I’ve had a couple of chats lately about how pregnancy affected my pelvic floor and the strength work I’m doing since I’ve started back running. I’ve touched on both a bit in other posts, but thought it could probably be a post on its own.
Before I was pregnant, I don’t think I had any idea what my pelvic floor was. A physio told me early on that a good way to find them was attempting to stop midway through going to the bathroom. At the time, I thought it was impossible.
During my pregnancy, the midwives told me to start working on the pelvic floor muscles, and I went to a class at the hospital that included a few exercises. It was recommended that we do them a few times a day, both standing and sitting. I tried to remember by doing them every time I had a snack at my desk (which was frequent!).
Knowing that I wanted to get back into running ASAP after giving birth, I was pretty determined to do them, and got the hang of it pretty quickly. I remember thinking, “I’m awesome at this pelvic floor stuff.”
I had a couple of chats with other mums during my pregnancy about if I was feeling pressure on my pelvic floor while I was running. I was also asked recently if running late in my pregnancy did any damage to those muscles. I was lucky not to feel any discomfort when I was running during pregnancy, and while my pelvic floor muscles are not as strong as they were pre-pregnancy, that is normal with or without running.
When I was starting back running after my baby was born, I found a really good physio who checked my pelvic floor control. What I didn’t realise when I was doing the exercises during my pregnancy, is that while I was activating my pelvic floor, I was also activating all of the other muscles around at the same time (in particular my glutes).
She taught me how to isolate the muscles through smaller movements and how to activate them while sitting, standing and lying down. She also gave me a few ways to test my pelvic floor control. This is a summary of what I did (note, I did this on advice from the physio and it may not be suitable for everyone):
10 x pelvic floor activations sitting, standing and lying down (daily from six weeks post baby)
Toilet test – activating muscles to stop flow (after one week of exercises)
Star jump test – drinking a few cups of water, waiting until I really needed to pee, then doing 20 star jumps (after two weeks of exercises)
I was able to do all of these, which gave me confidence that I would be able to prevent any leaking while I was running. However the biggest test of my pelvic floor control has come at the end of the hard races I have done, where fatigue has really set in.
It was good to know the muscles were working while I was fresh, but having them hold on when they were tired at the end of a prolonged effort was a different story. I know that they were weakened during pregnancy, because I’ve never felt any discomfort in those situations in the past. But a few times post baby I’ve found myself really having to hang on.
The good thing is, I have always been able to. The tricky part is that you will only be in that situation by putting yourself in that situation. For me, increasing the pace little by little after getting confident my body could handle a certain level, combined with the daily exercises, is helping me get back to my pre-pregnancy strength.
I had about 2cm of separation post birth, which has gone down to about one now (maybe 1.5cm around my belly button).
There were some basic exercises in my hospital handbook, which I started almost straight away, then increased it with help from the physio. Similar to the pelvic floor exercises, I needed a bit of help with isolating specific muscles, which is why it’s been so valuable for me to have a good physio.
Below is a summary of what I have been doing, which as above may not be suitable for everyone.
Activating deep core muscles
Table top with toe taps and leg extensions
Planks and side planks – building up from knees to feet
Because I am building back up from very little running, the physio gave me a strength program to help prevent injury. I am notoriously bad at doing strength work, mostly because I struggle to fit it in around running and working.
This time has been a bit different because I started it when I wasn’t doing much running, so have had a bit more time. Initially I was able to fit in strength, core and pelvic floor on most days. As my running has picked up and I’ve added more exercises, that hasn’t been possible. But I still manage to do some exercises most days, generally either core and pelvic floor or legs and pelvic floor. I have written before about how making running a habit helped me improve, and I think that has helped here too.
Here is a summary of what I’ve been doing (which also might not be suitable for everyone):
Squats (double and single leg)
Glute bridges (single leg)
I’ve also been incorporating pelvic floor into these, by learning to activate those muscles while doing these exercises.
It’s not easy at times to fit it all in. I feel like these exercises add quite a bit to a pretty full schedule. I’ve had to get a creative a few times, for example doing my step ups outside my building while waiting for my daughter to wake up from a nap in the pram. I also often space them throughout the day when I have a few spare minutes. I’m hoping they will make me a better runner overall!