A question I am often asked is ‘can I run with prolapse?’ I absolutely believe you can, and have helped many clients to get there. But here’s the thing, running with prolapse isn’t just about the pelvic floor, it’s about the whole body (and mind!).
Here’s my checklist to help you get back to running confidently
Pelvic Floor Strength (of course!) for running
I’ve put this first, because, of course this is important. The 2019 Return to Running Guidelines written by Tom Goom, Emma Brockwell and Grainne Donnelly (I’ve linked to these here because they are brilliant) suggest a minimum of pelvic floor strength of 3/5. Plus, the absence of leaking, pain and heaviness during activities as the starting point. If you are seeing a pelvic floor physio, they will be able to assess your pelvic floor (strength + coordination). If you are yet to see one, you can ask your GP to refer you OR find one in the Squeezy app or via Mummy MOT
An assessment with a pelvic floor physio is also a great way to assess your posture and how well you recruit your pelvic floor muscles. They may suggest you follow a strengthening or relaxation then strengthening programme.
Full body strength for running with prolapse
A strong body is a great ally for a strong pelvic floor. Runners (with or without pelvic floor dysfunction) may overlook the important of strength training but it builds the foundation for injury-free running!
You can start with bodyweight exercises which are easy to do at home. Then you can load the exercises with dumbells or kettlebells.
Awesome strength exercises for runners include:
- single leg squats (often done sit to stand)
- lunges
- deadlifts and single leg deadlifts
- core work (including progressions to planks and sit ups)
- rotation exercises
Mobility for runners with prolapse
Mobility is often overlooked but is defined as the ability o control movement through a range of motion.
If you are post natal, post prolapse rehab, post surgery etc your mobility may not be great. This is because you’ve been less active or found that movement in different ranges of motion brings on symptoms.
Areas that may need mobility work for running include:
- ankles
- calf muscles
- hips
- thoracic spine rotation
Impact for female runners
We can’t ignore that running is a high-impact exercise. For a weak pelvic floor, this may lead to leaking, pain or prolapse.
Toleration to impact can be built up over time. This means the pelvic floor (and whole body) is better at managing the repetitive nature of running, jumping and skipping.
Some of my favourite “impact building” moves:
- the no jump jump!
- lateral hops
- hops forward
- jumps forward
- jump lunges
- burpees
Having a plan for running with prolapse
Running 5km is not a plan! However, having a graded programme that builds up running and reduces walking over time, is a great way to return to running.
The NHS Couch to 5km is a fantastic starting point as it builds over time, alternating between running and walking over 9 weeks. Therefore, if you notice symptoms at a certain point, you can go back a week or 2 and notice at what point the symptoms kicked in. You can then hang out here where it feels good before trying to progress again. The key is finding the right rhythm for you (which may be longer than 9 weeks, and that is totally ok!)
Sleep deprivation, nutrition and hydration for female runners
We can’t talk about post-natal, post prolapse or post anything running without addressing these.
It is likely that you are a new (or new-ish) mum reading this. Your baby might get you up in the night (frequently). Or you have rubbish sleep when they are ill, teething or going through a developmental leap.
Your sleep is precious and your training will be a million times better if you recognise the days you have the energy to run versus those you don’t. Having a flexible plan is important!
Eating enough food and drinking enough water is also critical. Not only will you be able to train better but it’s likely you’ll get injured less frequently.
The concept of RED-S (relative energy deficiency in sport) does not just affect athletes. It also affects new mums trying to lose baby weight or women in general who may be exercising for weight loss and not eating enough nutrients.
If you would like to know more about RED-S, I’ve linked to an article in Runners World
Patience and kindness
Maybe I should have put this one at the top! But I think it’s important to say that getting back to high intensity exercise with prolapse takes time. You may feel you take as many steps back as you take forwards some days. Patience and kindness can take you a long way in your rehab, recovery, and enjoying your return to running (or lifting, or gym classes, or whatever!)
Confidence in running with prolapse
I’ve left this one to last because I think it’s a great way to conclude. It’s often the missing link if you have done rehab and have been given the green light to run. You don’t want to be thinking about your pelvic floor for your run. You don’t want to be wondering if you are “doing more damage” or “making things worse”.
Feeling confident comes from knowing that your body is ready. It also comes from believing that running isn’t bad for the pelvic floor. You may need to update your beliefs around running or high-intensity exercise.
This is exactly what I help clients within The Positive POP Framework. I created this to help clients with pelvic organ prolapse get stronger, more confident and back to the exercise they love.
Disclaimer: Beth is a highly qualified coach and personal trainer but recommends all women experiencing pelvic floor issues see a pelvic floor physio before starting any exercise programme. Return to running may look different for each person.