Prolapse and long distance running

[Stephanie]

Hi Tasha,
My question is related to prolapse and long-distance running. I am 28 y/o and had my first baby 5 ½ mos ago. I have struggled with post partum incontinence and was diagnosed with a grade 1 – 1 ½ cystocele. I ordered your DVD after my 6week post partum check when I was devastated to learn I had a prolapse. In retrospect, I started running much too soon (5 ½ weeks PP) and struggled with urinary leakage during all my runs. I know now I did not give my body enough time to recover! I did your DVD for about 3 mos, then started your advanced workout. I have been doing the advanced workout 3-4 days/week for about 6 weeks. I am now running 10-15miles total/week (usually 4 days/week). I can run relatively symptom free…I do stop to empty my bladder during running to prevent myself from leaking—might be more of a habit at this point. I REALLY want to train for a half marathon, but do not want to do more damage to my body. I don’t want to have my bladder falling out of me when I am older ( I also want to have more kids)! What are your thoughts on long-distance running with a mild prolapse–will I make it worse? I feel like things have improved greatly “down there”, though I still have days where I feel less support and more laxity. I do not feel things have completely returned to normal, though not sure if they ever will (I have seen great improvement). I know there are exercises that would be better (swimming and biking, like you have mentioned), but I love to run, so naturally that is what I want to do. Any thoughts on this? Will I ever be able to run another marathon (without causing further damage)?

Also, is a prolapse ever reversible? I am a bit confused, as the PT I saw for biofeedback said no, that the damage that has been done is done, though you can train the muscles to compensate for it. However, at my early post partum check, my midwife said it may “go away” or improve with time.

Thanks again. I have spent a lot of time on your blog, finding it both informative and encouraging. I think most women feel so alone in this, so it’s been wonderful to have a place to talk about it and ask questions!
Stephanie

[Tasha Mulligan]

Stephanie,
I would agree with your midwife…this weakness or damage has occurred, so even if your body heals, it still has replaced the original connective tissue with scar tissue – so it is not the same. However, that being said, I do feel that with good habits, such as good posture, consistent strengthening of your entire pelvic basket, and an awareness of those days where you feel more lax or less support – that you can see a consistent and significant reduction of symptoms. So if you begin at a grade I, significant reduction may be reducing your prolapse to a level that you no longer notice it. Even if that occurs, I hope you always remember how important it is to strengthen this part of your body, because you have a lot of years left.

As for running. I don’t know. None of us really know if running will make it worse in the long run. Much like our hips, our low back, or our knees, our pelvic floor is asked to absorb increased stress when we run. Some camps argue that by introducing low level stress, you strengthen bone, muscle, and more. Other camps say that you are speeding up the break down of your joints. So much of this may depend on your strength, your running style, and your ability to train smart.

My personal view with running is that I am going to do it as long as my body will allow. My symptoms are better now following 8 years of running and 2 more children since discovering my prolapse…but that is just my story and others may disagree. I believe the stress I introduce with running has helped to further strengthen my pelvic floor, however, I do not run when I am ovulating because I feel an increased laxity during those couple of days, and I also train smart, working several short, higher intensity runs during the week and just one endurance run per week. Again, this is what has worked for my body, and you need to navigate your own path when it comes to running.

Please feel free to ask any more questions, and please keep us updated on any tips you find that make a difference. A couple from me: 1. Focus on your push off. This will decrease your impact with each heel strike. 2. Wear triathlon shorts to provide a little extra compression support to your perineum and the muscle that lye deep to that. 3. Cross train

Hope all this is useful in your own personal journey.

-Tasha

[Stephanie]

Tasha,
Thanks so much for your response. Your insight is very helpful and encouraging. I am realizing I need to “rethink” how I exercise, meaning become smarter about training and making sure to integrate cross-training and core strengthening into my program–which I am sure is better for me anyway–prolapse or not!

Would you ever consider writing a blog post with some examples of your weekly workouts and an example of weekly training plan (# of days run/bike/etc)? It’s so easy for me to get stuck in a “running rut”, which I am realizing is probably not the best for my body.

I do want to encourage anyone reading this who is struggling with post partum incontinence, to keep with the exercises, be patient, and things will improve!!! I was so worried I was going to have to give up what I love (running) because I would constantly leak urine. I started the Hab-It DVD at about 7weeks PP, then worked up to the advanced workout at about 4 mos PP. I saw the greatest improvement in my symptoms between 4-5mos PP. (I also went to a few sessions of biofeedback, which was helpful in making sure I was isolating the correct muscles) I now rarely ever experience any leakage during my routine activities or with running. Some days I do feel less support “down there”, likely b/c of my prolapse, though the core exercises have helped so much, and when I am doing them consistently, my pelvic floor always feels tighter and more supported. I just thought I would share my experience. I know it was encouraging to read stories of others who’d had improvement in symptoms when I was struggling and feeling like things would never get better!

