Should you avoid running if you have a weak pelvic floor?

Question: Should you avoid running and jumping if you sometimes leak urine (say, when you cough or sneeze)?

Answer: Running is great for fitness. It also builds strong bones and leg muscles, helps keep your weight in check and it’s a powerful stress buster.

But running, and other high-impact activities like jumping, put a lot of pressure on your pelvic floor, the sling of muscles at the base of the pelvis which support the bladder, bowel, vagina and uterus.

A weak pelvic floor can cause leakage of urine and this is very common in women, especially those who’ve had a baby, whether they run or not.

Hormonal changes around menopause can make this worse.

One in three women who have ever had a baby will have had bladder leakage of some kind in the past month, according to Jean Hailes Foundation for Women’s Health.

Pelvic floor physiotherapist Mary O’Dwyer is loathe to scare anyone off any physical activity, but says if you leak — even a little bit when you cough or sneeze — it’s a sign your pelvic floor is not doing its job.

This means running and jumping are not the ideal choice of exercise — at least in the short term, until you can work on a program to improve your pelvic floor function.

“Leaking urine is a red flag and should alert you to finding the cause,” she says.

“When your pelvic muscles are weak, it’s a similar situation to when you’ve had a sporting injury. You need a period of rehab where you might need to do modified activities for a while until you get your optimal strength back.”

Lower the impact

“The first step is to be assessed by a pelvic floor physiotherapist, who can help you work out where to go from there. It will be different for every woman.”

However, she stresses that with the right help, most women will be able to improve their pelvic floor support so that a trial of running becomes an option.

For some women who have had severe trauma to their pelvic floor, for example during a difficult childbirth, lower-impact exercise may remain the preferred option though.

The good news is there are other forms of exercise that put less pressure on the pelvic muscles that you can do while you’re improving your pelvic floor.

These include walking, swimming and seated cycling on a stationary bike.

Prolapse risk

The trouble with running when you have a weak pelvic floor is that over time, the impact can lead the weakened pelvic floor muscles to become progressively more stretched and weakened, Ms O’Dwyer said.

This means they do not offer the correct level of support to the bladder, uterus and bowel that sit above the pelvic floor.

This puts extra strain on ligaments that hold these organs in place in the body.

Ultimately, if these ligaments become too strained, it can lead to a condition called prolapse — where part of the bladder, uterus or bowel protrude into the vagina.

This can be damaging to women’s self esteem and sex life and can also affect how these organs function.

Sometimes surgical repair is needed for a prolapse, but this is not always successful in the long term.

It is far better to prevent the problem deteriorating to the point of prolapse by getting help at the first sign of trouble, Ms O’Dwyer said.

Help may involve more than just exercises to contract and lift the pelvic floor muscles. Women may also need to learn to improve their posture and breathing and avoid activities like heavy lifting and bowel straining that put a stress on the pelvic floor.

There are also devices called pessaries worn inside the vagina, which may allow running because they provide physical support to prolapsed organs, reducing strain on them.

A pessary needs to be fitted by a health professional.

To run or not?

Ms O’Dwyer said there can be signs, other than leaking urine, that your pelvic floor needs to be stronger to cope with the sustained impact of running. These include:

• You have seen or felt any bulge at the entrance to, or inside of, your vagina (this can indicate prolapse of bladder, uterus or bowel);
• You feel a sense of heaviness in the vaginal area or that something may literally fall out
• You feel an urgent need to urinate after you have been running;

Running is also not advisable for women who’ve had a baby in the previous four months, as this is when the pelvic floor is weaker and most vulnerable.

Reducing running stress

Pelvic physiotherapist Michelle Kenway says you can reduce the stresses on your pelvic floor when you run by:

• Mixing up your running surfaces to avoid continually running on hard surfaces (think gravel sand and grass instead of roads and cement paths)
• Reducing your stride length, running speed or running distance
• Wearing well cushioned footwear
• Avoiding downhill running — this involves greater forces on your pelvis
• Mixing up your workouts — don’t make running the only exercising you do
• Manage your body weight — carrying excess weight puts more strain on your pelvic floor when you run

Where to get help

For help or advice about pelvic floor issues, you can contact your GP, the Australian Physiotherapy Association, or the Continence Foundation of Australia.

The National Continence Helpline 1800 33 00 66 also offers advice and referrals.

For information on exercising safely for your pelvic floor, see the Continence Foundation’s Pelvic Floor First website.

We thank physiotherapists Sue Croft and Alex Lopes, who is also chair of the Australian Physiotherapy Association’s pelvic health group, for their assistance with this article.

This post originally appeared on ABC News.