Dr. Rachel Selman | Overcoming Isometrics: Are We Missing the Passive Side of Pelvic Floor Rehab?

[Lynn Schulte]

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Show Notes:

Are we missing a big piece in postpartum rehabilitation by focusing on the pelvic floor muscles?

In today’s thought-provoking episode of the Birth Healing Summit Podcast, Lynn Schulte is joined by physical therapist, strength and conditioning coach, and 2026 Strength and Conditioning Association Personal Trainer of the Year, Rachel Selman, to discuss a concept that’s beginning to change how clinicians think about postpartum rehabilitation and athletic performance: overcoming isometrics.

If you’re looking for fresh clinical ideas that bridge pelvic health, strength and conditioning, and sports performance, this is an episode you won’t want to miss.

Key Discoveries from this Episode:​

• How principles commonly used to treat tendinopathies may have exciting applications for postpartum athletes experiencing heaviness, pressure, prolapse symptoms, or urinary leakage.
• Why overcoming isometrics differ from traditional isometric exercises – and why that distinction matters.
• How to safely introduce pressure into rehab rather than avoiding it altogether.
• Clinical reasoning for treating endurance athletes versus power athletes with pelvic floor symptoms.
• Why postpartum runners may leak despite having “normal” pelvic floor strength.
• The engineering principle of creep and its potential role in pelvic floor dysfunction.
• Why collaboration between pelvic health therapists, strength coaches, athletic trainers, and researchers is essential for advancing athlete care.
• An exciting discussion on future research exploring pelvic alignment, passive tissue changes, and return-to-sport guidelines.

Clinical Takeaway​

Sometimes the limiting factor isn’t muscle strength – it may be the passive tissues responsible for force transfer and support. This episode challenges clinicians to think beyond isolated pelvic floor strengthening and consider how collagen, fascia, bony alignment, and graded loading may influence long-term outcomes in postpartum and athletic populations.

This isn’t simply another discussion about pelvic floor strengthening. Rachel and Lynn challenge conventional thinking while exploring how sports science, biomechanics, and pelvic health intersect. Their conversation raises important questions about how we assess postpartum recovery, prepare athletes to return to sport, and translate emerging research into meaningful clinical practice.

Whether you treat postpartum clients, runners, CrossFit athletes, or women with prolapse and urinary incontinence, you’ll leave this episode with new ideas – and likely a few new research questions of your own.

Listen now and discover why overcoming isometrics may become one of the next frontiers in pelvic health rehabilitation.

Frequently Asked Questions​

What are overcoming isometrics, and how might they help with postpartum pelvic floor rehabilitation?​

Overcoming isometrics involve producing force against an immovable resistance rather than simply holding a position. While traditionally used in strength and conditioning and tendon rehabilitation, Rachel Selman discusses how they may offer a new way to load and strengthen the passive tissues that support the pelvic floor. This approach shifts the conversation beyond muscle strength alone to consider fascia, collagen organization, force transfer, and tissue resilience.

Why might someone experience pelvic pressure, prolapse symptoms, or urinary leakage even when their pelvic floor muscles are strong?​

Pelvic floor function depends on more than muscle strength. Passive tissues – including fascia, tendons, ligaments, and other connective tissues – also contribute to support and force transfer. Rachel explains that factors such as tissue resilience, collagen organization, pelvic alignment, and how the body manages pressure may help explain why some athletes continue to experience symptoms despite having “normal” pelvic floor strength.

Should postpartum athletes avoid pressure and loading if they have pelvic floor symptoms?​

Not necessarily. The goal may be to develop the capacity to tolerate and manage pressure rather than avoid it altogether. Rachel discusses the importance of graded loading and individualized clinical reasoning, particularly when working with different types of athletes. Endurance athletes, power athletes, runners, and postpartum athletes may place very different demands on the pelvic floor, making an appropriately dosed return to loading an important part of rehabilitation and performance.

About the speaker​

Dr. Rachel Selman is a Doctor of Physical Therapy, Certified Strength and Conditioning Specialist, and NSCA Performance and Sport Scientist specializing in pelvic health and athletic performance. She is the owner of a multidisciplinary wellness facility in Charlotte, North Carolina, where she works with athletes across the lifespan – from youth competitors to postpartum and perimenopausal athletes.

In 2026, Rachel was named the National Strength and Conditioning Association’s Personal Trainer of the Year. She is an international educator, author of the forthcoming book Floor It: Using the Pelvic Floor to Power Athletic Performance, and a national conference speaker on the integration of pelvic health, performance, and sports medicine.

Rachel’s mission is to help athletes, clinicians, and coaches rethink the pelvic floor as a critical component of performance, resilience, and long-term health.

Link for the book to pre-order:

Connect With Lynn​

Have a comment or question about today’s episode? Message Lynn on Instagram or Facebook, or Email Lynn.

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