Northern Beaches Mums Group
Northern Beaches Mums Group

Strong Women are MORE likely to Experience Deep Core Dysfunction

Professional athlete and coach Clare Hozack explains why strong women are MORE likely to experience deep core dysfunction.

I am a mum of 2, and have specialised in training Pre and Post Natal Women since 2007. I also have a hernia, a mild prolapse, and chronic back pain….

How did this happen to me?

The fact is that elite female athletes are MORE likely to experience stress incontinence than the general populations (over 45% compare to 30% in general populations)1. Female athletes also experience a greater stretching and lengthening of their deep core and pelvic floor, although the ramifications of this are yet to be confirmed2. It also depends on the sports you do; 66% of 19 year old gymnastics and basketball participants suffered stress incontinence vs 0% of golf players3.

The point I am trying to make is that having a 6-pack, being thin, being strong and sporty predisposed me to deep core dysfunction, and no one ever picked it up. The same is true for every gym junkie and sports women reading this ? look after your pelvic floor, or it will literally let you down.

  • How many of you participate in basketball, netball, crossfit, or bootcamp?
  • How many of you do body attack, run, or play tennis?
  • How many of you participated in sport before having kids?
  • Did anyone teach you to uptrain your pelvic floor during these activities? Did you realise that they were even stretching?
  • And why do you think these people are more likely to develop deep core dysfunction (including stress incontinence, back pain, abdominal separation, etc)?

To avoid going too deeply into the anatomy, consider instead an upside down water bottle. The lid is our pelvic floor and my hand is the superficial core muscles (the big lifting ones like your 6-pack and your back). If the lid isn’t able to withstand the intra-bottle pressure that builds up when I squeeze, what happens? The same is true for our bodies ? the pressure has to release somewhere, and it will go at the weakest point.

The act of being pregnant is an additional risk factor, along with being overweight. The more weight you carry around on a day to day basis, the more load you are putting through the deep core musculature.

Other contributing factors include constipation, smoking, and a chronic cough. And contrary to popular belief, it really does not matter how the baby came out; if it grew to term inside of you, then you have a stretched pelvic floor and deep core, and need to see a women’s health physio before returning to exercise.

If women are taught to up-train their deep core to be equally as strong as their superficial core from day one, we could theoretically reverse this outcome, which will affect most of us! After all, in addition to the 30% of non-elite athletes that experience SUI, about half of us will have a prolapse after having our children, and one in 10 experience a hernia.

I have learned a lot through my journey as an ex-athlete, and now a mum of two. I cannot stress enough the importance that the fittest and strongest among us go and see a Women’s Health Physio and ensure your deep core is working like it should for the tasks you are performing.

I’d also like to reassure the fittest and the strongest of you that there is a logical rehabilitation pathway to return to your favourite sports and exercise modalities. Just because you have a muscle imbalance ow, does not mean that you’re stuck with one for life!


Clare Hozack is an ex-Australian Sailing Athlete, current Strength and Conditioning Coach, and trainer for mums for 19 years. Clare has both coached and experienced pelvic dysfunction, spinal injury, and other core dysfunctions and is passionate about empowering mums to lift, move, and LIVE healthily; by both rehabilitating the properly post birth, and pushing them past their mental and physical limitations once they’re able to. Clare is creator and managing director of IntoYou, a small training studio in Collaroy Plateau dedicated to this cause.