What’s HIIT Doing to Your Pelvic Floor?
Lockdown may be pretty much over, but it’s fair to say that the last four months have presented us with a few challenges. While we wrestled with Zoom work meetings and teaching our parents how to FaceTime, gym closures meant we also had to work out how to workout, without leaving the house.
Fortunately, the fitness world rallied to ensure we could keep our endorphins up during international lockdown. From online yoga classes to Instagram Lives with dance instructors, there was something for everyone - but it seems that High-Intensity Interval Training (aka HIIT) was the home-bound workout of choice. As we desperately looked for equipment-free, fast workouts - that we could fit in between homeschooling and our 4th virtual quiz of the week - it’s no surprise that ‘HIIT’ saw a 57% spike in Google searches. Minimal time expenditure, with maximum impact, there’s a lot to love about this efficient way of working out - but are there any drawbacks to the nation’s favorite exercise? And can something so intense be any good for our pelvic floors?
What is HIIT training?
For those of you that don't know, HIIT stands for High-Intensity Interval Training. It's when you do short sharp bursts of exercise (usually between 30 and 40 seconds), followed by a brief period of rest. The exercises vary but think lots of squats and even more burpees. Routines generally combine a few different moves in a sequence and are all about getting your heart rate up and ensuring you work to maximum capacity (aka experiencing sauna induced levels of sweat).
Fitness influencers on both sides of the Atlantic are huge advocates for the transformative power of HIIT. During the lockdown, Joe Wicks, aka "The Body Coach" even brought the concept of interval training to a whole new generation, with his daily PE lessons/workout sessions, which were watched by over 20 million children worldwide.
The highs of HIIT
There are plenty of reasons why HIIT has such a dedicated group of fans. Firstly, HIIT is amazing at burning calories, with one study proving that it’s 20-30% more effective than other forms of exercise, such as running or cycling. But HIIT doesn’t just work its magic during the exercise session itself. Interval training has been proven to increase your metabolic rate for hours after you’ve finished, meaning you could technically still be burning fat, even when you’re back on the couch watching Netflix.
Not only does HIIT help you burn calories, but it can also be effective in building muscle. While weight training has always been considered the 'gold standard' for increasing muscle mass, we defy anyone doing 100 squats in 30 minutes not to feel tighter and toned afterward.
...and the lows
However, like everything in life, it's possible to have too much of a good thing. High-Intensity Interval Training is, as its name would suggest, pretty intense. This can put your body through a lot of pressure, which, of course, puts you at risk of injury. As said by women's health physiotherapist Georgie Adams, “HIIT really does ‘hit’ the whole body, but the most common sore or injured areas I see are the knees, shoulders, wrists, and lower back. Most of this comes down to either overloading the system (too much too soon!) or not enough control in the joints.”
An overload of HIIT not only puts your physical health at risk, but your mental wellbeing too. When we do a HIIT class, the intensity puts our body into ‘fight or flight’ mode, releasing adrenaline and cortisol. While a burst of these hormones isn’t a bad thing, sustained levels can make us feel increasingly stressed – constantly feeling like we're trying to escape a predator (in prehistoric times) or staring at an inbox with 2,351 unread emails (in 2020). The general advice is that HIIT should be balanced out with low impact exercises - such as yoga and pilates - to ensure both our minds and bodies are given a break.
HIIT and your pelvic floor
HIIT routines often involve a lot of jumping and squatting – two major red flags for anyone who suffers from pelvic floor issues - but does that mean we should be avoiding it altogether?
“HIIT places a lot of pressure on your pelvic floor,” explains pelvic health physiotherapist Jennie Hughes. “It’s good to be aware that excessive amounts of this type of training can weaken the pelvic floor and cause issues such as leaking urine. This is a sign that the downward pressure from the specific exercise you’re doing is too much for your pelvic floor strength.” While this might not mean you need to hold back on interval training completely, it might be worth adapting your routines until you are sure your pelvic floor can handle what you’re throwing at it. “Your exercise may need to be tailored back to ensure your pelvic floor is working optimally to provide the support it should naturally be doing during exercise,” says Jennie.
Georgie agrees that while HIIT isn’t totally off the workout menu for those with a weak pelvic floor, it is something we need to keep in mind: “HIIT isn't necessarily bad for the pelvic floor, but like with other muscles, we need to prepare it to meet the demands of the exercise required,” says Georgie. “HIIT exercise often includes impact and core exercises which require our pelvic floor to be strong, that can turn on (and off!) quickly, and has the endurance that is up to the task we set for it.”
Kegel exercise before HIIT exercises
So, if you’re craving all the benefits of HIIT, but are concerned about issues like incontinence or prolapse, the advice is simple – you need to train your pelvic floor before you train anywhere else. “HIIT just requires rehab, training the pelvic floor along with all the other muscles to avoid over-straining or worsening of your condition,” says Georgie.
Both Jennie and Georgie agree that checking-in with a pelvic health physiotherapist can ensure that you're training safely, and can help you develop a plan to get you back to a high level of intensity. It’s also clear that pelvic floor exercises, like the ones aided by the Elvie Trainer, are key, whether you’re experiencing symptoms or not. “If you are asymptomatic then there is no problem with completing HIIT training in moderation,” says Jennie, “but pelvic floor exercises are always recommended to complete no matter what your exercise level or tolerance.”
While your HIIT class might be so fast it’s over before you know it, Georgie suggests taking a more mindful approach to your pelvic floor training. “Try to practice quick pulses as well as long holds of the pelvic floor, and no breath-holding! Slow and steady wins the race here, take the time to ensure all your muscles are working together effectively and there’s no reason you can’t enjoy HIIT stress-free.”