Seven Exercise “Don’ts” Your Physical Therapist Wants You to Know

Are you ramping up your exercise and activity?

Whether you are hitting the walking, running or hiking trails, jumping on a bike for a ride or into the lake for a swim, or signing up for that pilates class - go for it! Walk. Run. Jump. Swim. Pilat. But, say our fabulous physical therapists, Brianna and Meagan, do your chosen activities correctly so you don’t do your body more damage than good. So here’s what not to do (and what to do instead.)

ONE. Don’t ignore your body’s warning signs and “power through” exercises that are hurting you.

Classes that work your core can be especially problematic for those with weak pelvic floor muscles, like new moms or women in perimenopause and menopause.

“I’ve been to a few core classes,” Meagan says, “and honestly, I know one Army Ranger who could do the whole workout with perfect form. If you can’t maintain perfect technique, or if you’re getting red flags from your body, you need to modify the exercises or stop so you don’t injure yourself.”

So what are the warning signs?

1. If you’re leaking urine or “tooting,” Meagan says, your body is telling you there’s a mismanagement of pressure.
2. If you have pain, especially highly localized pain that doesn’t improve as you continue, that’s a sign that something may be injured.
3. If your hips make a pop, click, or snap sound while making some movements, you need to address the weakness in that area before continuing with more demanding exercises.
4. If you can’t do the move without arching your lower back, or if you have to put your hands under your butt, modify the exercise by putting your feet on the floor or rest during this part of the program.
5. If you’re compensating for pain or inability by using some other part of your body to complete the exercise, you may not be strong enough for this exercise yet. Back up, get stronger, come at it when you won’t hurt yourself.

As Meagan says, “The smart athlete will always outlast the tough athlete,” so if your body is telling you to modify, stop, or slow down, modify, stop, or slow down.

Do instead: listen to your body, modify exercises when needed, learn how to strengthen your core correctly. To test if your body is ready for challenging core work, lie on your back and find and engage (but don’t over-engage) your pelvic floor and transversus abdominis muscle (TA). Continue breathing with gentle, controlled exhalations.

If you’re able to do this and maintain it, then you can add in leg and arm movements to make the exercise more challenging. If you can’t or aren’t even sure what the heck any of this means, consider visiting a pelvic PT to learn how to exercise right. While learning to breathe and recruit your TA may not be as satisfying as an hour of sweaty Crossfit, you may save yourself from incontinence during exercise or worse, prolapse, further down the line.

TWO. Don’t hold your breath

Holding your breath is really not good for your pelvic floor, as it increases pressure on the pelvic muscles and can contribute to incontinence and prolapse.

Do instead: Breathe like you’re cooling soup any time you increase effort, our PTs say. Even if you’re just opening a heavy door, lifting, bending, twisting, or moving from sit to stand, make sure you’re breathing with a light, controlled exhale. Just don’t hold your breath.

THREE. Don’t restrict fluid to avoid having to urinate

No one wants to leak while lifting at the gym or have to desperately seek a porta potty while out for a run, but doing without water can do real damage to your body. As the weather gets warmer, we need to add more fluids so our bodies can recover properly and completely from our activity.

Do instead: Hydrate. If you’re leaking, there’s a problem; stop the exercise routine until you can get the issue diagnosed and treatment underway. If you’re concerned about needing a bathroom while out for a run or bike ride, map out a route that takes you past the city park, friendly gas station, or coffee shop about the time you usually need to go. Track your hydration and urination until you start to see patterns – the better you know your body, the better you’ll be able to map your route according to your body’s needs.

FOUR. Don’t hold your belly in during exercise or in your day-to-day life

Keeping those pelvic muscles tight all day every day is so hard on the pelvic floor, Meagan and Bri tell us, and it’s a recipe for incontinence or prolapse at some point in the future.

Do instead: let your abdominal muscles relax naturally. Don’t “suck it in” or consciously engage your core; build your core intentionally, using the exercises your PT teaches you, then it’ll be there when you need it. If you’ve done the work to build a strong core, it’ll be there and doing its thing as you exercise; you shouldn’t need to consciously engage it.

FIVE. Don’t ramp up exercise too quickly

Now that the weather’s getting warmer for many of us, there’s a tendency for folks who haven’t done much all winter to suddenly go all Ninja Warrior and overdo it. As Brianna says, “If you haven’t run for four months, maybe don’t start with a four-mile run. It’s too easy to hurt yourself and then lose interest in continuing.”

Do instead: ease back in, keep the duration short and intensity of your activity low and gradually build. Walk a mile a day for a few days, then run/walk a mile or walk two miles. Need more challenge? Walk up a hill, Bri says, or a flight of stairs. You’ll get that good cardio workout you wanted without danger of injury.

SIX. Don’t use tired, ill-fitting gear

So many of us have said some version of, “When I’m a ‘real’ runner, I’ll buy myself some real runner shoes.” We feel like we have to “earn” the good gear, or prove we’ll stick with it long enough to “deserve” spending the money.

Yes, gear can be expensive, and not all of it is necessary. But you are more likely to stick with an activity if you have the basic equipment you need to enjoy it and not get hurt. For runners, that means good shoes and probably good socks. Go to a running store; have them evaluate your gait and get you in the right pair of shoes.

If you dragged your bike out of the basement for Bike to Work Month, great! Now go get it fitted at a bike shop or sports medicine clinic (bonus, the latter will sometimes be able to charge your insurance for the fitting). They’ll move the seat up and down, adjust the pedals, move the handlebars until the bike is the right length and height to save strain on your spine, neck, shoulders, knees, and hips. You don’t need a $5000 triathlon bike (yet!), but you do need to make sure the bike you’re using is sized for your body.

SEVEN. Don’t accept “challenges” that push you too hard

We’ve all seen them on Facebook, our buddies doing 30 days of planks or burpees or a run streak. These challenges can be really hard on your body, Meagan says, because our bodies need rest days, especially from repetitive motion.

Do instead: launch your own challenge. Challenge yourself to breathe correctly or drink enough water for 30 days. If you don’t like doing nothing, even for a day, do a challenge that has “active rest days” built in. If you’re running four days a week, swim, bike, or rock climb the others. Allow your body to recover.

It's always great to be out doing fun, active things. Don’t miss out on the chance to enjoy seasonal activities by sidelining yourself with an injury.