Running Strong

Your Pelvic Floor Should NOT Hold You Back from Running

Exercise and running are supposed to be fun, rewarding and a way to improve your overall health. But if you are dealing with some of the things below, then your runs may not be so fun…

These are all common things our patients tell us and things that push them to come get help from a pelvic floor physical therapist. These are also symptoms that many people just “deal with” thinking they may go away in time or think that there is no way to get any help or see any meaningful change. 

Dealing with these issues is not something that you have to just live with AND should not hold you back from doing the things that you love. Don’t continue to suffer when your runs can be so much better and empowering…

Pelvic Floor Muscles

The pelvic floor muscles are a group of muscles that form a hammock at the bottom of the pelvis or hip bones. These muscles help our bladder and bowels to function properly and empty easily. They also help with sexual function; they stabilize our lower back and aide in lymphatic drainage. For a small group of muscles, they don’t get enough attention with how important they are!

Just like all the muscles in our body, they need to be strong and flexible. Meaning they need to have a good balance of length and strength so that we have full control of our bladder, our bowels and sexual function. But then life happens, and things can get all mixed up. Sometimes it is from a surgery, having a baby, going through menopause, getting injured, adopting different habits that may not be advantageous for our pelvic floor and so much more. 

The most important lesson to take away is that the pelvic floor muscles are great at learning. Meaning when things are not working well, we as pelvic floor physical therapists can help you fix things. You can learn movements, exercises, habit changes that can all have a positive effect on your bladder, your bowels and intimacy. This can all in turn have a wonderful effect on exercise and being able to run without your pelvic floor holding you back.

Let’s talk through some common symptoms you may be struggling with during running that indicates your pelvic floor is not working as well as it can. 

Planning your runs around the bathroom

Urinary and/or fecal urgency make you feel like you must search for a bathroom the instant that you get alerted you need to use the restroom. Urgency is an emergency situation where you have to rush or make a mad dash to the bathroom or else you may leak having an accident. 

Our bladder should give us a warning or two that it’s filling so that we can make the decision if it’s a good time or not to go to the bathroom. Then we know that our bladder is full, and we are not rushing to the bathroom to empty a very small amount. 

On average, we should empty our bladder about 8 times per day. Sometimes the urgency takes over and we start emptying more frequently. Then we need to guide you as a pelvic floor physical therapist how to get your bathroom habits back on track. Bladder and bowel diaries are helpful to track how often you are really going to the bathroom and to look for trends based on what you are eating or drinking throughout the day. 

Bowel urgency, especially when exercising can be related to what we are consuming before our workouts or even the day before. Sometimes our body responds poorly to a food group and that will make our stool loose and contribute to urgency needing to rush and find a bathroom ASAP. It can also be related to the strength in and around our pelvic floor needing balance in all the muscle groups surrounding our pelvis. 

Research tells us that internal releases to the pelvic floor muscles can make a positive impact on reducing urinary and/or fecal urgency. We help the muscles lengthen and learn to relax so that then they can contract when they need to. A balance of length and strength is important in every muscle group, even the pelvic floor.

Pressure, heaviness and feelings of falling out

These symptoms can be a result of pelvic organ prolapse (POP). This happens when the organs in our pelvis (bladder, uterus, rectum) descend down through the vaginal canal creating excessive pressure in our pelvic floor. There are varying degrees of prolapse where you may only feel pressure or to the extent where you are feeling something come out of the vaginal opening. We as pelvic floor physical therapists are trained to help you work through and guide you on what your body needs to heal when you have a prolapse.

Going through a pregnancy and childbirth causes increased pressure in the pelvic floor and puts us at risk to have a prolapse. The more children we have increases our risk for prolapse, being newly postpartum and perimenopausal can add to pelvic organ prolapse. There are a variety of risk factors outside of childbirth such as a chronic constipation, heavy lifting when you are not managing the pressure and breath holding. 

When we are pregnant, our center of gravity shifts and the downward pressure on our internal organs combined with ligamentous laxity that happens throughout pregnancy to get our body ready for our birthing time can add to the demand on our pelvic floor muscles. These are important factors to consider as you continue to be active throughout your pregnancy and modifications can be needed. Now postpartum, the hormone roller coaster continues, and the ligamentous laxity takes months or longer to stabilize. Meaning jumping back into running at the 6-week mark postpartum can have negative impacts on your body in the long-run. Making sure that your body is ready to return to all forms of exercise is essential for the long-term health of your body. Pelvic floor physical therapists can help you with a return to running program so that you know your body is ready 100%. 

