Now that the weather is cooperating, many of my patients are wanting to get back outside and exercise. I get a lot of questions about different types of exercise and how they affect the pelvic floor, but the most frequent questions I get are about running. Running is a great cardiovascular activity with many physical and emotional benefits, but running injuries are common. It’s estimated 50-75% of runners are injured each year, and 25% of them will seek medical care for that injury. As a physical therapist, and one who specializes in the pelvic floor, I see injuries/issues related to running pretty frequently. The good news is, these issues are common, but not normal, and can be corrected to get you running further and faster!
Here are some common running themes that I see in my patients:
Doing too much, too soon: Training load is important. You want to stress your body enough to produce positive changes, but too much stress and little to no recovery, or increasing that load too quickly can lead to break down. Being aware of your training volume and intensity is important to prevent overuse injuries (stress fractures, iliotibial band syndrome, plantar fasciosis, posterior thigh pain, etc). To keep yourself on a good training path, you can find running programs online or in books that are a good framework to follow. Another option, that I personally use, is finding a knowledgeable running coach who can tailor a running program to your exact needs.
Leaking while running: Whether it’s leaking the first couple steps or after a couple miles, urinary leakage during running is a common, but not normal, running issue. It can be caused by many reasons, but often because the load is too great or running mechanics are off. I find that a lot of my patients try to tighten their pelvic floor or abdominal wall throughout their entire run. While this may seem like a good idea, it actually hinders the pelvic floor from being able to move through its full muscle excursion, which can limit its ability to maintain changes in pressure with each foot strike. Check in on your next run and see if you’re constantly gripping either pelvic floor or abdominal wall.
Postpartum running: I believe the postpartum period is forever. Once you’ve had a baby, you’re postpartum, but for this section, I’m going to refer to the initial postpartum period, right after delivery. At 6-8 weeks after delivery, the uterus and vagina have returned to pre-pregnancy size. At your postpartum OBGYN check-up, you are usually given the go ahead to return to activity. That sounds great, but it can be overwhelming! Many factors, such as if you’re breast feeding, how much you’re sleeping, calorie intake, hydration, pre-pregnancy fitness level, etc, factor into how postpartum activity will feel. Some women are able to start or get back into running without difficulty, but if you find yourself displaying any pelvic heaviness, urinary or fecal leakage, or back/hip/pelvic pain with activity, you should see a pelvic floor physical therapist who can help.
Running is a great activity that should be enjoyed without worrying about injury or pelvic floor discomfort. If you’re noticing any of the issues I mentioned, I recommend seeing a pelvic health physical therapist who can work with you to help correct any mechanics (breathing, postural, strength, coordination) or training volume issues so you can get out and enjoy those miles!