How to Keep Running When Your Client Has Pelvic Dysfunction

Last month we did a little campaign to prove that “modifying does mean make easier”.

You can still be a part of it! To participate:

1. Complete our FREE course: 5 Ways to Burpee with Your Post Natal Client 
2. Check out the Burpee Madness Test
3. Hyperlapse yourself, your clients, or friends and family attempting the test, using any burpee format you wish!

The point is, that even though those burpees are modified, they’re still not easy, and the intensity of the burpee madness test remains the same even as the burpees are modified for various pelvic dysfunctions.

Which brings me to this months topic. How to modify running, without necessarily making it easier, to reduce impact on the pelvic floor. You can learn the process of returning a client to running here.

For someone with pelvic dysfunction, being told they cannot run can be devastating. Sometimes, there’s a little modification you can make to their running that means they can keep going, even with pelvic dysfunction. That’s what we are going to go through in this month’s blog.

Number one – Coach a forefoot landing with barefoot practise.

Note that the forefoot is not the toes, we’re not coaching tippy-toes running! To demonstrate why, I’d like you to get up out of your seat and do a little pop jump for me. How did you instinctively land? Why do you think you landed like that?

Now try landing on your heels.

Doesn’t feel good does it?

So our first tip for reducing the load on the pelvic floor when running is to take their shoes off, and do some landing drills on their forefoot. You can start with the pop jump. Progress to landing on one leg, to hopping, to split lunges, to single leg bounding – the goal is to drill that instinctive forefoot landing to take advantage of the elasticity provided by all those bones and joints of the foot, which, research shows, can significantly reduce the ground reaction force (ie. impact) on the lower limb, and reduce risk of some injuries of the knee and ankle complexes^{1 2 3 4}.

The logic with this tip is that if ground reaction force is reduced at the ankle and knee, then the impact on the hip and pelvis is also reduced.

Number 2 – Start with Uphill, or Upstairs

When a client has pelvic dysfunction symptoms when running, they feel like they have to choose one of two things:

1. Quit running
2. Ignore it and carry on

But what if there was a third option? Symptoms of pelvic dysfunction are sometimes caused by the weight your organs, accelerating down with gravity on every landing step, and putting downward pressure on the the pelvic floor muscles and pelvic organs.

To reduce this impact, but not the intensity of the run, I ask these clients to run upstairs, or uphills first, progressing to stair or hill sprints, before we attempt running long distances or on the flat. You can use the time to send her to a pelvic physio, or to work her through a pelvic strengthening program (check out ours here) .

Try it and let me know how it goes!

Number 3 – If you’re trying to reduce Pelvic Floor Load When Running, try soft sand and grassy surfaces.

There’s two reasons why this may work for your clients with pelvic dysfunctions:

1. It’s an uneven surface, or in the case of soft sand, it’s also unstable, this mans your body is doing a thousand more tiny adjustments, which can stimulate the deep pelvic muscles to coordinate and work where a stable surface may not.
2. For the same reasons as above, you generally take smaller steps and forefoot land, thus reducing the impact on the lower limb, including the pelvis
3. Also, variety. Because of the unstable, varied nature of these two surfaces, no two strides are the same. This allows her to work over a larger variety of muscles and she may not tire in her PF as quickly as literally “pounding the pavement”.

Soft sand is especially high intensity, without being high impact, and will leave your client feeling like she’s “done something” if that’s important to her.

Finally, Number 4 – Address misalignment…

There’s two main ways that posture can affect the pelvic floor in women:

1. kyphosis, or upper cross syndrome
2. lordosis, or lower cross syndrome

Kyphosis, or upper cross syndrome is a collection of postural misalignments that ultimately looks like a slump. It’s the tight chest and the long rhomboids, the short abs and the long back muscles. As it’s a syndrome, it’s not any one thing, but a combination of events and symptoms. Sitting for long periods and feeding a baby is one of the ways to develop a kyphosis, as is long hours at a computer.

The issue as it pertains to the pelvic floor is that a kyphosis contributes to downward and outward pressure of the lower abdominals. This means the pelvic floor has to be stronger to withstand that pressure, often without the support of the abs (if there’s also a diastasis).

Lordosis, or lower cross syndrome is another collection of symptoms that ultimately results in what I call a “telly tubby” posture. I’ve heard other people say they have a “sway back” or ‘tight hip flexors” which may or may not be true; what is true, is that a lordosis puts the pelvic floor muscle group in a “less than optimal” position, making it harder for those muscles to coordinate, stretch, relax, and tension effectively. The stretching of the abdominal wall during pregnancy can contribute to a lordosis.

Addressing these syndromes – not just the long or “weak” muscles, but the tight and restricted ones too – may help your client run, symptom free, even if she has pelvic dysfunction(s).

Women’s posture and mobility MINI COURSE

None of these tips are a magic bullet. It is also probably that none of them will help with her rehab. What they will do is allow her to keep running, which may be important to her, without making things worse.

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