Thanks again, Tasha! Keep passing on all your helpful information!
Stephanie

[Tasha Mulligan]

Stephanie,
Thank you for sharing your story of your journey toward taking control of and truly understanding your own body. You are right in that women need to read about the feeling of empowerment that you have once you get there! Congratulations to you and thank you for sharing!!!

Tasha

[Samantha]

Hi Tasha,

First, thank you for making such a wonderful DVD! I am 7 weeks PP with my second child. When I went for my 6 week checkup, I was told I might have a mild cystocele. My midwife said “it might just go away”. I feel some pressure and swelling on some days. I also can see a bit of swelling. I am a marathon runner and have been so afraid that I won’t be able to return to my passion. After reading terrifying, disturbing, and depressing information online, I came across your product. To be able to do something to improve those muscles, gives me hope. My question to you is: how long should I wait before beginning to run again? Until all the symptoms (feeling of sweeling, visual) are completely gone? If I start running will the cystocele get worse?

Thank you so much!
Samantha

[Tasha Mulligan]

Samantha,
I would error on the conservative side on this. Allow your body time to heal and work to engage all of the muscles of your pelvic basket that have been stretched up to 3x their original length during your late term pregnancy and delivery. Be sure you have achieved a base strength of all of the muscles of your pelvic basket before returning to running. This means 4-6 weeks of the Hab It dvd along with regular walking is appropriate.

With your long term goals of running, I would then encourage you to progress to the Advanced Stabilization program to further challenge your pelvic basket strength to support higher intensity exercise.

By slowing down and going through each step, you ensure you are doing everything you can to support your pelvic floor. Also, it will allow you to read your own body and truly feel the important muscle contractions you need to feel. Body awareness is so very important!

-Tasha

[Stephanie]

Hi Tasha,
I had a few questions and wanted to give an update. I am now 11 1/2mos post partum and overall am doing great. However, I have been a bit discouraged in the past month as I feel my symptoms are acting up again. I have continued to do the advance workout 3-4 days a week and have been running 4 days/week. I started upping my mileage in an attempt to train for a 1/2 marathon. I got up to an 8 mile run and felt great. Very few, if any symptoms of weakness on my run. Whether related or just a coincidence, in the couple weeks to follow, I felt my symptoms return and felt my pelvic floor was much weaker. I backed way off on my running (3 days/week), started swimming 2x/week, and started again focusing on getting my Habit advanced workout in more consistently. I am doing better, but still feel things are not as controlled \”down there\” as I would like.

I am looking for advice–do you think I need to be doing the advanced workout daily, with the amount of activity I am hoping to return to? Also, I am still breastfeeding, though starting to wean and I just got my period back this week (1st one after baby). I am wondering how both of these things will affect my pelvic floor and continence? (this all occurred right when my symptoms started acting up) I know my midwife told me my symptoms should improve more after I quit breastfeeding bc of dryness down there. Do you have any insight on this? Do you think I can only get to a certain point until I stop breastfeeding?

I know I have continued work on my posture (that is so difficult for me to remember throughout the day!), and hopefully I will continue to become more aware of this.

Thanks to you and your workouts, My core is the strongest it\’s ever been, so that is encouraging to see, and definitely a positive outcome of my pelvic floor issues. 🙂

Thanks for all your help!
Stephanie

[Tasha Mulligan]

Stephanie,
Your body is going through a lot of changes right now – so great choice on adding in swimming and “backing off” on your running. I also think you are fine on completing the Advanced program 3-4 days/week in the peak of your training, but you always want to allow for your “off season” where you come back to stabilize and then you will decrease your training mileage and come back to the Advanced Program 7 days/week.

Think about the changes internally/hormonally. You are decreasing your breastfeeding and have just got your cycle back. This means you are set for more cyclical rise and fall of progesterone and estrogen. There may be certain times within your cycle where your pelvis feels less stabile. For me this is during ovulation, for other women it is during menstruation. You will have to read your own body and you may find that you have 2-3 days every month where your pelvic basket isn’t stabile/strong enough to go for a run.

You have done a great job of reading your body. Continue to do this with a focus of prolonging your running life as long as you can. This is just like someone with knee degeneration. There may be times when you have to allow for more rest. Listen to your body to allow for running for years to come!

-Tasha

[Abby]

I am a mother of five. Since my last baby who is two now, I have been diagnosed with a stage three prolapse.
For about five years I have enjoyed both hiking and running with my husband. We run a lot of trails, that included the Grand Canyon and the mountains in our area.
I understand that downhill can be a strain on the pelvic floor. I just can’t accept that I have to give up these activities that I so much enjoy.
I am about 5 weeks into your work out video. I was so happy to hear of someone who had kept running with the same problem that I have. But then I realized that the stage of the prolapse was probably an issue. I am wondering what stage your prolapse was.
I guess I am just looking for your personal advice for my situation.
I do really enjoy the long distance.
Another question is the impact of weight? I am 25 lbs heavier than before I had my last baby. I feel stuck because of my prolapse. For myself weight and exercise go hand in hand. I have cut way back on running because of my prolapse.
I have had several visits with a physical therapist but I love having the video at home with your instructions!
I do wear a sea sponge for support most days. However I try to constantly think about my posture. I have good days where everything feels tight and pretty bad days with lots of pressure.
Thanks for this website and for you time! It is such a big part of a lot of women’s life.
Abby

[Tasha]

Abby,
You are on the right track. If you are looking for someone “who was there”, I am your girl. After the delivery of my 3rd baby. My cystocele was a lime sized bulge outside of my vaginal opening! Now I would say a grade I – I don’t notice it except for those 1-2 days around ovulation. You will continue to notice improvements with different activities for years to come!

