Is a Weighted Vest Bad for Your Pelvic Floor? What the Research Shows

You've probably heard about using a weighted vests for bone health. Research points to wearing one as an easy way to protect your bones, or even build them if you use it for strength training. However, there's been a lot of chatter about whether using a weighted vest is safe for your pelvic floor. 

You might also have heard that weighted vests are risky if you tend to leak a little when you sneeze or feel a heaviness low in your pelvis after a long day. When you add weight to your body, it might seem like it could make things worse. 

However strength training is one of the best ways to combat many pelvic floor issues, including stress urinary incontinence. Here we've broken down what the research shows and how you could start using a weighted vest for better pelvic floor health and bone health without worrying about an accident.

Understand what your pelvic floor is doing

Your pelvic floor is a sling of muscles and connective tissue located at the base of your pelvis that holds up your bladder, bowel, and uterus and also controls when you pee. It works with your deep core to stabilize your trunk while you move. 

Whenever you lift off or brace, pressure builds up inside of your abdomen, which is called intra-abdominal pressure. This pressure pushes down on your pelvic floor from above and research suggests that this downward force is the main reason loaded exercise can pose problems for pelvic floor health. 

Pressure builds up and how well your pelvic floor can handle it varies a lot from woman to woman. Something that might cause trouble for one person could be completely fine for another. 

Know the signs of a weak pelvic floor

Before you start loading up, it helps to know what a weak or struggling pelvic floor actually feels like. Symptoms can be varied and tend to come together rather than only experiencing one at a time. 

Research suggests that urinary incontinence affects about 55.8% of women, with leaking while coughing, sneezing, or laughing, causing the worst symptoms. Here are some signs worth checking for to see if a weak pelvic floor is affecting you.

• Leaking urine when you cough, sneeze, laugh, or lift
• A heavy or dragging feeling in your pelvis, or a bulge you can feel at the vaginal opening
• Needing to press on the vagina to finish urinating or to have a bowel movement
• Trouble controlling gas or stool, or constipation with a lot of straining
• Pain during sex, which can affect 38% of women a year after a first birth
• Low back or pelvic pain (research suggests women with pain in that area are more likely to have weak pelvic floor muscles along with urinary symptoms)

On the other hand there are some people who have a pelvic floor that is too tense rather than too weak, which can look more like hesitancy when you try to pee, bloating and worse pain when you insert a tampon or have sex. Those symptoms can be missed more often and are more rarely connected back to the pelvic floor. 

Regardless of your symptoms it doesn't mean that you can't use a weighted vest. What it does mean is that you should be assessed first because a clinician (like a pelvic floor physiotherapist) is the best person to tell you whether your pelvic floor needs strengthening or releasing, and those two paths look very different from one another. 

Here's who the scary statistics came from

Most of the studies showing scary numbers about exercise and pelvic floor symptoms come from a narrow group of athletes. 

About 41% to 49% of female power lifters and 37% to 54% of female weight lifters report urinary incontinence. Deadlifting may cause leaking most often, around 42.5%, followed by squats at 36.3%. Heavy loads and lifting in competitions where you're maxing out your lifts increase the risk even more. 

The reason for this is that once you lift above about 80% of your one-rep max, you automatically hold your breath and bear down in a pattern called the Valsalva maneuver. This maneuver drives pressure into your pelvic floor, which is what can cause the problem. 

Training at high volumes or high impacts (like CrossFit over five times weekly) triples the likelihood of leaking gas. Symptomatic pelvic organ prolapse, where pelvic organs move downward from where they should be, is most common in Olympic weightlifters and powerlifters, affecting roughly 23%.

So you can probably see that none of these numbers actually came from someone wearing a weighted vest or even doing simple bodyweight movements with one. 

How regular movement protects you

Adding weight to your exercise doesn't always stress your pelvic floor. In fact, research shows that controlled loading can actually help.

