What They Didn’t Tell You: From Core to Floor
Your go to podcast for real talk about women’s bodies, pelvic floor health, hormones, pregnancy, sex, and healing all through a mix of science and intuition.
What They Didn’t Tell You: From Core to Floor
Why You Leak During Workouts
Leaking During Workouts? Pelvic Heaviness? Back Pain? Let’s Fix That.
In this episode of What They Didn’t Tell You from Core to Floor, Dr. Millie is back in the studio with personal trainer & core specialist Zoe Corin to unpack one of the most common and most ignored , fitness struggles: pelvic floor symptoms during exercise.
Whether you're leaking during jumping jacks, feeling heaviness in a squat, or wondering “is something wrong with my body?” this one’s for you.
We break down:
- Why symptoms like leaking, heaviness, and back pain happen (even if you “feel strong”)
- The real difference between weakness vs coordination
- Why tight muscles can still be weak
- What “pressure management” really means, in normal human language
- How your breath + core + posture work together (and how they might be working against you)
- The surprising connection between posture, inner thighs & pelvic floor
- Quick cues and tests you can try right now to feel the difference in your own body
No shame. No scary medical talk. Just real guidance from experts who truly get it.
And if you’ve ever been told to “just do more Kegels”… this episode will blow your mind.
Links:
Reconnect With Your Core in Just 5 Days
Join the waitlist for Millie Schwecky and Zoe Korin's Core Girl's Club!
Follow Millie: @milliedpt
Join the Core to Floor community: https://millie-schweky.mykajabi.com/intimacy
Connect with Zoe Corin: @strongerwithzo
Dr. Millie Schweky: [00:00:00] Hey sis, and welcome back to what they didn't tell you from core to floor. I'm your girl, Dr. Millie Schlei pelvic floor PT here to teach you everything you need to know about your body. We are back nice and cozy in the studio with Zoe Coran. We had two weeks off of doing a show together and now we are reunited and we're here today to talk about pelvic floor symptoms and how they come up during our workouts and what we can do about them.
Dr. Millie Schweky: Like just coming off of the last couple of episodes, we spoke about getting back into exercise after having a baby, and then we also spoke about diaas hysteria or abdominal separation. So if you didn't listen to those episodes yet, I recommend definitely catching up after this Diasis recti. Abdominal separation is something that is not exclusive to postpartum woman happens to be.
Dr. Millie Schweky: I'm bringing it up because today we're gonna talk about leaking and pelvic floor heaviness a bit, and back pain and a lot of the times. These things are linked. I know the research on diastasis is not that good, so I can't even tell you that [00:01:00] that's evidence-based, but a lot of the time people that have diasis recti, yeah, it's, it's like our anecdotal evidence and our cynical evidence, but.
Dr. Millie Schweky: You know what it is, what we see happen in the real world a lot of the time, and I think it's because if you recall, ESIS is a pressure management problem, meaning your body is not able to regulate the amount of air that's inside of it. And a lot of the times this comes out in work, in workouts or in exercise classes where someone would feel pelvic heaviness.
Dr. Millie Schweky: So can you tell us a little bit like what kind of complaints you're hearing? What moves are bothering people the most when it comes to pelvic heaviness?
Zoe Corin: The average person often can't even, doesn't even know what their pelvic floor is meant to feel like. Where the heaviness should be, what's normal, what's like what's normal, what's common, what's okay, what's not okay.
Zoe Corin: I think often it's usually things when legs are open. Okay. It's the more like a open neck position. Think a wider squat, [00:02:00] like a sumo squat or a side lunge, or obviously a jumping jack. Anything that kind of separates the leg a bit more. I feel like that's when people are like, oh, something feels a little bit like.
Dr. Millie Schweky: That's interesting because the adductors or the inner thigh muscles work with the pelvic floor and when they're in a lengthened position, it's actually harder for them to contract 'cause they're working through a larger range of motion. Sorry for all the big words for you nerds out there. I hope this is making you happy, but yes, when you're doing, and let's like,
Zoe Corin: and also I think often I feel it comes with like a really hard core exercise.
Zoe Corin: So someone would you like, you know Yes. They had a comment here that she was doing a hollow hold and she was like, oh, there's too much for my pelvic floor. I was like, first of all, awesome that you know that like cool that you are so connected to your body that you're like, I'm going to take it a notch down.
