Running with Pelvic Organ Prolapse

Written by Yvonne McKenny women’s health physiotherapist & certified Pilates instructor

Pelvic organ prolapse is one of the most common conditions in Australia. It is said to effect 75% of ALL women at some point of their lifestyle. This is not an uncommon issue!

What exactly is pelvic organ prolapse?

Prolapse is the dropping of one of the pelvic organs, namely the bladder, uterus or rectum toward the vagina.

If you’ve been diagnosed or concerned that you have a prolapse, you may already be feeling a sense of heaviness or dragging with low impact activities like standing or walking. You may feel apprehensive at best, or scared at worst, at the idea of running with a prolapse for the implications that high impact might have on worsening your prolapse.

Your concerns are understandable but know there are many strategies and things you can try to make running a safe and a comfortable part of your life once more.

Tips for running with prolapse:

1. Reduce stride length, increase cadence: That is, aim for quicker and shorter steps. Cadence should be >170bpm and this can be measured on many tracking devices but a simple metronome can be set on your phone/headphones to help set the pace. Alternatively, you can find playlists on Spotify that fit the appropriate cadence so you can run along to some fun and fast paced beats instead of listening to the monotonous tap of the metronome. Whichever suits you!

2. Avoid running downhill: Downhill running means far great ground reaction forces and therefore greater impact to be absorbed by the body. Flat surfaces or uphills are much better (albeit much harder!).

3. Wear support garments with specific perineal support: We often recommend tights from SRC Health. This can provide an external pressure at the perineum that can improve comfort and support with impact activities like running.

4. Run on softer surfaces: Mixing up your training surfaces from hard, unforgiving concrete, to the softer grass or dirt track may be slightly gentler on the impact forces passed on to the pelvic organs.

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5. Cushioning your landing: Wearing well cushioned shoes is likened to running on a softer surface and should also be considered. Also, a move from a heavy heel strike to a more midfoot running style may also help cushion your landing.

6. Manage training loads: The longer you run, the more impact on your pelvic floor. Start with small, manageable distances, monitor the time to onset of symptoms and work within those limitations.

7. Consider a vaginal pessary: These are silicon devices inserted inside the vagina to support the pelvic organs. There are many different shapes and sizes and these would need to be fitted by a pelvic floor physiotherapist in order to get the best fit for you. Note, that not all types of prolapse are suitable for pessary use.

What can I try right now?

You may want to try inserting a tampon first, before running. This MAY mimic the support of a pessary and may be helpful in reducing some of your symptoms. Don’t worry, if this does not work, that does not mean that the appropriately fitted pessary for you wont work.

Preparation for running with Prolapse:

If you’re still symptomatic with running it’s important that you consider the following to further improve your ability to manage your pelvic floor loads.

1. Improve your hip and pelvic floor strength: Hip stability, leg strength, knee/ankle/hip mobility and pelvic floor strength and endurance are very important areas for consideration in preparation for running.

2. Learn to breathe properly: When we inhale with our diaphragm, our pelvic floor relaxes, and when we exhale our pelvic floor lightly activates. We do not want a rigid and over tensed pelvic floor – this is unsustainable and does not allow for impact to be appropriately absorbed.

3. Managing body weight: More weight means greater downward forces on the pelvic floor and their organs. Reducing bodyweight (if overweight) may greatly improve symptoms.

If you find you’re still quite symptomatic, unsure, or seeking further clarity, it is best to seek the personalised advice from a pelvic floor or women’s health physiotherapist.

Author of this article:

Yvonne McKenny has B. App Sci (Physiotherapy) USYD and APPI Certified Pilates Instructor. She is a musculoskeletal and women’s health physiotherapist and a certified Pilates instructor who works at Evoker Premium Physiotherapy in Sydney’s CBD.

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