“I peed a little while running”

This is the comment I got last week from one of my new mamas, so I thought I’d write a Blog about it!

So the thing is - I peed myself while running loooong before I had kids. It's actually quite common in distance athletes like runners. Picture yourself on a run with a semi-full bladder: your bladder bouncing around happily on your fatiguing pelvic floor. Once you go past the point of fatigue, those extra few times pounding pavement may just allow a little something to squeak out. It was something I just accepted as a normal part of the distance running experience and never did anything about it. I just didn’t know that you even could do anything about it! And in all truth, I was embarrassed to even talk about it!

Here’s what I say now. There is nothing to be embarrassed about if this has happened to you! But also know that just because it’s common doesn’t mean you have to suck it up and deal with it. There IS something you can do about it. And it doesn’t have to be avoiding water before runs or worse - not running altogether!

Last week, I talked about the Knack in relation to preventing leaks while sneezing, coughing, laughing or jumping. But you can't do the Knack every single time you land while running, can you? That would just be impossible to time! It would also make running super awkward and uncomfortable if you had to overthink all those things while out for your run.

BEFORE you head out on your first run postpartum

• Wait at least ~12 weeks. This allows for early pelvic floor healing to occur and allows your pelvic floor to better support you.

• Check out this post for a Return to Running Screen. It’s mostly based on the 2019 Guidelines by Grainne Donnelly, Emma Brockwell and Tom Goom. If you pass this screen WITHOUT leaks or worsening of pain or vaginal pressure, then you may be able to start the return to running.

Now what if you’ve done this, and you’re still leaking?

It’s a common misconception that your pelvic floor isn't STRONG enough to hold your pee in. Sure, that may be the case. But before you go doing a million Kegels a day (please don’t do that), try one of these 3 things instead:

1. Pelvic floor RELAXATION

If you've had a vaginal birth especially with any tearing/episiotomy/trauma and/or pelvic organ prolapse, it's very common to hold excess tone or tension in your pelvic floor. Why? When we experience pain or symptoms like prolapse or incontinence, we often clench our pelvic floors in anticipation of reproducing these symptoms. This can happen without even realizing it! We often also clench when we’re stressed (crying baby, sleepless nights...)! So it’s fairly common for a new mom to have an increased amount of resting tension in the pelvic floor.

Now imagine going for a run with all that tension? Your pelvic floor muscles may not be able to work properly to support you! Imagine you have a really tense neck, and instead of focusing on relaxing that tension, you hit the gym and lift really heavy weights. How would that feel? Not so great! It’s the same when we have tension in our pelvic floor muscles! In order for our pelvic floor muscles to tolerate the big load that comes with running, they also need to start from a resting comfortable position and not a shortened tense position.

How do you know if you have pelvic floor tension?

The best way to know is to have a pelvic Physiotherapist perform an internal assessment.

But what if you don’t want to do that? One thing you can try at home is to practice pelvic floor relaxation BEFORE your runs. Here’s how:

• Get into the child's pose

• Inhale, while you relax your belly and your pelvic floor at the same time. Picture your pelvic floor muscles blooming like a flower. Release any gas you’re holding in.

• In this child’s pose, inhale and exhale as you practice relaxation. Repeat for 10 breaths prior to runs.

The goal of this is to restore the NORMAL resting length of the pelvic floor so that when you go for a run, your pelvic floor muscles are able to respond more readily.

2. Change your running posture to “tits over toes”

When running, lean your upper body forward so your tits are over your toes (as Brianna Battles coined the term "tits over toes" running). What this does is changes the pressure on your pelvic floor, and helps to transfer some of the load onto your glutes (butt muscles) instead of on your pelvic floor.

3. Strengthen your core, glutes, pelvic floor and legs.

You may need more time to strengthen your body. Not just your pelvic floor, but your glutes, core & leg muscles too. On top of that, you need to coordinate those muscles to work as a team. Just like a basketball team with 5 all-star players that don’t well as a team would be extremely frustrating, strong muscles that don’t work well together can also be frustrating. Coordinating the muscles take time and practice. Reach out to me if you need help - I’d love to support you!

After reading this, let me know, which of the options do you think you fall under? Which work best for you?