Zoe Corin: But yeah, you like regular core exercises. It's directly correlated. It would make sense if you're not managing the pressure,
Dr. Millie Schweky: it's going somewhere. One of the first things [00:03:00] I ask my patients when they come in for anything that seems like it's a pressure management issue is do you ever feel like something's falling out of your vagina?
Dr. Millie Schweky: And when they don't know what I'm talking about, I'm like. You know, the day before your period when like it feels a little bit heavy or like when you're on your period and you feel like, I don't know, just something like there's something you are there and they're like, oh, oh yeah, yeah, I know what you're saying.
Dr. Millie Schweky: And a lot of the time it's more relevant after like a really long day on your feet, which totally makes sense. 'cause Gravity's doing this thing all day long, your muscles compensate till they can't. And then you're like, okay, pelvic floor has to give. But it can happen pretty quickly when you start. A workout.
Dr. Millie Schweky: So what causes this? Like, why? Are people feeling this? And a lot of people think that they're just weak and they need to do Kegels, but that happens
Zoe Corin: to not be the case. So I think it comes down to a few things. I think it's, um, often ignoring like really clear signs and just [00:04:00] continuing to work out with this weakness without the pressure management not connecting to like the breathing and not, and not being aware.
Zoe Corin: So I think a lot of it comes down to just not being wet and not treating. When needed. Another thing comes down to is, as we just spoke about the doctors, the inner thighs, like having weak inner thighs can really affect how your pelvis is being is holding the pressure during, uh, working out, and obviously as we go back to every time.
Zoe Corin: Cool. So managing the pressure through your core. So how it could be, you could be all of those together, but really what it comes down to is awareness. I don't love to use a squad, but weakness,
Dr. Millie Schweky: so I wanna talk about weakness for a minute. 'cause I think a lot of people think weakness means a muscle is stretched out loose and floppy.
Dr. Millie Schweky: But a lot of the time I will find a weak pelvic floor that's too tight. It can either be shortened or [00:05:00] hypertonic. Shorten means the muscle's actually short because it's tight, like it, it is shortened position physically and hypertonic means that the muscle is just holding onto more. Tone because it's trying to protect you.
Dr. Millie Schweky: It's compensating for another muscle group, let's say the glutes or the adductors, or sometimes even the lats or the abdominals. So
Zoe Corin: I like to explain it if we're talking about tightness, is that if you imagine your muscle being in like a really contracted tight position and not being able to expand, so not being able to loosen up, it's got nowhere to go.
Zoe Corin: So it can't strengthen if it's always in this position where it's just. Squeezed in.
Dr. Millie Schweky: Mm-hmm.
Zoe Corin: So if you can't let it loose and relax it, you are not gonna be able to contract it, which means you are not gonna be able to strengthen it. So as you just said, most often I find like people with like, like say to me, oh, like I have really tight inner thighs.
Zoe Corin: I'm like, well then we need to work and strengthening or inner thigh. As you just said,
Dr. Millie Schweky: if you [00:06:00] have a muscle that feels tight and you keep stretching it and it's not getting better, it's because the muscle, the muscle's already over lengthened. But it happens to be that your brain gets the same signal from the muscle, whether it's weakened tight or lengthened and tight.
Dr. Millie Schweky: Both of them are forms of tight, but it could be over lengthened and tight. That's a different kind of weakness. So a lot of the times, strength and coordination. Is the answer which brings me to my next point, which is the difference between strength and coordination with the pelvic floor. So just to give you like a little rundown and then you could tell us about how you incorporate this into workouts.
Dr. Millie Schweky: What is the difference between strength and coordination when it comes to the pelvic floor? I'm actually gonna start with coordination. Coordination is, are you able to contract your pelvic floor? So that's lifting it as if, let's say you're stopping a flow of urine or picking up a blueberry with your vagina.
Dr. Millie Schweky: Are you able to let go of that? So that's kind of like how your pelvic floor should be at [00:07:00] neutral or are you able to bear down, let's say you have a bowel movement, it's like really difficult to pass and you wanna push down on it. Are you able to go down like that and bulge? You would be shocked how many times I tell someone to contract their pelvic floor and they bulge.
