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Pelvic Floor and Running: What You Need to Know From a Specialist

Last Updated on November 1, 2024 by Amanda Brooks
Home / Guides to Running Injuries

Not so long ago women were told that their uterus would fall out from running. True story. And yet now we’ve gone the other direction to not thinking much at all about our pelvic floor or assuming it only relates to women after childbirth. It’s important for both men and women, so today we’re going to dive in with a specialist!pelvic floor physical therapy

Dr Amanda Fisher of Empower Your Pelvis joined us for an in-depth discussion on the Tread Lightly Podcast which you’ll find below, but we wanted to provide some high level notes for anyone needing help who may not have 30 minutes.

I love this image from her company because we just have so many misconceptions about the pelvic floor or a general lack of knowledge! Hopefully this episode will get you started on learning more.

What is Your Pelvic Floor?

Both men and women have a pelvic floor, which is why it’s interesting we only think of it in relation to childbirth. Having issues can cause leakage and pain for both genders.

28 muscles actually make up your pelvic floor. They support our intestines, bladder, uterus for women, colon, and our rectum in the back.  All of which gets jostled as we run and thus needs our pelvic floor to be not too tight or too weak to help control everything.

As you might guess these muscles are involved in controlling our bathroom habits and sex. So…ya know, pretty important stuff here!pelvic floor muscles

Is Running Bad For Pelvic Floor?

No. Running is not bad for your pelvic floor.

Just like it’s not bad for your knees, but that doesn’t mean you can’t have knee pain if you skip out on doing strength training, finding the right shoes, etc.

Unfortunately for awhile it became normal to pee yourself while running, which simply ignored the fact that something is going on with our pelvic floor. In fact, Dr Fisher started down this path of research, study and helping others because it was happening to her even as a college athlete and she just knew it wasn’t right.

Over the years of study, what she’s found is that some patients have too much tension and others too little.  Which comes back to the age old tale of over training a muscle (asking it to work too hard all the time) and not building up in a steady way that allows it to get stronger.

How Does Running Impact Pelvic Floor

You’ve probably heard that every step you take while running is 2.5 to 3 times your body weight, with your calf muscles actually getting up to 8 times your bodyweight. Assume there are say 1500 steps per mile and then imagine your pelvic floor holding up all of your bouncing organs?!

Ah ha, now we’re starting to visualize why it’s so important and wondering what we can do to help.

By default your muscles are working without you thinking about it, but if something is off then you’re going to start experiencing some symptoms that let us know we need to pay attention.pelvic floor and running

The most common symptoms with pelvic floor dysfunction in both men and women:

  • Leakage while running or other impact activities
  • Hip Pain
  • Back Pain
  • Pressure down there
  • Pelvic pain (usually around the tailbone)

These issues tend to crop up based on certain lifestyle factors, weakness or potentially running form.

Postpartum: No surprise here, after giving birth in any method you may need to work on the pelvic floor. That could be from tension or looseness, so a specialist like Dr Fisher can really improve your return to running.

Sucking It In: If you are constantly in a state of tightening your abs or sucking it in, this is likely creating too much tension in your pelvic floor.

Overstriding: Heel striking we aren’t so worried about, but landing with your foot in front of your body leads to pain from the ankles to knees right on up to your pelvic floor.

Mobility Restrictions: This is one of the biggies that Dr Fisher works on with her patients and can easily be added in to your day!

Do You need to Stop Running with Pelvic Floor Issues?

You probably know by now that around here we don’t believe rest resolves very many issues.

Instead, the goal is to modify away from anything causing significant pain and keep working our strength or mobility where we can.

What’s important to note is these may not happen in mile 1. Instead you need to start paying attention and is it that when you hit 5 miles things start to feel off…ok great, then let’s start working to make improvements so you don’t notice it until 6, then 7, and so on.

Listen to the full episode here to understand more about pelvic floor health and running!

Is Your Pelvic Floor Ready to Return to Running?

As noted, we really believe seeing a specialist after giving birth is your best bet. But we know busy, new mom, life…so here are some things to consider. As always you should have been cleared and should be building back slowly, in our running after pregnancy episode we talked about the guidelines saying 12 weeks is ideal based on the trauma the body experiences.

You want to complete these tests using good form and not feeling any symptoms we mentioned above:

  1. Walk 30 minutes with no symptoms
  2. Jump rope (or imagine one) for 1 minute with no issues and without feeling your knee collapsing inward
  3. Single leg glute bridge raise and lower 15 times
  4. Static forearm plank for up to 60 seconds

Again these are little tests that have had some studies around them, but not the same as getting cleared.

Physical Therapist Caroline Packard is a fantastic resource as well for tons of strength movements and knowledge around dealing with prolapse, diastis and pelvic floor issues.pelvic core pain

What Can You Do to Improve Pelvic Floor for Running?

You know I’m all about prevention and a lot of what Dr Fisher shared falls in to the category of this is great for us overall as runners! What’s tough here is we don’t want to tell you to work on tightening or loosening without knowing what you need.

But across the board a few things we love:

  • Doing more deep squats and holding. This is incredible for total hip mobility.
  • Single leg exercises from simple things like standing on one leg and holding (proven sign of longevity), to single leg calf raises to Bulgarian split squats.
  • Deadbugs in all varieties.

Dr Fisher is big on building moves in to your day, so doing the deep squat while brushing teeth or trying to march while on the phone.

“single leg marching…Can I keep my pelvis stable and move one leg up and down or out to the side or airplanes…but can I keep the pelvis stable while moving.”

All right, hopefully this has all given you some new information!

But of course please feel free to drop your questions or follow Dr Fisher on Instagram to continue learning more.

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Amanda Brooks
I am a running coach with over a decade of experience helping thousands of runners to achieve their goals from running injury free to crossing that marathon finish line with a PR. I’ve run over 28,000 miles in my own running journey since 2002. Run To The Finish is my place to share that love and my deep dive in to researching all things running. I hold multiple run coaching certifications, as well as a personal training certification. But it’s my ongoing desire to learn and progress as a coach that has allowed me to help runners from their 20’s through their 70’s! More ways to connect with me:
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