My next question is – have you read through the Educate Yourself section? If not, put that on your “to do” list. A must and will benefit you to read through and gain a deeper understanding of your body.

Finally, with your goals, it is time for you to move on to the 7 Day Advanced Program. After 4-6 weeks of that the hab it cardio and/or hab it plyo will have you about as confident as you can be in your body!

tasha

[Samantha]

Hi there

Similar to everyone here I’m an avid long distance runner and triathlete. I’m 4.5m pp and been diagnosed with a grade 2 cystocele. Despite 6 weeks Physio and a brief period of it feeling much better, mostly it doesn’t feel much better and even walking is uncomfortable.
I’m breastfeeding and lost quite a lot of weight from doing so and wondered whether breastfeeding and the weight loss (I am small anyway and now 16.7 bmi) might be contributing to the ongoing symptoms and lack of improvement. I’m happy to be patient but really welcome any advice or experience people have. I’m doing the holistic core restore programme with pc strengthening and relaxation daily!
Thank you
Sam

[Tasha]

Sam,
Your bmi is great and would not be a negative effect on your prolapse, rather the opposite. I would encourage you to read through my Educate Yourself section. So much helpful information in there on posture, breathing, and understanding each muscle of the pelvic basket and how they work together to support your pelvic bowl and its contents.

It sounds as though you may not be working through the Hab It program, so reading through the entire Educate yourself section is highly recommended. If you read about things in there that you are not addressing through your core restore programme then I recommend you give Hab It a try!

tasha

[Heather]

Tasha,
I delivered twins vaginally 6 months ago (babies number 3&4 for me). I was diagnosed with a “mild” cystocele at 6 wks PP. Unfortunately my ob gave me the green light to start running and after about 10 min on my first run I could tell my symptoms were getting worse and I stopped. When I went to see a physio she told me in addition to the cystocele I also have a urethrocele. Truthfully I think the urethrocele causes the majority of my discomfort (it feels like I always have a tampon falling out).
I’ve been doing your DVD for a few weeks and feel like my pelvic floor is getting stronger, but the urethrocele doesn’t seem to be affected by anything improving internally. Is there any hope I will ever be able to run again with a urethrocele? Would you ever recommend surgery for someone who wants to return to running?

[Kathryn]

I have stumbled across your site and reading with interest.
I am in the UK and a Mum to 3 children (youngest is 11) I’ve had a prolapse since the birth of my youngest so for 11 Years. It has worsened and got lower recently, for the past year I have taken up running and love it so much. I love the headspace and freedom it gives me, I belong to a club and run 3-4 times per week. I am currently training for a marathon and as my long run miles have increased my prolapse appears to have got lower. The marathon is in April and I can’t bear the thought of having to pull out due to this.
I had a grade 3 prolapse when I took up running and was naive as I didn’t realise the extent it could worsen and it is now bulging very low and sits just by the entrance to my vagina.
I know people will think, just stop running but I have lost 3 stone and the happiest I have been in years and I don’t want to.
I have shortened my stride length and do shorter runs in the week and one long run at the weekend (training) I have also purchased prolapse supporting running tights and have had a ring pessary fitted so taking precautions to try and minimise further damage whilst continuing this activity I enjoy so much.
I have to conclude that it has worsened over the last year and even though the weight loss has surely helped, the running is stretching those muscles which are clearly very poor.
I have a Kegel exerciser and have been using this since late August 2017 but haven’t noticed any improvement from that.
I am very interested in the programs you offer and wondered if you could let me know what is the best place for me to start? I want to avoid the dreaded operation for as long as possible and continue being active and running (I do 2 x cross train sessions a week) I loathe swimming though so that isn’t an option for me.
Thank you so much

[Tasha]

Heather and Kathryn,
I would recommend you both progress to the Hab It Cardio program after you have worked through the original Hab It proram for 4-6 weeks. At this point, you should have a clear picture of and how to contract each individual muscle of your pelvic basket and should feel how they tend to co-contract with each other. For example, my pelvic floor and TA engage when I perform an adductor squeeze. Once we see how no one muscle is the key to my success but rather a basket weave of all of them tightening and pulling simultaneously, then we are on the path to recovery.

I have recently started recommending a progression to Hab It Cardio before the 7 Day Advanced because I just wrote it in 2015 and I feel the education in Hab It Cardio and the easier planks are a much more appropriate stepping stone in your return to recreational activities such as running.

Use the tools I have on this site and they WILL benefit you!

tasha

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