Managing pelvic floor impact postpartum for a positive return to run experience.
It likely goes without saying that running is an activity which places a high demand on your pelvic floor. Every time you land on one leg you are producing a force that is around 3 to 4 times your body weight, and it’s important that your pelvic floor has the capacity to manage that force safely. After pregnancy (whether you had a vaginal or cesarean delivery), your pelvic floor may need some help to be able to manage that impact adequately again.
What are some signs or symptoms that your pelvic floor isn’t managing the impact from running? Two situations I routinely address with my clients in my physiotherapy practice are: 1) leaking urine while running, and 2) experiencing pain in the pelvic floor during or after running. While these may be experiences you frequently hear about, it doesn’t mean that you simply need to put up with them as the price you pay for being pregnant. Experiencing these symptoms simply means that your pelvic floor could benefit from a little bit of TLC!*
If you have seen a postpartum healthcare provider and have the all clear to begin adding some light impact work, I have two favourite exercises** you can try to help gradually prepare your pelvic floor for the impact demands of running. You will notice that both of these are done with your body in a more horizontal than vertical position. Being horizontal still allows you to create an impact force, but it is less than the amount of impact your pelvic floor would experience from a vertical load such as jumping.
1. Plank Jacks
Plank jacks are a combination between a high plank and a jumping jack. To do them, begin in a high plank position on your hands and your toes on the floor, then jump your feet apart and back together - just like you would do if you were doing a jumping jack. You can progress the impact by jumping your feet further apart, and/or by raising the height of your hands.
As you are able to do this exercise easily on the floor for one minute with no pelvic floor symptoms, you can begin to raise the height of your hands. You could use a chair, table, park bench, staircase or kitchen counter, etc. The higher your hands are, the higher the demand on your pelvic floor to manage the impact load.
2. Plank Mountain Climbers
Plank Mountain Climbers are a combination of a high plank and mountain climbers. To do them, begin the same way you began the plank jacks, with your hands and feet on the floor. Alternate jumping one leg ahead while the other one goes behind you. You can progress these the same way as the plank jacks, by making the distance between your feet larger, and/or by moving your hands to a higher surface when you are ready.
Like many things in your body, the pelvic floor responds well to progressive overload. Adding a little bit of increased impact at a time allows the muscles and other tissues in the pelvic floor to develop more strength, endurance and motor control. What does this mean for your postpartum running adventures? A healthy, strong, and highly functioning pelvic floor that can manage impact and support your body for many, many miles. Happy running!
* I always recommend seeing a pelvic health physiotherapist during pregnancy and postpartum if you are able. You can develop pelvic floor symptoms from having a pelvic floor that isn’t working as much as it should, OR from having a pelvic floor that is working more than it should. Pelvic health PT’s are truly the experts in assessing, treating and teaching you how to care for your pelvic floor.
** I want to give credit to Julie Wiebe, PT. I have seen these exercises taught and explained by many people over the years, but her website is the first place I saw them.