katie Sasser – PT, DPT, M.Ed.| Physio Room

The post Lightning Crotch in Pregnancy: Causes, Relief & Pelvic Floor PT appeared first on Physio Room.

Most people have a pelvic floor, yet few understand how it actually functions or why it plays such a critical role in issues like sex, incontinence, and persistent pain.

Dr. Andrew Fix is joined by pelvic floor physical therapist Dr. Katie Sasser for an honest and informative deep dive into a topic that affects everyone but rarely gets talked about. Dr. Sasser explains what the pelvic floor is, how it supports essential functions like bladder control and sexual health, and why dysfunction in this area is more common and more fixable than most people realize. From incontinence and pelvic pain to postpartum recovery and erectile dysfunction, this episode covers the wide-ranging symptoms that pelvic floor therapy can help resolve.

Dr. Sasser shares the five key functions of the pelvic floor and challenges the stigma that keeps so many people silent about their symptoms. Whether it’s leaking during a workout, discomfort during sex, or clenching your core out of habit or stress, she breaks down the connection between everyday experiences and pelvic health. You’ll also learn why stress, jaw tension, and even scrolling on your phone in the bathroom can throw things off and what you can do to start reconnecting with your body. If you’ve ever felt dismissed or confused about what’s happening below the belt, Dr. Fix and Dr. Sasser’s discussion offers encouragement and tools to start feeling better.

Quotes

• “You mentioned that a lot of women seek out this care. I actually think that men, if this area is affected, are way better at seeking out care for themselves. So things start to impact the penis, it is like, we got to handle this ASAP. The pelvic pain, for sure. Like if you have a pelvis, this applies.” (08:03 | Dr. Katie Sasser)
• “If you go to pelvic floor therapy and it doesn’t feel like a safe space, you should find a new pelvic PT.” (30:29 | Dr. Katie Sasser)
• “We don’t need to be clenching. And we do that, you know, women are taught to brace their core and hold their tummy in… and I’m like, Hey, you gotta let that stuff hang out.” (41:04 | Dr. Katie Sasser)
• “We are really good at just walking in and just surviving each day and just being so disconnected from our bodies.” (44:50 | Dr. Katie Sasser)
• “Being a mom is hard. Going through menopause is really hard. Being weak and in those phases of life is even harder.” (47:12 | Dr. Katie Sasser)

Links

Connect with Dr. Katie Sasser:
https://physioroomco.com/team/dr-katie-sasser/

Dr. Katie Sasser is a physical therapist with over a decade of experience and a deep passion for pelvic health. A graduate of the University of Missouri with a Doctorate in Physical Therapy and a Master’s in Education, she blends physical care with mental well-being to support women holistically. Now practicing at Physio Room in Colorado, she specializes in treating pelvic floor issues like leaking, hip and back pain, prolapse, and postpartum recovery. As a mom of four, she understands the physical and emotional demands of motherhood and is committed to helping women regain strength, confidence, and a pain-free life. Whether you’re chasing kids, lifting weights, or hiking mountains, Dr. Sasser is ready to help you feel your best.

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The post 183. Pelvic Floor Physical Therapy Explained | Dr. Katie Sasser appeared first on Physio Room.