A Cesarean section delivery is another factor to consider being it is a major abdominal surgery. There is a lot of care and attention that should go into healing after this surgery with focused core control prior to getting back into running. And then as life goes on after having our children, perimenopause affects our hormones as well. There is a decrease in estrogen that affects our pelvic floor muscles causing dryness and thinning of the vaginal tissues. This can also contribute to weakness in the pelvic floor and a guided exercise program to address this is important so that you can safely run without having a negative effect on your pelvic health. 

Pelvic floor physical therapists can help you understand what is going on with your body in terms of the degree and type of prolapse you may be experiencing. Also, we can help guide you on a healing path of what your body needs in terms of lengthening or strengthening of the pelvic floor muscles. We take running as an exercise and help you break it down into parts to make sure that you can do each part without having any pelvic floor symptoms. Then we put it all together back to running so that you can run successfully without any unwanted pelvic floor symptoms. We also work through how to manage internal pressure, prevent breath holding with exercise and throughout life as well as how to properly breathe! Breathing is underestimated in the power that it has to cause a positive effect on our body. Our breathing should work with our pelvic floor to aide in strength, length and control of this area of the body. 

Pain around your pelvis during or after your run

Feeling pelvic pain, back pain or hip pain while you are running or afterwards is a sign that something is not balanced in your system. There could be a muscle weakness, an alignment that needs to be addressed, tension that needs to be lengthened or pressure management strategies that have to be considered.

Running is a full body sport and ideally, we are using so many of our muscles to do this workout. If our arms are rigid while we run, then we won’t get enough propulsion to move ourselves forwards. If we are landing on our heels when they hit the ground, we will have more impact throughout our entire spine and more aches and pains. You get the idea that how our body moves while we run is important!

Pelvic pain in particular can be coming from the muscles that attach to the bottom of the pelvis and support our bladder, bowels and sexual health. It also could be stemming from instability along your back, abdominals and hips. Pelvic floor physical therapists can identify the origin of your pain and look at other contributing factors to know all the areas that need to be addressed to get the long-term change in your running. 

Having a physical therapist look at your running form and walking form to see what can be improved is an essential part of optimal running. Going through running drills to address instabilities can be incredibly impactful to allow you to have the best runs without your body paying for it or hurting in the process. 

Leakage of urine or bowels during your runs

Stress incontinence is more common that you think affecting over 40% of female athletes. This means that the excessive pressure in your system triggers leakage of urine or bowels. The pelvic floor muscles are always thought to be weak and so many people think strengthening is the only solution. 

More often than not, pelvic floor tension is causing the stress incontinence. Essentially the pelvic floor muscles are too tight holding on for dear life ALL the time. Then we get excessive pressure in our system such as with running, coughing, sneezing, jumping, etc. then our muscles are not able to engage any further (they are already as tight as they can be). So sometimes stress incontinence needs to be addressed with lengthening, releasing of trigger points in and around the pelvic floor AND pressure management. 

Understanding how our breathing affects our pelvic floor whether at rest or with exercise is helpful in having continence. Pelvic floor physical therapists teach patients how to properly breathe so that it translates into their running form for increased endurance and relief of their leakage. 

Rushing to the bathroom constantly

Frequency of emptying your bladder is frustrating and feeling like you have to empty all the time does not facilitate the ability to exercise for very long. Our bladder has a muscle around it and muscles are receptive to stretch. When we start emptying our bladder every hour or even more often, then we don’t allow the bladder itself to fully stretch to its full capacity.

Then the bladder gives us incorrect information in terms of when it’s full and when we have to empty. Meaning it tells us we have to empty ALL the time. Urinary or fecal frequency can also go hand in hand with urgency, which we talked about above.

Both symptoms are things that pelvic floor physical therapists are trained to help with. Understanding where these muscles are and how they should work helps things to make sense why your current habits may be holding you back from your best workouts. 

If any of this resonates with you and you would like individualized help to get your workouts to a better place without unwanted pelvic floor symptoms, then Breakaway Physical Therapy is the place to be. We have pelvic floor specialists who will work one-on-one with you to talk through your goals, your passion and make a roadmap to get you to where you want to be in terms of your health. Call us today at 410-721-6333 to change your life for the better, get the help that you deserve and start living life as the healthiest version of YOU!