“You do not have to lift a surfboard with your vagina!” Yep, I said it. A strong pelvic floor is not necessarily a healthy one. We’re aiming for function, not superpowers.
This past weekend I had the pleasure of presenting to a group of female runners at Lively Athletics on the importance of a healthy pelvic floor. I love talking to runners because I am one. I get the runner mentality: We’ll only do something if it keeps us from getting injured (or more likely, if it fixes the injury we already have), and we’ll keep running no matter what you tell us.
How do you “sell” pelvic floor work to runners? Show them, through exercise, how hugely important their pelvic floor is to their overall core stability, and give them a strategy that they can easily incorporate into their running. We started with the basics of alignment, breathing and pelvic floor engagement (in everyday life and while running), and then applied this strategy to a series of lower- body and core exercises, to give runners the most bang for their buck.
Following are some of the basic things covered in my presentation.
Women at the Pelvic Floor Workshop for Runners practicing their belly breathing. Normally I recommend bolstering your head and shoulders (to keep the ribs from flaring) while in a supine position, but we were only here for a minute or so.
Alignment is one of the most important factors in restoring pelvic floor function. Your pelvic floor muscles work at their best when in they are in their midrange, which occurs you are in neutral alignment. What does “neutral” look like?
Drop your ribs.
Neutral posture is when your ribcage is positioned directly over your hips. Many people (new moms especially) have a flared ribcage and need to be reminded to drop their ribs throughout the day and during exercise.Untuck your butt.
When you stand with you butt tucked under you, you assume a posterior pelvic tilt. Not only does this limit your ability to utilize your pelvic floor and associated muscles, but also it leads to weak, underused glute muscles. Instead, stand in a neutral posture with your butt untucked.Don’t suck in your gut.
When you suck in your stomach, you are unable to breathe with your diaphragm and your pelvic floor muscles can’t relax. Over time, your pelvic floor can become tight, weak and dysfunctional.
USING THE SYSTEM
Your pelvic floor works with your diaphragm, transverse abdominus and multifidus muscles to help create stability for when you move. This starts with breathing. When you inhale using your diaphragm (allowing your belly and ribcage to expand), the pressure created causes your pelvic floor and transverse abdominus muscles to relax or lengthen. When you exhale, your pelvic floor automatically lifts and your TA engages. All of this happens just by belly breathing, but we can get more out of our core muscles if we are intentional about how we use them.
Diaphragmatic breathing with kegel (Piston breathing, from Julie Wiebe)
- Assume a neutral posture (you can be sitting, standing, lying down or on all 4s). Place one hand on your ribcage and one on your belly.
- Inhale through your nose, letting your ribcage expand laterally, as if opening an umbrella. Feel your belly rise gently and your pelvic floor soften.
- Exhale through pursed lips and gently lift your pelvic floor muscles. Imagine you are picking up a blueberry with your vagina. Feel your ribcage return to a closed position as if you are collapsing an umbrella. Notice your whole belly gently draw inward.
Blow before you go (Julie Wiebe)
Once you are able to breathe properly and can coordinate your pelvic floor with your breath (not just engage these muscles, but relax them), it’s time to put them to work. When you are about to perform a challenging movement—whether while strength training or in everyday life—you want to “blow before you go.” This means that you need to exhale and engage your pelvic floor before you start moving. This timing allows your core to function as an anchor while you move.
WHEN YOU RUN
When your pelvic floor muscles are doing their job, they work with your other core muscles to stabilize your pelvis. This should happen automatically when you run—you should never have to be squeezing your pelvic floor and picking up blueberries on a run. But what you should be doing is breathing with your diaphragm and practicing good alignment. The key here is to lean from your ankles, drop your ribs, and breathe with your belly. You should feel as if you’re falling forward, rather than reaching your feet out in front of you. Click here for a video explanation.
When you run like this, versus with your butt tucked under you, not only is your pelvic floor not in a better position to do its job, but also you will eliminate the tendency to overstride– which is a huge contributor to injury.
You may be familiar with running techniques such as the Pose or Chi methods. Both of these emphasize leaning from your ankles, as described. You may have tried to change your running form after reading about one of these methods, but found yourself unsuccessful. That’s likely because you were gripping your abs and breathing with your chest. When you switch to belly breathing, this posture will feel more natural and your body won’t fight it—in fact your body will want to run this way because it’s easier.
STRENGTHENING THE SYSTEM
All of this stuff is great, but there are also things we can do to get our pelvic floor muscles to work even better. That’s where strength training comes in. Here is where you put your core to work so it works for you! Check back here for Part 2 of this blog, where I’ll share five pelvic floor exercises for runners.
Also, see my recent articles for Runner’s World and Zelle, where I interview Julie Wiebe, PT, on this topic:
https://www.runnersworld.com/the-body-shop/new-exercises-for-strengthening-your-core
https://www.runnersworld.com/injury-prevention-recovery/help-for-pelvic-floor-dysfunction