5 Tips for Running with Prolapse
Pelvic organ prolapse is something that many women can experience after birth. It is more common with vaginal births but can also affect c-section mothers who labored for long hours. It is defined as the descent of one or more of your organs into the vaginal wall. The most common types include a cystocele (bladder prolapse into the anterior vaginal wall), uterine prolapse, or a rectocele (rectal prolapse into the posterior vaginal wall).
Symptoms typically include:
Heaviness in the pelvic region
Pressure
Pelvic and/or low back pain
Feeling like a tampon is falling out (even though you aren’t wearing one)
Pelvic floor physical therapy has high grade evidence behind it for treatment of pelvic organ prolapse. There should most definitely be a referral to PT before considering any type of surgery. It is possible to reduce, eliminate and manage the symptoms you are experiencing.
Can I run with pelvic organ prolapse?
If you are experiencing symptoms with every day activities that don’t include high impact, it may be best to hold on running, build a foundation and work with a PFPT before getting back to running. If you don’t feel symptoms during daily life activities (walking, climbing stairs, squatting, strength training), then you could be in a good place to try running.
Here are 5 tips to consider when running with prolapse:
1. Run in the morning.
Symptoms are often less first thing in the morning because you were lying down all night. Use this to your advantage. Heaviness is often worse at the end of the day after being upright and gravity taking it’s toll, so evening runs could be tough.
2. Consider timing of meals and bowel movements.
Bloat and fullness after a big meal take up space and add pressure to the abdominal cavity, which could make heaviness worse. Along those same lines, constipation or running before you’ve had a bowel movement could also contribute to some pressure. Try to avoid big meals and poop before running if possible.
3. Use a pessary.
Pessaries are removable devices that can be inserted internally to provide structural support for prolapse. If you are feeling symptomatic during your runs, this could be a great option for symptoms management. These are fitted to the individual usually by a urogynecologist.
4. Do the prep work!
This is the hardest part but definitely the one that pays off the most. Running is a high impact and single leg sport. You have to be able to land with control, have adequate shock absorption, and lower body/trunk strength to perform the task at hand. Your strength training routine should support this and must be done before returning to running.
5. Check your running form.
There are loads of different running cues that can be helpful for keeping symptoms at bay. Consider trying different running speeds, higher step cadence, trying a midfoot strike instead of your heel, leaning forward, increasing trunk rotation, and moreeeee. If you need help with this, working with a PFPT who also knows the demands of the sport can be super helpful. With my patients, we perform a running assessment on the treadmill to see where they are at, and try out one or two of these cues to see how they feel.
Try some of these out and see how your body responds! Remember, PFPT is a fantastic option for treating prolapse and should always be considered as a first line of care.
