Running is an incredibly popular form of exercise across all ages, genders and abilities. It is a free, cardiovascular, strength-focused exercise that offers headspace to the individual. We have seen people break world records, run for distances we never thought possible, through various terrains and still cross the finish line with a smile. There’s something special about running.
Pregnancy is a time of positive change in a woman’s life as they prepare for the birth of their child. During this time, the abdominals and pelvic floor muscles are placed under strain to support the growing foetus, and the glutes may develop tension in response to positional changes of the pelvis. As a woman transitions into the postnatal period it is important to consider these changes (irrespective of mode of delivery) in order to optimise their return to normal function.
Running is a single-leg activity. At no point during a run are both legs are down at once. As you can imagine, this increases the load that is transferred from the ground into the leg in addition to the demands of the pelvis in maintaining stability. The muscles that provide stability to the pelvis are: deep abdominals, pelvic floor and gluteals.
The postnatal period is a time of healing and regeneration. A woman’s body transitions back towards the way it was before. Depending on a number of factors (many of which are outside of our control), this may be more achievable for some. It is paramount for women to seek the advice of a skilled physiotherapist at the early stages of their postnatal healing journey to identify areas requiring input.
What does a Postnatal Check Involve?
After hearing your birth experience, a number of screening questions regarding abdominal and pelvic floor function will be asked. Following this, an abdominal wall assessment using Ultrasound will be conducted to determine your ability to use the deepest layer of your abdominals in a functional way. A check for abdominal separation will also be performed.
An internal pelvic floor assessment is offered as the gold standard way of allowing your practitioner to determine the strength, flexibility and function of the muscles, as well as ensuring your pelvic organs are well supported under strain/load. This will indicate how prepared your body is to start running. An external Ultrasound assessment of the pelvic can be offered as an alternative.
Any concerns regarding bladder/bowel/sexual function will be addressed in an open and comfortable environment.
Running and the Pelvic Floor
A common issue that women face when returning to running after pregnancy is urinary leakage. There are a number of reasons why this occurs, most commonly: reduced pelvic floor strength/function, reduced stability of the bladder and overactivity of the muscles.
Recently, there has been research conducted to see what the pelvic floor actually does while we run (the findings are fascinating!) and from this it’s been deemed as important as our external muscles in ensuring correct form.
The pressure inside our abdomen increases with running, creating more work for the pelvic floor muscles in supporting our organs and preventing leakage. They contract in a lengthened position while we are in ‘flight-phase’ to allow for mobility, and contract in a shortened position on heel strike, offering stability. It is clear that in order to run safely without symptoms, we need a fully functioning pelvic floor.
1. Do not grip your pelvic floor while you run – it needs to contract and relax according to what phase of the run cycle your leg is in.
2. Thoracic rotation – not pelvic rotation
3. Increase the number of steps you take to reduce the impact from the ground into your pelvic floor.
4. Breathing: when your right foot strikes the ground inhale, when your right foot strikes again exhale. This ensures coordinated, controlled breath which optimises diaphragmatic and core function.
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