Dr. Millie Schweky: And how many times I tell someone to bulge their pelvic floor. They contract. And you would also be shocked by how many times I have someone do a very simple abdominal exercise. Let's even start with breathing. When you inhale your pelvic floor to relax, a lot of times I'll see the pelvic floor contract on the inhale and relax on the exhale, which is the opposite of what we wanna see happening.
Dr. Millie Schweky: Or I'll be doing an internal exam and ask them to do something as simple as a. Abdominal brace or a crunch and I'll feel their pelvic floor bear down. So these are the kinds of things that will cause that leaking and that pressure. And it's not, 'cause your muscles are purely weak, it's because you're not coordinated.[00:08:00]
Dr. Millie Schweky: So there's something to learning co Uh, the, I actually call it like choreography of the pelvic floor. It's like learning a dance. 'cause a lot of the time the piece, the vagina toilet. Yeah, the vagina dance. It's like the pieces are not moving together and you just need to get them like on the right. Pace.
Dr. Millie Schweky: And then when they, when they work together, they work together. So now imagine you're just going about your life doing everything backwards and feeling symptoms. If you layer that onto lifting something heavy. Imagine how much more fish your No, but I'm saying you're doing it wrong, right? You do. Let's say you're doing it wrong and backwards.
Dr. Millie Schweky: Now you're doing it with a dumbbell that's 10 kilos or five pounds or whatever. It's gonna come now you're reinforcing a faulty movement pattern, which is why I think it's so important when you're exercising to really know what you're doing and to work with someone really qualified so that they can ask you questions and know if you're working internally.
Dr. Millie Schweky: Correctly because exercise, when you're doing [00:09:00] repetitions of an exercise, you could either be reinforcing a good movement pattern or a faulty movement pattern. So you always wanna check and make sure you're breathing your core. Your pelvic floor is all on the same page so that you're not compensating and reinforcing a bad habit.
Dr. Millie Schweky: So what, obviously, like as a personal trainer, you're not checking people internally to see what they're doing. So what kind of questions are gonna be helpful for people to ask themselves when they're working out so that they know if things are, you know, moving in the right direction?
Zoe Corin: So I think for a lot of people it's often touch or visual.
Zoe Corin: Okay. So it's, it's very hard to imagine things just in your head to imagine your pelvic floor and especially if you can't connect to it. So I like to either put, tell people to put their hands underneath their like bum. Okay. So to make sure, like if they're using their pelvic, if they think they're using their pelvic floor, it's not coming from squeezing a bum.
Zoe Corin: Mm-hmm. I like to tell people to, if we're doing breathing, to really kind of put your hands around your rib cage, really feel that the breath [00:10:00] is going there and, and I would then put their, my hands on their shoulders to make sure that the breath isn't going up. It's going. Into the rib cage and going lower.
Zoe Corin: So I think a lot of, a lot of the work is often with a few kind of with feeling, feeling a little bit more where your body's going, and also visually helping. So we'll do it, you know, in front of a mirror. And let's say we're doing a band pull apart. If you've got a band in front of you and you're pulling it and you wanna really activate your kind of deep abdominal muscles, pick up the pelvic floor, you are gonna see the difference of your belly.
Zoe Corin: Drawing in and collecting and compared to when your belly bears down and it pops out, these are things you can physically see. So I like to take them to a mirror, let them feel it a bit more. It's very hard, as you said, because I don't do internal examination to really get them to gauge their pelvic floor and know that we're on the same page.
Zoe Corin: But I feel like when they get the. [00:11:00] The rib cage mobilized in breathing. The pelvic floor comes with it a bit better.
Dr. Millie Schweky: Yeah, it does. And you know what, I've been in your classes before and you use the word collect a lot and I love it. 'cause I feel like it really encapsulates what we're trying to do when we're trying to lift the pelvic floor.
Dr. Millie Schweky: When you say collect, I'm thinking like front to back and side to side. Bring on from the bottom to the top. And I really love that cue. And a lot of what the beauty of. Exercises in general. Last week's episode was actually about how much I love exercise and how it keeps me grounded is because you actually get to understand what things feel like in your body.