• Mild to moderate activity like brisk walking lowers the odds of having or developing urinary incontinence
• Sedentary older women reported more severe pelvic floor symptoms and more frequent prolapse than active older women
• Women who lifted heavy weights as part of a broader activity routine reported fewer prolapse symptoms (7.1%) than inactive women (21.3%)
• In older women with urinary incontinence, adding weight training to pelvic floor muscle training improved symptoms faster than pelvic floor training alone

The risks of not moving around come at their own cost, and should definitely be considered before making any calls on whether wearing a weighted vest is safe for your pelvic floor.

So, is wearing a weighted vest bad for your pelvic floor?

There aren't any studies that directly tested wearing a weighted vest and how it affects the pelvic floor in women. All of the conclusions in the research come from other kinds of loading. 

Since a well designed weighted vest for women only spreads about 5 to 20 lbs evenly across your torso, close to your center of mass and you carry it while walking or doing exercises like step-ups, squats, or push-ups, it's likely safe for your pelvic floor. Plus, you are nowhere near the 80% of one-rep max mark. You're also not holding your breath to brace against a barbell so the pressure is more like carrying a full grocery bag than a competition deadlift. 

That said, if you already have symptoms or are diagnosed with pelvic floor dysfunction, treat this research as a starting point for a conversation with a pelvic health physiotherapist rather than a full-out green light for you to strap on a vest and jump around. 

Start light and let symptoms set the pace

Sports medicine clinicians typically add load gradually and watch for symptoms along the way. Weight should increase only when symptoms are under control, and if there are any signs of pelvic floor trouble, you should drop back to a lighter load.

The YVO Warrior Vest is perfect for this because it holds up to 20 lb using eight modular 2.5 lb pouches, so you can move up in small increments instead of jumping or having only one set weight to work with.

Stay at each stage for at least two weeks. If a week feels like too much, you can always drop back one stage and rebuild from there once you're ready.

Choose exercises that suit a sensitive pelvic floor

If you know or suspect you have pelvic floor symptoms, simply walking is a great place to start and your pelvic floor is actually already working while you do it. Your pelvic floor muscles fire in bursts throughout the walking cycle, mostly when all of your weight is on one leg. The muscles work even more when you walk faster. 

Start with exercises that use both feet and let you breathe normally:

• Flat walking

• Step-ups onto a low step

• Sitting down and standing up from a chair

• Carrying groceries evenly in both hands

If you don't have any major symptoms, move on to:

• Hills
  
  
• Longer walks
  
  
• Bodyweight squats
  
  
• Running
  
  
• Jumping

Watch for the signals that mean back off

Check in with yourself during and after every session. Watch for these signs during every workout.

• Leaking urine during or after a session
• A heavy, dragging, or bulging feeling low in your pelvis
• Pressure that builds and does not settle within an hour
• New low back or pelvic pain
• Holding your breath to get through a rep or a hill

Breathe out on the effort and exhale as you stand up from a squat, step up onto a curb, or push up an incline. Breath-holding is what spikes the pressure, and it is the easiest thing to fix.

Keep doing your pelvic floor work

It's still important to do direct pelvic floor training since that's the first line treatment for urinary incontinence. 

You might have been told to do Kegels, but likely haven't been told what one should really feel like. Most women end up bearing down instead of lifting, which is the opposite of what you want. Here is how to do one the right way.

1. Stack your ribs over your hips. Sit tall on a firm chair with a gentle arch in your low back, not tucked under and not heavily arched. When your ribcage sits over your pelvis, your diaphragm sits over your pelvic floor, and the two can work together.
2. Find the breath first. Put one hand on your belly and one on your ribs. As you inhale, feel both hands move outward and imagine your pelvic floor softening and widening downward. As you exhale, feel it all settle back up.
3. Add the lift on your exhale. Gently lift your vagina and anus up and into your body. Aim for about 30 percent of your maximum effort. This is a quiet lift rather than a hard clench, and you should feel it deep in your pelvic floor and low belly.
4. Let go completely on the inhale. The release matters as much as the lift. If the letting go is harder to feel than the squeeze, spend a few weeks practicing only the release before you add the contraction back in.

