About organ prolapse
Although running is very popular among young mothers, this article applies to all women who exercise and play sports.
Studies show that 50% of women who have had at least one child will experience organ prolapse, and that 20% of childless women will also be diagnosed with this condition. In other words, having a C-section doesn’t protect your perineum! On the upside, only 5–10% of these women will experience symptoms. Essentially, many women don’t even realize there’s a problem. One of the things that can weaken the perineum, increasing the risk of organ prolapse, is high-impact physical activity. The impact on your perineum created by running is equivalent to three times your body weight.
What is the perineum?
The perineum, or pelvic floor, is a group of muscles found at the base of your pelvis. It originates from the pubic symphysis, surrounds the vagina and anus, and attaches to the coccyx. Its primary function is to control the passage of urine, stool, and gas. It is the only muscle group at the base of the pelvis, making it solely responsible for supporting the pelvic organs (bladder, uterus, and intestines). In women, the perineum includes the clitoris, urethra, vagina, and anus, whereas in men, it includes only the urethra and anus. This muscle group also plays a role in sexual function and helps stabilize the pelvis, an especially important role when running.
How does it affect running?
Anatomically speaking, the pelvis supports the sacrum, which in turn supports the lumbar spine. If the pelvis becomes unstable during running, this could throw the entire spine out of balance. A stable pelvis helps to keep the legs properly aligned during running. Of course, the pelvic floor isn’t the only muscle group involved in running—never underestimate the importance of the transverse abdominal muscles and the gluteal muscles!
How soon can I start running again after giving birth?
Imagine suffering a severe sprain of your pelvic floor muscles—that’s what giving birth is like! Think of it this way: would you ever consider running on a sprained ankle? Just like after a sprain, the perineum is swollen after childbirth. The natural healing process for a muscle sprain takes roughly three months, which is why many experts recommend waiting three months after delivery before starting to run again. As with recovering from an ankle sprain, once you resume running, you’ll need to do muscle strengthening exercises to avoid re-injury. Time heals all wounds, but your muscles still need help to regain strength.
If I gave birth more than three months ago, or even a few years ago, am I less at risk?
Not necessarily. There are many risk factors for a weakened pelvic floor, including childbirth, pregnancy, menopause, high-impact activities, obesity, chronic cough, and more.
Here are a few signs that your perineum isn’t ready for running:
- If you experience leakage while running, it’s a sign of a weakened pelvic floor.
- If you feel heaviness while running, your pelvic floor may not be ready to support three times your body weight.
- If you have pain in your knees, ankles, or elsewhere, it may indicate a lack of pelvic stability and perineal strength.
How can I know?
During a pelvic floor rehabilitation assessment, the therapist will perform a manual vaginal examination to evaluate the strength (on a scale of 0 to 5) and endurance of your perineum, and to ensure you are contracting the muscles correctly without compensation. Studies show that 25–30% of women contract their pelvic floor muscles incorrectly, even after thorough physiotherapy assessment. After your evaluation, the physiotherapist will provide you with a personalized exercise program.
Have a great run!
