In her groundbreaking guide to pelvic health for athletes, Dr. Selman explores how the pelvic floor muscles work with the muscles around them. In this excerpt from the book, we turn our attention to the power of the pelvic floor and offer Dr. Selman’s pelvic floor self-test to see how you stack up.
By definition, power entails a speed component—the muscles function quickly to produce the required force on demand. Strengthening the pelvic floor may not be enough; sometimes we need the pelvic muscles to relax and other times we may simply need finer control, just like with other muscles of the body. As with our other muscles, the power generated can be compromised in a number of ways.
Pelvic Floor Endurance
Many athletes struggle with pelvic floor endurance, so repetitive movements can fatigue the pelvic floor and compromise performance. Much of our ability to produce powerful force relies on the communication between the brain and the muscle. In endurance efforts, the signal between the brain and the muscles can be slowly worn down over time. I often describe this as “static” that builds as the effort goes on. When we begin an endurance effort, the signal between the brain and pelvic floor is clear and efficient, but as fatigue sets in, that signal loses clarity, limiting force production. Think about this like your cell-phone data limit—once you hit a certain amount of data, you can still process incoming information, but the processing speed slows down.
Pelvic Floor Contraction Speed
Some athletes struggle with the speed of muscle contraction, which leaves them vulnerable in fast-movement tasks, such as frontal plane pivoting in basketball, the push-off in a softball pitch, or any lift requiring fast movement, from an explosive squat to Olympic lifting. These athletes may have the ability to produce a significant amount of force, but not at the speed required for their sport. This is often measured as rate of force development (RFD), and this concept can be applied to the pelvic floor.
In a treadmill study, runners who experienced urinary incontinence showed a 9 percent reduction in pelvic floor muscle RFD without a reduction in overall force—meaning that while they still could generate the same amount of force post-run as they could pre-run, they were not able to generate that force as quickly after a bit of fatigue had set in.
As an example, if a sprinter can maximally contract the pelvic floor in a clinical setting after a few seconds but can’t generate the same contraction in the initial push-off and acceleration of a race, we’re missing the point. In these cases, the signal is getting through to the muscle clearly but not as quickly as needed to accommodate the demand at hand.
Think about this like your internet speed—just because you have an internet connection doesn’t mean it works at the speed necessary for certain tasks.
Pelvic Floor Weakness
Still other athletes may have the coordination to quickly contract but can’t generate the force necessary for the task at hand.
If we return to the internet analogy, you can think of this as a fast connection without a lot of storage. Fast download speeds are great but don’t mean much when we can’t actually store the information.
Here, my sprinter may be able to contract the pelvic floor quickly on the track, but if they increase the load to the muscles by adding weight or force (i.e., push into the ground to get over a hurdle), those muscles may not be able to hold against that load.
Different athletic movements require different demands of the pelvic floor muscles:
When any variable in the power equation is diminished, performance is negatively impacted.
At the end of the day, it’s not enough for the pelvic floor muscles to be strong, coordinated, or responsive in isolation—they have to deliver the right amount of force at the right speed and at the exact moment the sport demands it.
Pelvic Floor Skill Assessment
We want to ensure that the pelvic floor is able to move both up and down in the same way I’d want to ensure that your knee can both bend and straighten. Pelvic floor power can be easily assessed with an internal exam, but let’s review cues for a DIY assessment (which is not the same as an exam by a qualified professional, but it is a starting point). The pelvic floor generally descends as we inhale and ascends as we exhale—we will use breath to our advantage in these assessments.
Pelvic Floor Health External Self-Test for All Athletes
Place your hand out in front of you, palm up. Then place it under your pelvis, between your legs from the front—your fingers will be pointing behind you. Your hand should be resting between the sit bones, as this is where most of the muscle “hammock” lies.
- Take a deep breath and then exhale over the course of 5 seconds. You want to feel a slow and steady lift of the muscles off the hand you are sitting on.
- Then as you breathe in over the course of 5 seconds, the belly and ribs should expand while the pelvic floor opens and gently lengthens downward into your hand. This should not require a breath hold and shouldn’t feel forced. The pelvic floor in this initial practice should coordinate with your breath—moving up as you exhale, then slowly lowering and lengthening as you inhale.
If you are able to perform the Reverse Kegel but find that it takes 5–10 seconds to achieve that position, continue working on this until it becomes more natural to move between the top and bottom of your range of motion.
This assessment can expose how you may end up losing power in tasks that require repetitive near-maximal contractions, like plyometrics!
We’ve been working on these movements using pelvic floor exercises featured in earlier chapters of Floor It!, and now we have the opportunity to add speed with a forceful exhale. You may notice that you have the coordination to do this slowly, but when you add force and speed by quickly exhaling and bracing the core, you are unable to produce the same upward lift. You might notice that your pelvic floor is actually doing the opposite—rather than lifting, the anus or vagina is opening wider, indicating a loss of pressure and stability.
The topic of quick movement presents a good opportunity to address the cough/laugh/sneeze situation. These are everyday moments that often cause pelvic floor symptoms because when they occur, there is a quick increase in pressure at the abdomen. Remember the shaken-up soda can? Think of it again here—when we cough, the pressure in that can increases. I need the sides of that can to move and expand, but not so much that it explodes. In the same fashion (but with less exploding), your pelvic floor muscles need to move downward when these events occur, but not so much that you have leaking. I do not expect the pelvic floor to move up and stay up while you’re laughing, but I do expect it to have the mobility and control to move down without fully “letting go.” Practicing quick contractions (see the Quick Flicks skill assessment in the book, a helpful pelvic floor strengthening exercise) can moderate this movement when we need it for these everyday tasks. Given this, if you had a finger inserted during a cough, it would be okay to feel a slight opening or lengthening at the pelvic floor. We just need to be sure that it is controlled enough to still hold back against the contents above it.
Let’s floor it! See more from Dr. Rachel Selman and her groundbreaking book on pelvic health and sports.
About Floor It
Floor It is the groundbreaking guide to your pelvic floor, the unsung hero of core strength and your hidden powerhouse for sports.
Dr. Rachel Selman, DPT, the NSCA’s 2026 Personal Trainer of the year, offers a fascinating resource to understand pelvic floor dysfunction and pelvic muscle training for endurance sports, team sports, power sports, and sports that involve twisting like tennis and golf.