Questions from You to Me: Getting Back to Running
Tags: core strength, Hab-It, Hab-It: Pelvic Floor, muscle strengthening, pelvic floor, pelvic floor exercises, pelvic floor muscles, physical therapy, postpartum, Posture, prolapse, running, stabilization, Tasha Mulligan, triathalons, triathletes, women's health, women's physical therapy
I am 6 weeks post-partum and I feel this heaviness in my vaginal area but no bulge. I want to start running but don’t know if I am ready. Is this similar to what you felt?
My prolapse sounds like a bit more than yours, with a grade III cystocele. When I stood in a half-squat position in front of the mirror, I could see the anterior wall of my vagina, about 1/2 fist in size, bulging out. So my pelvic floor had completely shut down. After my first delivery I had my eye on the 6-week mark to begin running again, but realized I couldn’t even walk around the block without increasing the prolapse and, yes, I felt that heaviness as if the bottom might fall out if I began to jog. After deliveries #2 and #3, I experienced the same level of prolapse, probably a little worse each time, but just began doing the exercises that had helped me recover after the first and I was good to go in 6-8 weeks.
The good news is that I have been able to return to triathlons, symptom-free every time. That is not to say that I can completely forget about the weakness I have in my pelvic floor. Often after I am sick or have done heavy yard work with lifting, etc. I will feel the pressure again, but a focus on my posture and commitment to my exercises get me back on track. Essentially, just like my patients who have re-occurring back pain have to do back stabilization exercises for the rest of their life to prevent symptoms from returning, so do prolapse patients. And that’s okay because all the exercises are postural and core stabilizing so we all should be doing these anyway to maximize our energy and health.
I think the positive part of all of this is that it teaches you about your body. My suggestions are to always stabilize by doing 4-6 exercises per day. Do any exercise that works your low back, glutes, lower abdominals, inner thighs, and pelvic floor for the next 4 weeks before you begin any cardio. Even now, I always do my stabilization exercises before I attempt to “squeeze” in my cardio, and I honestly am in great shape with better tone to my body than I ever had before kids! AND, I have better posture now, and know I will for the rest of my life because of these challenges!
How should I progress back to running?
I recommend working through 4 weeks of the exercises before you begin to increase your activity. Then, for the following two weeks, walk/jog to build up to regular running.
Think of your pelvic floor as just having gone through surgery, like a knee scope….you would work to get your quad firing again and hamstring strength and single leg balance for 4-6 weeks before returning to running. Your pelvic floor and all the other muscles that stretched during pregnancy need this same attention and opportunity to “turn back on” before you start to run!
Shannon said:
May 20, 10 at 6:21 pmHi Tasha,
I developed a rectocele after the birth of my son in December. I have have been doing the exercises on your DVD along with others from my physical therapist. I have noticed a big difference, and have been doing the ellpitical for about a month (slow at first), and have now been going longer and with more intensity. I was soooo happy to see your info on exercising. When this first happened to me, I was convinced that I would never be able to return to the level of exercise I was used to. I am happy to say that I am slowly getting back to feeling symptom free after a workout. I have yet to run, but I’m hoping to start that soon. I have been doing pelvic floor exercises for about a month and a half now. I am fortunate as well that I have no incontinence issues, or other prolapses.
My questions for you are about having your second and third babies. I know that the prolapse will happen again with another birth. I also know that you can do exercises while pregnant, but how do they help when it is inevitable that your pelvic floor is going to be stretched out with the birth?
Tasha Mulligan said:
May 21, 10 at 3:49 amShannon, the exercises will help through a process called “muscle memory”. It has been shown that if exercises are performed before knee surgery, that the recovery time is quicker and it is easier for the patient to contract the needed muscles immediately after surgery because those neuromuscular pathways have been primed.
The connections between our nerves and muscles have to be used in order to remain efficient and effective. By working those nueropathways to our pelvic floor, our transversus abdominus, and our multifidi muscles throughout pregnancy we essentially oil the machine so it will start up without a sputter after delivery.
Not to mention the injury prevention benefit of exercising these deepest core muscles during pregnancy. Our lumbosacral spine is really stressed during pregnancy, so strengthening the very muscles that will help to support this area as well as our growing belly is important.
Shannon said:
May 21, 10 at 7:05 pmSo informative!!!! Thank you!
Jenny said:
Jul 16, 10 at 7:15 pmHey Tasha!
I too am 6 weeks postpartum and have a cystocele I am not sure on the grade, but it seems to be almost as much as what you described yours was. I am really sad and depressed about this! My midwife today said that often she sees this in women who have had a lot of children or birthed a 12lb baby. I had a pretty untraumatic birth of my son (my first), however he was sitting LOW pretty much the entire pregnancy so my pelvic floor was really strained for the majority of it (and in fact the cystocele first appeared during the last weeks of my pregnancy when I was dilated to a 4 then 5 for weeks and he was as low as he could be before being born!)
I have your dvd (it is so wonderful and you are so wonderful in it, honestly I started crying at your introduction as I felt so alone and broken and it made me feel like there is hope and I am not alone!)
I have been doing the exercises for 1 week. Today I went on a run, I have been really eager to get some cardio in. However, I realize now after reading this post that maybe I should ease into that more. My question is: is there a type of cardio exercise that I can do now that won’t put my pelvic floor in jeopardy? Would swimming be ok? Or water aerobics? I’ve been wanting to start these back up as well.
Certainly I can wait the 4-6 weeks if that would be best but I would love to get out there more if I could. I’m so happy I found this website, it is a comforting relief to find such empowering information out there. Thank you!
Tasha Mulligan said:
Jul 17, 10 at 5:38 amJenny, I am so glad you found us and I am here to answer any questions along the way. As for your questions. Swimming is absolutely the best cardio you can do for your body right now! It gets you into extension which your body is needing right now because of the amount of time you spend cradling your new born as a new mom. Essentially everything we do brings us forward throughout our day, so the extension you will get in the water will be great. I say yes to both water aroebics and to swimming laps.
One note on the water aerobics – often there is work that requires stabilization with your abdominals as you move dumbbells or resistance paddles through the water. Be sure you are drawing your transversus abdominus up and in to activate the right abdominal muscle. If you do any work where you feel your abdominal contraction creates a “bearing down” force on your pelvic floor then ease up on that exercise.
Tasha
Jenny said:
Jul 18, 10 at 10:17 pmThank you so much Tasha! That is good to hear! I am so happy I found you and this resource!