Two cues that help: Imagine picking up a blueberry, or drawing a tissue slowly up out of a box. Practice two sets of 10 breaths a day, and expect it to feel awkward for the first week or two.

There is also a timing skill worth learning called the knack, where you squeeze your pelvic floor just before you cough, sneeze, or lift something heavy, so you're already bracing before any pressure causes a leak.

When to bring in a clinician

You should talk to a pelvic health physiotherapist or your doctor before you load up if you have been diagnosed with pelvic floor dysfunction, pelvic organ prolapse, or just had a baby within the last year. 

Book an appointment if your symptoms don't get better despite training consistently or if they get worse or if you have any ongoing pelvic pain. 

If you already work with the pelvic health physio, bring your vest to a session so you can load up in front of them while they watch your breathing and bracing to learn how your body handles it and give you any tips you might need.

Start with two pouches

Starting with two pouches, which is 5 lbs. on flat ground, and building from there is a good idea if you have pelvic floor issues. If this causes you no problems, you can always add more load.

Load one pouch in each front pocket, and walk for 20 minutes, paying attention to what your body is doing, then decide if you should add another few pounds. 

Find your starting weight in 2 minutes

Carry power!

FAQs

Are weighted vests good for the pelvic floor?

No study has tested a weighted vest as a pelvic floor treatment, so nobody can honestly market it as one. What the research does show is that mild to moderate activity like brisk walking lowers both the odds of having urinary incontinence and the risk of developing it, and that sedentary older women report more severe pelvic floor symptoms and more prolapse than active older women. A vest makes your walk more demanding, which supports your bones, muscles, and heart. Pelvic floor muscle training is still the tool that targets the pelvic floor directly.

Are weighted vests safe for prolapse?

Check with a healthcare provider before you start. Prolapse ranges widely in severity, and the right load depends on your symptoms and what your clinician finds on assessment. Some women with mild prolapse train comfortably in a vest, and others need to build pelvic floor strength first. Prolapse is also common enough to discuss openly, with symptomatic uterine prolapse reported by about 14% of women in one large study of 1,446 women.

Can I tighten my pelvic floor muscles by walking?

Walking activates your pelvic floor automatically, though activation is not the same as strengthening. In one trial, women who walked and did general strengthening showed no measurable gain in pelvic floor strength, while a program built around deliberate pelvic floor contractions did produce gains. You can close that gap by squeezing your pelvic floor on purpose during part of your walk, which research suggests recruits the deep muscles that stabilize your trunk. Adding a weighted vest raises the demand of the walk itself, and the contractions are what train the floor.

How much weight should I start with if I leak when I sneeze?

Start at 5 lb, which is one 2.5 lb pouch in each front pocket, and walk on flat ground for 20 to 30 minutes. Stay there for two weeks. If you finish those walks with no leaking, no heaviness, and no lingering pressure, add the next 2.5 lb. Leaking with a sneeze is also worth mentioning to a pelvic health physiotherapist, because it responds well to training.

Do I need to see a pelvic floor physiotherapist before using a vest?

Not everyone does. If you have no symptoms, starting light and monitoring yourself is reasonable. Book an assessment if you leak, feel pressure or heaviness, are within the first year postpartum, or have diagnosed pelvic floor dysfunction. One session to check your technique is a small investment for how much it clarifies.

Do Kegels still matter if I am training with a vest?

Yes. Pelvic floor muscle training is the established first-line approach for urinary incontinence, and adding weight training on top of it worked better than pelvic floor training alone in older women with incontinence. Research also suggests supervised programs produce larger strength gains than training on your own, so a few guided sessions are worth it if you can arrange them.

About the Author

Rachel MacPherson, CSCS, CPT

Rachel is a certified strength and conditioning specialist with over a decade of experience, and a pre- and postnatal exercise specialist. She specializes in helping women build strength and confidence through evidence based training.

Disclaimer: This article is for educational purposes. Always consult a healthcare professional before starting a new exercise routine.