How to Become a Better Runner: A Focus on Pelvic Health

When I started running about a decade ago, if I ever thought about strengthening, I thought about the typical muscle groups–leg muscles, like quadriceps, hamstrings, and calf muscles for power and endurance, the ab muscles for stability, and glutes and hip muscles for strength and balance. 

I took a break from running to start a family and recently came back to it. When I did, something was different. While I still focused on the major muscle groups for strengthening, I noticed that things weren’t quite working the way they used to. As I ran down hills, I noticed a slight urgency to pee even if I had gone just before I left.  I felt a bit of pain and pressure in my back even after strengthening and stretching those muscles. I noticed my breath was not deep and that I was clenching muscles I didn’t even know I had. 

The final straw came one day after a run. I was sitting on the couch watching a show and I sneezed. With my body not knowing what muscles to release and which ones to contract, that sneeze caused a reaction that I never thought would happen (or at least wouldn’t happen until a much older age). 

And so, after a bit of embarrassment, I decided it was time to focus on a much neglected, if not completely forgotten muscle group. 

This muscle group?

The Pelvic Floor. 

In truth, I hadn’t heard about pelvic floor physiotherapy until I had attempted to go back to running after my first pregnancy. Many women that I knew, including those who were runners, had never gone to one either. It was new territory for me both as a woman and as a runner. 

To help Runners of the Six discuss the importance of the pelvic floor in running and the benefits of seeing a specialist, Jayme Filgiano, a physiotherapist specializing in Pelvic Health at the Physio Spot in Markham answers some of our questions. 

Photo by Otto Norin on Unsplash
What is the Pelvic Floor?

According to Filgiano, the pelvic floor is a set of muscles, ligaments, nerves and connective tissues that are shaped like a hammock and located within the pelvis at the base of the spine.  This group of muscles helps not only to control opening the bladder and rectum but also provides support for internal organs and stability for the back and hips. 

Most people don’t think about their pelvic floor health on a regular basis. Filgiano states when the pelvic floor is too tight, weak, or uncoordinated, symptoms such as urinary leakage and urgency (feeling like you need to pee), heaviness or pressure in the pelvic area, pain in the hips/lower back and coning/doming of the abdominal area can occur.  

While stressors such as pregnancy, and subsequent labour and delivery can lead to dysfunction, pelvic health is important to all individuals. Although there are some anatomical differences, everyone can benefit from pelvic floor strengthening. 

Why is Pelvic Floor Strength Important to Running?

As Filgiano explains, normally, the pelvic floor automatically engages as part of the inner core (pelvic floor, diaphragm, abdominals and back muscles). This helps to manage any increase in pressure, provide support for the trunk, and to breathe efficiently for optimal performance.   The pelvic floor has a natural “give” to absorb impact each time the foot hits the ground despite the pressure that running puts on it. 

Filgiano states that symptoms of incontinence (leakage), urgency, and pressure or pain, while they may not be evident on a regular basis, may become more noticeable during a run due to the stress on the pelvic floor. When these symptoms are ignored, it can lead to additional musculoskeletal problems or increased severity of your pelvic floor dysfunction.  

How Can Focusing on Pelvic Health Improve Running?

Filgiano outlines the “ABCs”  of the benefits of pelvic health and running:

  1. Activation: The pelvic floor muscles should automatically engage as part of the inner core (pelvic floor, diaphragm, abdominals and back muscles) when running. When the focus is on activating the inner unit as a team and coordinating this with larger muscle groups, speed, power, and endurance can increase without any symptoms. 
  2. Breathing: Learning how to breathe during a run is key to managing intra-abdominal pressure and preventing pelvic floor dysfunctions. Breathing well helps activate and relax the inner core appropriately and supply the much-needed oxygen to muscles during a run. 
  3. Comfort (Leak Free or Pain-free Running): A strong and adaptable pelvic floor allows for better pressure management to meet the demands of a run.  
What should you look for in a PT specializing in Pelvic Health?

In our discussion, Filgiano explains that in looking for a pelvic health physiotherapist it is important to find someone that listens to your concerns and builds a treatment plan that is specific to your individualized goals. There is no one-size-fits all program out there.

For example, if you want to run without leakage, run without pelvic pain or pressure, or run post-partum, the treatment plan may involve doing certain lying down or sitting exercises. However, these types of exercises alone may not translate into improvements during your run. Running is an exercise that requires large body movements, repetition, trunk rotation, different intensity levels, and so much more- therefore there might be a need for specific training to meet this demand. 

All runners want to stay injury free as much as possible. While you incorporate strength training for the major muscle groups, don’t forget to give your pelvic floor some attention too!

Lead Photo: Photo by Alora Griffiths on Unsplash

Thank you to Jayme Filgiano for contributing to this blog plost and providing information on pelvic health. Jayme Filgiano is a physiotherapist  who focuses on women’s health, pediatrics, and orthopaedics. She treats a variety of pelvic health conditions including incontinence, pelvic pain, and pregnancy related concerns.  The Physio Spot is located in Markham, ON at Unit 2 2726 Bur Oak Ave. For more information about Pelvic Health Physiotherapy, Physiotherapy and Running, or other services the clinic has to offer, visit: https://thephysiospot.ca/