Pelvic floor health in athletes

When you hear the words, “pelvic floor” you may automatically think it’s more relevant to women – as pelvic floor health is often referred to before, during and after pregnancy. While it does play a key role in pregnancy and postpartum recovery, the pelvic floor is more important than you realise when it comes to natural movement and running. In fact, the pelvic floor is one of the most overlooked and misunderstood areas of the body in terms of therapy and rehabilitation – for both male and female athletes.

What is the pelvic floor?  

Your pelvic floor is an umbrella term that refers to layers of muscle and other tissues that stretch like a hammock from your tailbone to your pubic bone. This “hammock” supports your pelvic organs including your bladder and bowel as well as a woman’s uterus.

It works as part of your entire core area to support your back and spine, as well as your breathing patterns and any movement you do.

What causes pelvic floor dysfunction (PFD)?  

Pelvic floor dysfunction is very common and often occurs in women after pregnancy, as well as those who are very overweight or obese. It also affects those who have never given birth and studies show that it’s more prevalent amongst young female athletes.

The following factors can play a role in pelvic floor dysfunction:

• Excessive running and jumping
• Long hours sitting or standing
• Riding bicycles and falls
• Traumatic injuries such as a car accident or surgery
• Overuse of the pelvic muscles, such as pushing too hard on the loo often caused by constipation

It’s important to remember that while some areas of your pelvic floor may be weaker and underworking, other areas will be overworking or feel too tight. So, when we work on ways to strengthen your pelvic floor, we take all these factors into account.

Another point to consider is that if your pelvic floor is completely lax and the whole “hammock” we refer to feels stretched your body will compensate somewhere else. A lax or stretched pelvic floor will often spasm and can become painful. The pelvic floor is often linked to core and diaphragm tension too.the pelvic floor and diaphragm should move in concert, so restrictions or tension in one affect the other, remember a lax pelvic floor can often be a tight pelvic floor. A very tight or held core can overpower the pelvic floor and cause pelvic floor dysfunction.

What does PFD feel like?

• Finding it hard to urinate or have regular bowel movements
• Constipation
• Incontinence issues (urine leakage)
• Frequently feeling like you need the loo

A healthy pelvic area can:

• Open-up your stride when you run
• Improve your overall posture
• Help with lower back and hip health
• Help with down-regulating stress

Other areas of the body that play a role in pelvic floor health include:

1. Your upper cervical spine. If it’s locked, it may rotate your pelvis or jam it up
2. Your sit bones. Sitting in a hollow chair or a leather sofa (the kind you sink into) can push your sit bones together. This then flares and exposes the front of your hips, which can cause pelvic issues too.
3. Your sternum and sacrum. Typically, your sternum moves in sync with your sacrum and vice versa, they signal to each other – if the one is locked it can cause problems with the other and have a negative impact on your pelvis and entire pelvic floor area. A fall off your bicycle, while running or even participating in activities such as snowboarding, can cause spasms or a locking sensation in your sternum as well as your sacrum and tailbone. Emotional trauma plays a role too. If you’re feeling deflated and uninspired, it has an impact on your chest posture. Your sternum may drop down and affect your sacrum too. Breathing into your sternum and increasing chest mobility can help to release this tension.
4. Lower body tension can also affect your pelvic floor, starting from your feet. If you suffer from plantar fasciitis and or are scared to stand on Lego, chances are you have pelvic floor tension. Tension in your calve muscles and the deep posterior muscles behind your shins, cross your knee into the hamstrings and adductors (muscles on the inside of your leg). If these are tight and tender, there’s a good chance all that tension will move into your pelvic floor, causing pain and tightness there too. The aim is to soften and relax those muscles. Rolling out your feet, calf stretches and groin stretches and mobilizations can help.
5. A tight or locked core and diaphragm. If these areas are locked, the tension can move down into the pelvic floor area, causing PFD. Remember, your abdominal contents which are fluid, weigh around 15 pounds. If your core is too tight, this can push down into pelvic floor and cause dysfunction..

How to improve your pelvic floor functioning

Kegel exercises can be used to strengthen, rehabilitate and restore pelvic floor function. When performing a Kegel exercise, the aim is to gently contract the muscles of the pelvic floor as if you’re stopping urine midstream. Hold for 2-3 seconds, then relax. Your glutes and thigh muscles should remain relaxed throughout. Kegels should be done softly and gently. Avoid walking around with tension in your pelvic floor.

Kegels with rounding and arching

As a baseline, practice 10 soft rounding and arching movements with breathing, where you breathe in on the “arch” and out on the “round” part of the movement.

WATCH This rounding and arching video to see how it’s done:

Then, you want to add five sets of Kegel exercises to this movement. As you round and breathe out, Kegel softly (remember not to use your glutes when you perform a Kegel exercise). Then, arch your back and relax your pelvic floor, breathing in as you arch. This should be a flowing, synchronous movement. Once you have a feel for doing the Kegel on the exhale and the round, swap it round and try a Kegel as you breathe in and arch. 

If you feel like you’ve mastered the movement of rounding and arching with breathing and Kegels, and it feels smooth and gentle, then start doing this in a kneeling position with one leg forward and one leg back, or try it in various lunge positions – such as a front lunge and side lunge, so you’re taking the opportunity to gently contract your pelvic floor in different positions.

You can also practice Kegel exercises with breathing in the frog-leg position or  with one leg straight and one leg bent position.

Remember:

Performing Kegels in different positions and postures is vital to restore your pelvic floor health. This coupled with a relaxed diaphragm and relaxed postural muscles can be a real game-changer for health and performance. 

Want to learn more about pelvic floor health and how it's connected to all movement, but particularly running? Head to our Instagram page  for an in-depth review.