Pelvic Floor Problems
Solving a once taboo problem that affects most female runners after childbirth
As a longtime runner, after giving birth, I longed for the day I could put my baby in my jogging stroller and run the neighbourhood. Finally, the day came when I hit the pavement with my boy. It was lovely… until I felt a rush of warmth between my legs. I had peed. What the heck was going on? Pelvic f loor dysfunction affects an estimated 50– 67.5 per cent of women after childbirth, and is a difficult obstacle for a return to running or any strenuous exercise. It’s not an issue that’s talked about openly, and has been viewed as a normal part of life after childbirth even by healthcare professionals, feeding a culture of shame and invalidation. Thankfully, that culture is changing. The pelvic f loor is a series of muscles and connective tissues that run between the pubic bone, the tailbone and the two “sit” bones. The tissues form a bowl-like trampoline that offers five different functions: bowel and bladder control, support of pelvic organs, support for sexual function, a sump-pump action with the diaphragm to help with lymphatic drainage and an integral part of the core. “When the muscles don’t co-ordinate properly, are weak, or tight and tired,” says Robyn Synnott, a registered pelvic health therapist . “The result can be stress or urge urinary incontinence, diastasis rectus abdominis (“mummy tummy”), pain during intercourse, pain in the pelvic area, constipation or pelvic organ prolapse.” Most of the patients Synnott treats have experienced pelvic f loor health issues after childbirth, and typically, these untreated issues stay the same or get worse with subsequent births.” However, Synnott also treats these issues among female athletes who have not had kids, often from highintensity, core-focused sports such as CrossFit, ballet, Pilates and distance running.
“Any type of bladder leakage is a sign that your core system is not functioning properly,” says Synnott. “While strengthening the pelvic f loor muscles is important, it is not the issue with every patient and Kegels can even be contraindicated for some. If a woman suspects a pelvic health issue, she should seek help from a pelvic health physiotherapist.”
Patients can access a pelvic health physiotherapist directly. At an assessment, patients typically give a history of the problem; undergo an internal physical assessment; and receive treatment, including self-management information and exercises, breathing and posture tips, stretches and musclestrengthening act iv it ies . Synnott stresses, “The internal exam is much less invasive than a pap and is usually pain-free.”
If you experience pelvic health issues while running: DISCONTINUE THE EXERCISE Either stop completely or decrease the intensity. KEEP PROPER POSTURE Ribs aligned on top of your pelvis, knees soft, weight balanced between the heels and balls of the feet. Then, gently lift the tailbone (it might feel as if you are sticking your butt out). BREATHE PROPERLY Inf late your body like a balloon when you inhale (release the abdominal and pelvic f loor muscles) and def late when you exhale. AVOID TRADITIONAL SIT-UPS AND CRUNCHES, which i ncrease abdominal pressure and don’t focus on the core.
Although less common, men can also experience pelvic f loor health issues. “They tend to have prostate-gland-related incontinence, pain, erectile dysfunction and tension in the pelvic f loor muscles,” says Synnott.
Eventually, my love for running overcame my embarrassment and I got the help I needed. After a few months of treatment, I can run incident-free. Now I can get back to running… with my son.
For more information and to f ind a reg istered pelvic healt h physiotherapist near you, visit pelvichealthsolutions.ca.