Your pelvic floor and running

 

Running and associated pelvic floor problems are a concern for those who are dedicated runners and who enjoy this as a form of exercise.

We recognise that many women seek to enjoy running throughout life, so the points below are to help to prevent or minimize symptoms of pelvic floor dysfunction.

Can running cause and/or increase pelvic floor problems?

Unfortunately, the answer is yes and here’s why…

Running is high impact exercise which involves both feet being off the ground simultaneously. When the heel strikes the ground during running, the physical force associated with landing passes down through the pelvic floor muscles and connective tissue supports, then down to the ground via the lower limbs. This impact can stretch the pelvic floor and its support structures especially if they lack strength to withstand the impact. When repeated over time, as with high impact exercise such as running, the non-elastic tissues can become progressively and irreversibly stretched.

 

There are a number of things that you can do to protect your pelvic floor when running:

  1. Keep your pelvic floor muscles strong by regular maintenance exercises to optimize support and control. If your muscles are strong they will sit higher and will be thicker and stiffer to resist downward strain.
  2. Mix your running surfaces: running surfaces such as gravel, sand or grass can help reduce some of the impact associated with running. Avoid continual running on hard surfaces such as roads, cement paths and treadmills because the impact is much higher.
  3. Reduce your stride length: long stride length and high speed running can increase the impact and downward pressure, so slow down your speed and shorten your stride.
  4. Reduce running distances: running long distances increases connective tissue strain and muscle fatigue and then failure of support. Try to alternate your distances to include short distance runs and avoid repeated long distance running.
  5. Wear well cushioned footwear: these will reduce the impact and help to protect joints and soft tissue.
  6. Avoid downhill running: stick to flat surfaces where you can, running downhill increases the impact of body weight on the pelvic floor
  7. Mix up your workouts: choose other alternatives to running on a regular basis. Cycling and “spin” classes provide a great “pelvic floor safe” cardiovascular workout. Water running (aqua jogging) is an excellent alternative and reduces the potential for strain and impact.
  8. Manage your body weight: any increase in body weight will place increased strain on the pelvic floor.
  9. Avoid running in pregnancy and the postnatal period: during pregnancy soft tissue softens in preparation for childbirth including the pelvic floor complex. The increase in body weight and the weight of the growing baby also places strain on pelvic floor tissues and muscles. Pregnancy is a time to choose low impact exercise for pelvic floor protection. Following birth the pelvic floor is at its most vulnerable due to the effects of birthing, breast feeding and decreased oestrogen levels. Take time to recover your pelvic floor strength and function before returning to high impact exercise. It is recommended that you do not resume running until you have finished breast feeding and have had at least three non-breast feeding periods.
  10.  There are pessaries and continence devices that you can use vaginally to provide more support for any prolapsed tissues but you will need advice from your gynaecologist or a women’s health physiotherapist before trialling anything like this.
  11. Try intermittent running and walking: for example walk for five minutes, then run for ten minutes. This gives the connective tissue time to recover some tensile shortening.
  12. Try running on a rebounder (or mini trampoline) this minimises impact and gives a good cardio workout and you can do this in any weather!

  13. .if you can afford to buy Skins for support then wear these when you run any distance. They will provide excellent support and compression. Otherwise just wear good support undies over your usual undies.

  14. Gravity is not your friend!!

 

 

Linley Edmeades NZRP

Pelvic Health Physiotherapist

July 2015