Dr. Millie Schweky: So there's not someone physically there always telling you, you know, this is up, this is down you. It's up to you to get in touch with your body and tune in and see like what exactly everything. Feels like, so you could actually learn how to know if you're doing something right or if you're incorporating a not so good [00:12:00] movement pattern that's gonna lead to that pressure down the line.
Zoe Corin: I will say just the practice is really important in these things. Like when I see good people once a week and they, I say to 'em, have you practiced your breathing or have you practiced your like. Connecting to your pelvic floor and they're like, you have to like scot over again each week. And I feel like that is really, when it comes to like breathing on pelvic floor, it really requires tedious work.
Dr. Millie Schweky: But you also don't need that much time a day, which I like to remind everyone, like, you could do a minute in the night and a minute in the morning.
Zoe Corin: You don't wanna do too much. Yeah. But there does need to be some co consistency.
Dr. Millie Schweky: It ends up spilling over to your whole life. Like I'm trying to explain to people like, okay, this is how you breathe, and they're like, great.
Dr. Millie Schweky: Am I supposed to always be thinking about this? I'm like, no. You think about it when you're practicing, and the point is that you're rewiring your brain to understand that this is. How it's supposed to work automatically, which you did do at some point in your life. Your body just forgot because either you were in a stressful situation, you're breathing shallow, or you were pregnant and now you are not pregnant [00:13:00] anymore 'cause you're postpartum.
Dr. Millie Schweky: And like all of your alignment and attachments have changed. Practice your breathing, practice your core. And the point is that when you're in your real life, it spills over and then you'll actually move more functionally as a human. Something that I actually came to you to work on was my posture.
Dr. Millie Schweky: If you recall. I was using my upper traps, so like I was struggling my shoulders a lot and not able to access like my whole entire low back. And at the time, I'm trying to remember, I think I was maybe like a year and a half postpartum. No, no, I think about two years postpartum, maybe two years. It was like a little, it was like, it was like a between a year and a half and two years postpartum, which.
Dr. Millie Schweky: For me, it was significant. Like I still felt postpartum at that point. And um, I remember I had a little bit of pelvic heaviness and a lot of it was because of the way my posture had changed. My, after I had my daughter, I carried quite large and my breasts were [00:14:00] humongous. So my whole. Posture was like hunched forward and it made the position of my pelvis change.
Dr. Millie Schweky: And then, you know what? I always just felt my bladder. I kind of just always felt it. I went to Pelvic four PT a couple of times for some release work that was helpful. And when I worked with you and we worked on my whole upper body, I actually felt the pelvic heaviness get better. So what have you done with your clients?
Dr. Millie Schweky: To help their posture. And what are, you know, do you have any other, like, stories about pelvic floor changes?
Zoe Corin: Yeah, look, thank God lots of, um, good stories coming out of people with pelvic floor changes. I think posture and alignment is a, a massive thing when it comes to pelvic floor. I try and also remind people, like even through class, it doesn't have to be a one-on-one thing, like.
Zoe Corin: Ribs stacked over pelvis because I feel like that is such, it's so minor. People can get that. It's not so confusing either. And it makes a massive difference because when we're [00:15:00] squatting deli, like whatever it may be, like if you are always in this feeling of like you're just a little bit tipping over, a little bit, tipping back.
Zoe Corin: That pressure onto the pelvic foot. It's real. It's happening. And even like, think about how we spend our whole days as moms. I do it myself. I carry my kid, my hips in the side. I'm slumped forward to try to like even out my balance. I'm always kind of in this like weird position. Now, if I have no awareness that that's not a good thing to do, then I would probably be doing it way more.
Zoe Corin: But I try and get myself out of it as much as possible. And I feel like just that positioning. Enough to put a lot of pressure onto your pelvic floor. So I think alignment, awareness and the breathing. The breathing is so essential.
Dr. Millie Schweky: I feel like we're always talking about breathing, and I love that look that people give me when the first exercise I give them in therapy is breathing and they look at me and they're like.
Dr. Millie Schweky: Why did I come to you? Like, imagine you're just
Zoe Corin: a walkout and like, Hey guys, we're gonna [00:16:00] lie down and do breathing.
Dr. Millie Schweky: Yeah.
Zoe Corin: I was, my sweat,
Dr. Millie Schweky: like, people don't get it. I'm like, you can't do anything until you know how to breathe. You can't do anything. So keep reaching it. We're just gonna keep reminding everyone on the episodes.
