Pelvic floor training for athletes is the missing piece in most performance programs, and this episode of The Hole Shebang makes the case for putting it back. Kristen Parise sits down with Dr. Rachel Selman, a pelvic floor physical therapist, strength and conditioning coach and sport scientist, to explain why athletes experience more pelvic floor dysfunction than non athletes, how the pelvic floor acts as a force absorber for the whole body, and why leaking during sport is common but never normal. If you run, lift, jump or coach anyone who does, this conversation reframes pelvic health as performance.
What you will learn
Rachel breaks down why the location of the pelvic floor at the base of the core makes it vulnerable to the pressure of sport, how symptoms like urinary leakage, urgency and even chronic hamstring and groin strains connect back to pressure the pelvic floor is not managing, and the four part program she brings to teams. You will also hear why prolapse does not mean the end of running or lifting, and how pessaries and external supports fit into a return to sport plan.
In this episode
- [00:00] From soccer player to pelvic floor PT: Rachel's own postpartum wake up call
- [05:10] What to actually tell someone who is pregnant or soon to be about movement
- [09:45] Her book Floor It and who it is written for
- [13:28] Why athletes carry more pelvic floor dysfunction, and the symptoms to watch
- [20:20] The four part team program: education, screen, questionnaire, one biased workout a month
- [29:49] The trampoline: pelvic floor as force absorber
- [33:59] Connective tissue, creep and the grocery bag analogy for endurance athletes
- [38:26] Overcoming isometrics and the sled push
- [43:05] Prolapse, pessaries and getting back to what you love
About Dr. Rachel Selman
Dr. Rachel Selman, PT DPT CSCS CPSS, is a physical therapist, strength and conditioning coach and sport scientist who treats and trains athletes at Synthesis Physical Therapy in Charlotte, North Carolina. Her first book, Floor It: Using the Pelvic Floor to Power Athletic Performance, releases October 6 2026.
Theme Song: Cruel Summer by Taylor Swift
Key topics covered: pelvic floor and athletic performance, leaking when running, force absorption, prolapse and return to sport, pessaries, overcoming isometrics, postpartum return to exercise.
Resources and references mentioned
- Floor It by Dr. Rachel Selman (pre-order): Simon and Schuster
- Sports Medicine and the Pelvic Floor: Science to Practice by Gráinne M. Donnelly: Elsevier
- Overcoming isometrics demos on Rachel's Instagram
Listen to more episodes like this (all at podcast.blueberrytherapy.ca)
- The New Postpartum Exercise Guidelines That Ditch the Six Week Rule with Dr. Margie Davenport
- Pelvic Floor Basics: Why Kegels Are Only Half the Story with Lauren Ohayon
- Prolapse and Pessaries: Losing the Shame with the Vagina Coach Kim Vopni
- Empowering Exercise During Pregnancy with Dr. Christina Prevett
- Simple Strength: What Really Works for Women's Fitness with Dr. Lauren Colenso-Semple
Connect with Rachel
Instagram and YouTube @Dr.RachelSelman, and www.SynthesisPerform.com.
Work with us
Wondering whether your pelvic floor is keeping up with your training? Book a pelvic health assessment at blueberrytherapy.ca, and we offer virtual visits across Ontario. Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca, and if this episode helped you, leave a review and tell us what you want to hear next.
Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.
