Tune into this advice, geared toward any runner who wants to support performance and avoid injury (not just women!).
People often associate the pelvic floor—a sort of bowl of muscles and connective tissues at the base of your torso—with urinary incontinence or occasional leakage, especially for women who’ve had babies. While that can certainly be the consequence of dysfunction, a healthy pelvic floor helps stabilise your core, supports your internal organs, and assists with other functions, like sex. And keeping these muscles and tissues healthy doesn’t only relate to women. It’s something everyone should be mindful of doing, especially runners.
“Running puts stresses on your body, and the pelvic floor is no exception,” says Alicia Jeffrey-Thomas, P.T., D.P.T., a pelvic floor physical therapist in Medfield, Massachusetts, and author of Power to the Pelvis. “The pelvic floor is sometimes taking on as much as almost four times your bodyweight while running, so it needs to be able to absorb that force and respond appropriately.”
Beyond preventing leakage, showing your pelvic floor muscles and surrounding muscles some attention while you’re running, cross-training, and going about your day-to-day can also make you a stronger runner and help you sidestep major injury. To help these muscles fire up correctly so they’re working well and you’re performing at your best, whatever you do—make sure you’re not doing these six things.
Ignoring Mid-Run Urinary Leaks or Urgency
Even if you experience a small leak or an urgent need to find a bathroom during a run only occasionally, don’t brush it off. “Leaking urine while you run is not normal,” says Stacey Futterman Tauriello, M.P.T., a pelvic floor physical therapist and founder of 5 Point Physical Therapy in NYC and Millburn, New Jersey.
Men often don’t experience leakage because their urethra is long, she notes, but urinary frequency or urgency can similarly signify an issue with the pelvic floor. “If you have a leak, or urinary frequency or urgency, something’s not right. Something’s not activating. And ignoring that sets you up for injury,” Futterman Tauriello says.
Along with holding up your organs, the pelvic floor also helps stabilize and unload pressure from the spine, says Futterman Tauriello. “If you leak urine while you run, most likely you don’t have spinal stabilization and could be setting yourself up for things like a herniated disc,” she says.
Running With Posture or Form Issues
Maintaining a less-than-optimal running posture, like running completely upright instead of with a forward lean, can have a negative effect on your performance—and put excessive pressure on your pelvic floor, too.
“Proper body mechanics and supportive shoes are crucial for pelvic floor fitness,” says Riva Preil, P.T., D.P.T., a pelvic floor physical therapist in NYC and author of The Inside Story: The Woman’s Guide to Lifelong Pelvic Health. “Think of the pelvis as the Grand Central Station of the body: It connects the lower extremities to the core and the upper body and serves as a shock absorber for any and all forces sent upward to the spine with each step taken,” Preil explains. “So it’s important for those steps to be taken, or jogged, in the healthiest and most biomechanically correct way possible to prevent injury to the body, including the pelvic floor.”
One common form issue is staying too stiff, says Jeffrey-Thomas. “Oftentimes, I see people trying to run while bracing everything in their body—like running with a stiff abdominal wall or not letting their torso rotate,” she explains. “The pelvic floor needs to be adaptive and reactive like a trampoline as it experiences those changes in pressure. If everything is held too rigidly, it limits the pelvic floor’s ability to respond and puts more pressure on it.”
Running with your chest too lifted is another problem, she adds, because it can mess with the relationship between your breath and abs and can cause the pelvic floor to absorb more force.
Doing No Strength-Training
Ignoring strength, especially in the supportive muscles around your pelvis, is a big no-no. “If your abs and glutes are weak, you could be pelvic floor-dominant—meaning you’re using these muscles more than you should be while you’re running,” says Futterman Tauriello. As a result, the pelvic floor becomes overused and tight.
Overall weakness can cause you to bear down while running, too, she adds, putting too much pressure on these muscles.
While squats and lunges are great, don’t forget about moves like clamshells to target the smaller, stabilizing muscles. “Training the gluteus medius may not be the most exciting thing in your workout routine, but if you’re only training big movements, you may be missing a piece of what you need to perform your best,” says Jeffrey-Thomas.
If you strengthen your lower body but tend to bypass your upper half, that’s a problem for your pelvic floor as well, adds Futterman Tauriello: “Working upper body is just as important because it helps with core activation,” she explains.
Going Too Hard With Strength-Training
Yes, adding strength work to your schedule to support your running is a great thing. But if you jump in too quickly and take on more weight than you’re ready for, that’s unfortunately another problem for your pelvic floor.
The issue, says Futterman Tauriello, is that when you’re lifting heavier than you’re ready for, you might not be breathing correctly through the movement. If you’re holding your breath or inhaling as you lift the weight, that puts excess pressure on your pelvic floor. “You’re not managing the pressure as you should be, and the bladder and pelvic floor can’t handle it,” she says.
Instead, Futterman Tauriello recommends starting slow, making sure your form is correct and you’re getting good contraction of the muscles you’re working before you work up to more weight.
Avoiding Stretching
If you’re strength-training, you also need to stretch, says Preil: “It’s a common trend I see—men who perform a lot of strengthening exercises, especially lower extremity strengthening, without doing enough stretching to counteract that tightening that occurs during the strengthening exercises.”
The downfall with that, she says, is a lack of stretching can lead to muscular imbalances, including in the pelvic floor. “In general, we should strive to strike a fine balance between mobility and stability within our bodies, i.e., between stretching and strengthening. When the pendulum swings too far to the side of strengthening, it can result in muscle imbalances, weakness, and pain.”
For instance, says Preil, if you’re doing a ton of weighted squats and lunges but not stretching the hips, it can cause dysfunction in the pelvic floor; the leg, hip, and pelvic floor muscles are all closely related and when there’s tightness in one, there’s likely also tightness in the others. So you have to stretch it out.
Doing Kegels and Calling It a Day
Kegels are the most well-known exercise for the pelvic floor. This movement—in which you tighten the muscles as if you’re trying to stop the flow of urine—can be really beneficial if weakness is your issue. But weakness is not always the cause of pelvic floor dysfunction.
“People want to think, if you do 100 pelvic floor contractions a day, you won’t leak or have pelvic floor issues ever,” says Futterman Tauriello. “But we have to ask: Are the pelvic floor muscles weak? Or are they just not able to activate correctly when that foot hits the ground? We have to figure out what’s going on.”
What’s happening with your pelvic floor muscles is very individual, she says, so figuring out the best approach to take care of, strengthen, and relax them is specialised. There’s not a one-size-fits-all approach to the pelvic floor, but following all the above advice can help ensure your pelvic floor muscles are activating appropriately to support every run. And seeing a pelvic floor physical therapist will help you pinpoint exactly what’s happening, so you can take the right steps to address it.