Dr. Millie Schweky: You know, my favorite question is when someone's leaking and they're like, isn't it just gonna let go away by itself? Unfortunately,
Zoe Corin: maybe if you are really lucky. Yeah, if you're really
Dr. Millie Schweky: lucky
Zoe Corin: And something, it depends where it's coming from. If it's coming from a place of like stress and just like feeling quite like low energy.
Zoe Corin: Yeah. Sometimes we like it can actually go away by itself, but most of the time it's it's a coordination thing.
Dr. Millie Schweky: So let's actually go over quickly the different types of leaking. There's urgent continence, which means when you're on your way to the bathroom, like when you feel like you have to go to the bathroom, you don't fully make it there on time.
Dr. Millie Schweky: Like right before you get there, you'll [00:17:00] miss a little bit. Yeah. Yeah. You'll, you'll feel that urgency of like zero to 100 real quick. Instead of the urge just gradually coming on, you'll go from zero to 100 and then you'll just not make it right. Urgency, urgent continence. Um, it could also come on when you hear water running or anything that just reminds you of getting home.
Dr. Millie Schweky: I call it key indoor syndrome. As you mentioned, like you put your key in the front door and all of a sudden, like your first few steps in the house you're leaking happens with so many people and it happens to be a quick fix. Um, 'cause that's a lot of bladder training, but that's one type of incontinence.
Dr. Millie Schweky: Incontinence just means loss of urine. And the other kind of incontinence that I think we're talking about more here is called stress incontinence. And it doesn't mean stress like, oh, I'm so stressed, my life is crazy. Stress meaning it. Your intraabdominal pressure or the amount of pressure in your body because of the way you're holding your breath and your posture is just [00:18:00] not coordinated well, as you said, a lot of the times it's coordination and once we get that coordination online, things start to.
Dr. Millie Schweky: Get better. 'cause again, your core, your posture, your breathing, your alarming, your pelvic floor, all need to be on the same page. Working out is a great way to practice that. Working out with good form, and sometimes simply a good workout routine with one or two sessions with a pelvic floor PT can be the answer you need.
Dr. Millie Schweky: I
Zoe Corin: feel like it's a light switch like once again. You've got it. You just have to get to that point where you're like, oh, I
Dr. Millie Schweky: get this. Yeah. Once it clicks, it clicks. I love that light bulb moment. Sometimes I'm there for it, like it happens in the clinic. Look, sometimes it clicks when they're like.
Dr. Millie Schweky: Physically in the clinic, like, oh, I felt it happened. Like, yeah, now do it again. Now do it again. Now do it again. We're gonna do it a thousand times until your body just can't do it anymore. Yes. So that's the different kinds of incontinence and no, it most likely won't go in its own. You gotta. Put some work in there and, uh, just to [00:19:00] wrap up, if someone wants to reconnect to their pelvic floor because maybe they don't feel it when they're working out, or maybe they don't feel their core when they're working out, like what?
Dr. Millie Schweky: Would you suggest they start with
Zoe Corin: I don't wanna plug a core program here, but I feel like our core resource is a really good one to start with. I think getting to know your body, being aware of how it should work, how to manage the pressure. It's just the game changer for your core. And if you get that down.
Zoe Corin: It opens up a world of opportunities for your body.
Dr. Millie Schweky: Yeah, we have a, we have a core resource, it's called the Five Day Challenge, where Zoe and I basically walk you through very quick check-ins every day for five days straight. It comes to your email where we show you different small movements, and we ask you where you're feeling it in your body, and if you're not feeling it, where we'd like you to be feeling it.[00:20:00]
Dr. Millie Schweky: We show you how to do it properly, and it basically unlocks the door to feeling super connected to your body, making sure that you can stay present and grounded and making sure that when you exercise. You're working the right thing so that you can go about and live your life a bit more efficiently and more symptom free.
Dr. Millie Schweky: So the link is gonna be in the show notes for you guys and just go ahead and click it and I am loving the feedback. I'm getting a bunch of emails. Keep them coming and please send this episode to your friends. We loved chatting with you about leaking and pressure today. Love a good leak and pressure.
Dr. Millie Schweky: We love it. And uh, have a good one. See ya.