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I am very privileged to have an article today on my blog written by a great Physio, a wonderful advocate for women and my lovely friend Michelle Kenway, author of Inside Out, a book comprehensively outlining the Do’s and Don’ts of exercising and general fitness for women with pelvic floor issues. I always get asked about running when women have prolapse or continence problems and Michelle has comprehensively answered all the questions!
Michelle’s article follows: –

Your pelvic floor and running – how to protect and improve your support

Running and pelvic floor problems is an issue of concernparticularly for those of us dedicated runners who need our regular running fix or look out! In this article I do not seek to endorse high impact exercise such as running with pelvic floor dysfunction. Rather I recognize that many women and men seek to continue to enjoy their running throughout life, minimise their symptoms and prevent worsening of pelvic floor problems if they do exist.

Can running cause and/or worsen pelvic floor dysfunction?

Unfortunately the answer is yes, here’s why…

Running is a high impact exercise which involves both feet being off the ground simultaneously. When the heel strikes the ground during running, the physical force associated with landing passes down through the pelvic floor and then to the ground via the lower limbs. This impact can have the effect of stretching the pelvic floor muscles and connective tissue supports, particularly if they lack the strength to withstand the associated impact. When repeated over time the pelvic floor can become progressively stretched and weakened, particularly with repeated high impact exercise such as running.

Fortunately there are a number of steps you can take to improve your pelvic floor support for running:

1. Perform regular daily pelvic floor exercises to optimise your pelvic floor strength and the support for your pelvic organs (including bladder, uterus and bowel).Pelvic floor exercises improve the physical support for the pelvic organs by strengthening the pelvic floor muscles, lifting them higher within the pelvis and making them thicker, stiffer and more resistant to downward strain.


Consider using a pessary device and speak with your gynaecologist or some specially trained Continence and Women’s Health Physiotherapists about your suitability for using a pessary. A pessary is a simple device that sits within the vagina and provides physical support for prolapsed vaginal tissues. The support provided by a pessary can help to reduce prolapse symptoms and strain upon prolapsed tissues.


Consider trialling a continence device if you experience bladder problems (stress urinary incontinence) with running. Simple devices such as Contiform that sit within the vagina and support the bladder neck can help to reduce bladder leakage with exercise. Your suitability for success using Contiform can be trialled by using a tampon during an exercise session and monitoring the effect upon your bladder symptoms. (Note that tampons are not a device designed for long-term use as a bladder support and should be worn according to their instructions to reduce risk of toxic shock.)

There are a number of strategies that can help you to reduce the impact of running upon your pelvic floor:

1. Mix up your running surfaces
Running surfaces such as gravel, sand and grass can help to reduce the impact associated with running.  Continually running on hard surfaces such as roads, cement paths and treadmills causes higher impact upon the pelvic floor.
2. Reduce your stride length

Long stride length increases the impact of running. Reducing stride length and keeping your hips more above the foot with impact helps to reduce the potential for joint and tissue strain. High speed running will be more likely to cause greater pelvic floor impact and downward pressure on the pelvic floor so slow down your speed wherever possible.

3. Reduce running distances

Repeated impact with running will increase the likelihood of pelvic floor connective tissue fatigue, strain and ultimate failure. Try to alternate your running distances to include short distance runs and avoid repeated long distance road running wherever possible.

4. Wear well cushioned footwear

Well cushioned running shoes are a must for reducing impact when running. These will help protect the joints and tissues of the pelvis and lower limbs and are well worth investing in as all dedicated runners will know.

5. Avoid downhill running

Stick to running on flat surfaces whenever you can. Downhill running increases the impact of body weight on the pelvic floor.

6. Mix up your workouts

Choose other alternatives to running on a regular basis. Seated cycling with low resistance (either at the gym or on the flat – no standing riding up hills) can provide a great ‘pelvic floor safe’ cardiovascular workout. Water running is aexcellent form of resistance and cardiovascular exercise. Water running markedly reduces the potential for strain and impact when running.

7. Manage your body weight

The weight of the upper body and abdomen is transferred directly to the pelvic floor during high impact exercise such as running. This is why overweight individuals are at far greater risk of joint and tissue injury including pelvic floor strain with high impact exercise. If you are overweight or should you gain a considerable amount of weight, be aware that your pelvic floor will be placed under increased strain with running.

8. Avoid running during pregnancy and post partum

During pregnancy the pelvic floor tissues soften in preparation for childbirth. They are also placed under strain from the mother’s increasing body weight and the weight of the growing baby. Pregnancy is the time to choose low impact exercise for pelvic floor protection. Immediately following childbirth the pelvic floor is weak, floppy and lacking support owing to the combined effect of: pregnancy, childbirth, decreased oestrogen (when breastfeeding) and physical fatigue. This is one of the times in a woman’s life when the pelvic floor is at its most vulnerable. Take the time and exercise to recover your pelvic floor strength and function after childbirth before returning to high impact exercise.


Hoping this running information helps you to stay healthy, well and continue your enjoyment of running if that’s what you love to do! Thank you Sue for allowing me the opportunity to feature as a guest writer on your wonderful site, Michelle.


For more information on pelvic floor safe exercise and free online exercise videos visit Michelle at