I just finished a morning run and I was thinking about how running has helped to strengthen my pelvic floor. These were thoughts I needed and wanted to share with those of you who have avoided whatever activities you used to do, including regular fitness like walking, running, hiking and aerobics, because of incontinence or prolapse issues. The truth is, that just like my legs and arms are stronger and more toned because of my running and stabilization exercises… so is my pelvic floor.
I certainly wasn’t symptom-free when I started. I had done all the exercises included in the Hab It: Pelvic Floor DVD, consistently, for 8 weeks and was symptom-free with my daily activities. But, now I wanted to get back to my regular cardio workouts. I remember when I first started running after delivering each of my babies (which was well after my OB gave me clearance at 6 weeks, because I felt such a heaviness in my vaginal opening). I felt like I had to suck my stomach in and keep all my air up in my chest to help pull my pelvic floor (PF) up. It wasn’t a comfortable feeling, but I knew through experience that if I pushed my body to a new level, it would adapt and strengthen to accommodate the new challenges. I also knew that if I avoided all the activities that caused my prolapse or incontinence to increase, my body would never strengthen to the degree that I needed it to, to maximize my activity level and feel like my old self again.
So I ran. I worked my way into it slowly, alternating running and biking days and building my time and intensity gradually. What happened over the next 4 weeks was a decrease in that heaviness I felt within my vaginal opening while running and I also noticed that I never thought about it during my daily activities any more, including yard work, vacuuming, and carrying one or two of my children at any given moment.
I did, however notice that I could still feel my prolapse when I would sprint. So that was my next challenge. I began tossing in ten 50-100 yard sprints twice a week. My body once again got stronger. I have heard the same stories from hikers who would continue to experience symptoms as they would descend from their hike, or women who avoided jumping jacks, etc. My advice has always been the same: Gradually increase the load and intensity of exercise and your body will respond with appropriate strength and endurance gains. Remember this is true when rehabilitating any muscle group in your bodies, including a leg muscle, a shoulder muscle, your back muscles, or your pelvic floor muscles.
My rehabilitation recommendation for advanced PF strengthening is to perform 6 core and PF stabilization exercises each day, including your Kegel exercise (both quick flicks and long holds) and exercises aimed at strengthening inner thighs, low back, transversus abdominus, and hip rotators (you can find four physical therapist-guided workouts on the Hab It: Pelvic Floor DVD). Also, learn to find neutral spine and be aware of your posture and hold it there with contractions of your transversus abdominus and multifidi muscles (also on the Hab It DVD).
And the bonus on the days where you can squeeze it in is 20 minutes or more of a cardio workout to challenge your weak PF muscles. The next question may be, “How do I fit that in to my already crazy schedule?” The answer will vary for each of you. It may be in the morning or during nap time or maybe at night. A 20-minute workout is easier to shoe horn in than an hour-long workout so I have included an example of one of my running workouts below. Usually I can get this one in before my kids wake up in the morning or during nap time because, let’s face it – I, like many of you, have 3 little ones right beside me most of my day.
This is one of my favorites, a quick and a good strength builder. But don’t forget, your stabilization exercises are the priority and the cardio is a bonus right now!
Treadmill Program – 20 minutes
The idea here is to be running at your comfortable 30-minute run pace at the 10-minute mark. This means start wherever you like and increase as fast as you like so that at the 10-minute mark you are at a pre-determined pace. Then the increasing begins. 1 mph every 30 seconds for the next 10 minutes. Challenge yourself!
1. Begin on treadmill, running at a good pace.
2. Build yourself up so that at the 10 minute mark you are at your normal treadmill running pace.
3. At 10 minute mark, increase your pace one tenth mph (i.e. from 7.5 to 7.6 mph)
4. Continue to increase your pace by one tenth every 30 seconds. ( This means that your race pace will go up 2 mph by the end of your run)
5. You are done at the 20 minute mark.