Running and Pelvic Floor Function
Running can be a fantastic form of exercise with undeniable benefits for physical and mental health. However, for many of my patients running comfortable can be limited by their pelvic floor muscle function. If you have ever wondered how running affects your pelvic floor, or if you've experienced symptoms like leakage or pelvic discomfort, you are not alone. The relationship between running and pelvic health can be complicated, but with the right information and guidance, running can remain an enjoyable and sustainable part of your fitness routine.
How Running Impacts Your Pelvic Floor
Running is a high-impact activity that sends forces through your body. Each step generates ground reaction forces of 2.4 to 3.9 times your body weight that travel up through your feet and into your pelvis. For a healthy pelvic floor, this is not an issue. Your pelvic floor muscles are designed to contract automatically to absorb this impact.
For those with pelvic floor dysfunction, such as muscle weakness or poor coordination, this automatic contraction may not happen effectively. This mismatch between the force generated and your body’s ability to absorb it can lead to symptoms such as heaviness or leakage.
Finding Balance: Should You Stop Running if You Have Symptoms?
If you’re experiencing symptoms like leakage, heaviness, or pain, running without addressing these issues may worsen them. It is like returning to running too soon after an ankle sprain; without proper rehabilitation, you risk further injury.
The good news is that addressing the root cause of your symptoms (pelvic floor physiotherapy can help with this) there is no reason you can’t start or return to running in a slow and gradual rate that allows for your body to return to running safely and confidently. Pelvic floor dysfunction does not mean the end of running; it just means it is time to adjust your approach.
Simple modifications that may help reduce the load through your pelvic floor
The way you run can significantly affect the forces impacting your pelvic floor. Here are five simple adjustments that may help reduce stress and improve your experience:
Relax Your Abdomen: Avoid sucking in your stomach or keeping your core overly tight while running. Letting your abs relax allows them to act as shock absorbers.
Align Your Chest: Keep your chest pointing slightly forward and avoid arching your back or lifting your ribs toward the sky.
Rotate Through Your Trunk: Incorporate natural rotation through your shoulders as you run. This helps your body use momentum efficiently and reduces stiffness. You can incorporate some thoracic rotation/ mobility exercises into your warmup.
Land Quietly: Try to make your footfalls as quiet as possible. A soft landing reduces excess force on your pelvic floor.
Warm Up: take the time to warm up your body in preparation for your run. Focus on thoracic and hip mobility.
Training tips to support your pelvic health as a runner
It is not so much a about optimising your pelvic floor, by about improving the function in all the muscles working together. It is good to challenge your pelvic floor and related muscle groups in lots of different ways, as this can help to improve their functional capacity. Here are four training strategies to consider:
Add Hills to Your Workouts: Running uphill reduces the force on your pelvic floor while helping you build strength and endurance. Walking downhill can also serve as a gentle warm-up.
Incorporate Trunk Rotation Exercises: Mobility drills like "thread the needle" or "open book" can loosen a stiff mid-back, improving your ability to rotate naturally while running.
Practice Single-Leg Stability: Exercises like single-leg squats, step-ups, and Bulgarian split squats build functional strength in your hips and pelvic floor.
Include Plyometric Drills: Running is like a series of single leg jumps. Preparing for this repetitive motion with plyometric exercises like box jumps or ladder drills can make your pelvic floor more resilient.
The role of Pelvic Floor Physiotherapy
If you are experiencing pelvic floor symptoms while running, working with a pelvic floor physiotherapist can help to identify and work on any issues or concerns. Before commencing pelvic floor muscle exercises, it is important to have a thorough assessment to ensure that the exercises you are doing are the right ones for your body. Some people may need to work on strength, others on endurance. There is even a group of patients that may benefit from learning how to lengthen and relax their pelvic floor whilst running. Other health allied health professionals such as exercise physiology, PT or running coaches may also form a useful part of your team depending on what your goals are.
