Running with poor pelvic floor- what is your solution

(323 Posts)
Runlikeareindeer Sat 21-Dec-13 10:52:32

So my pelvic floor isn't great after two vaginal deliveries, one that was forceps. I do my exercises (prob too late)

I'm running again and it is often difficult to control. I've tried tena lady (well the Aldi version) but sometimes that becomes sodden and then I have a great lump in my pants.

Is there anything I can do?

stephanienikkigomez Tue 20-May-14 09:43:36

I am a french women and was looking everywhere in London to find a good physiotherapist for my pelvic floor. In France it s normal to have a prescription after each pregnancy. I was looking everywhere to find this service in london.
Now i just finished my rehab with mummy's physio, they are specialist in all pelvic / women related issue and i advice anyone to use their services they are amazing . I am now back to running, no more incontinence , no more back pain. you can check them out www.mummysphysio.com

Thanks for this thread. Just read the whole thing! was supposed to be cooking dinner
I think I have a slight prolapse after (bravely) looking at the images Gussie posted, except mine is the other way around i.e. the bulge is from the back. Does it make a difference if you have the prolapse from the front or the back?
I am 42 and have had 3 children, all vaginal deliveries.
After my 2nd baby I did go to the doctor as I was worried things didn't seem normal down there, but she reassured me it was just how my vaginal opening had stretched & torn, so it looked different. But now after my third I am worried again it's not 'right'.

It doesn't cause me much discomfort generally - its not painful, and sex is fine - but I do find tampons work their way out which is annoying, and I occasionally leak. Not daily, but occasionally e.g if I exercise without going for a wee first, or sometimes when I cough. And after going on a friend's trampoline the other day, I now understand what people mean!!

This has been a very interesting thread to read. A little disheartening is the bit about not doing impact exercise, as I really need to drop a dress size and tighten up my saggy tummy, so had been doing some exercise DVDs and feeling rather proud of myself, but now wonder if I should carry on sad. Cycling is not an option as I live in a city with lots of busy roads so don't feel confident going out on my bike. Swimming I could do once a week, but the advantage of the DVDs is that I can do them every day at home without needing to find childcare so I can fit them in easily. I wonder if I do the pelvic floor exercises if I can do the aerobic exercises too?

I am going to domyblardyexercises regularly and see if that helps.

A couple of my friends had the operation, but I know it took them a while to recover and if it only has a life of 10-15 years that's not so great, so don't want to follow that route just yet.

fivecupsoftea Thu 17-Apr-14 11:58:08

I've just discovered this thread and have skim read all 13 pages. I am hypermobile, is there any hope for me in recovering my pelvic floor? I love running and tennis. I'm working hard at my pelvic floor exercises, but getting nowhere. Do I need to stop running for a bit - will that help? I'm seeing a specialist physio in a couple of weeks time, and am dreading hearing advice telling me to stop running, but I will do it if that what it takes. Is there any specific advice for people who are hypermobile?

That's positive though that they are going to do something about it! Tough decision to make in the mean time sad

runningLou Thu 10-Apr-14 14:54:51

Have weights, wear mooncup, and have started Pilates to build core strength ... no joy so far sad
Urologist said I need to come back for urodynamics test where basically they get to you wear a catheter whilst jogging on the spot to see how bad the loss really is. Not looking forward to that!! That'll be in a month's time.
They also said in terms of surgery options it's really a question of whether I want any more kids (have DD and DS) as I wouldn't have the possibility after the op ...

How did you get on with the urologist? There's a lot of advice up thread about the different exercises and also wearing a mooncup. Never tried personally but are the weights worth thinking about? Also yoga is great for general core strength which I think helps too. Running must one of the toughest things for your pf to cope with but if you love it and I assume you're good at it with a sub-50min 10k!!! then it's got to be worth trying everything above! Sorry I don't have personal experience, I've had two quite big babies but been religious with my exercises and I do quite a bit of lifting and pushing with my job which I think helps.

runningLou Wed 09-Apr-14 10:07:20

just bumping blush

runningLou Mon 07-Apr-14 08:21:16

I hope people don't mind me resurrecting this thread? After some urgent advice!
Had an absolutely horrific and disgusting experience yesterday running a 10k race. I was wearing a Tena lady extra, which I do need as I leak A LOT when running. Am 34, have had 2 normal deliveries, PF has been awful after each one then with physio has got back to the stage where it's not so much of an issue day-to-day, but is still disastrous when exercising.
Yesterday (and I really hope this isn't TMI for anyone), I was running hard (really wanted to be sub-50 and it's a difficult course, first half all hilly and on muddy gravel trails not roads), and basically the pad got unstuck, and started drifting, first out of my knicks, then down one thigh (at this point I was totally freaking out about what the runners behind me might have been seeing!!), then came to rest just above my right knee!!!!! I was wearing knee-length leggings - luckily with a short running skirt over so the initial lumps and bumps weren't visible. Anyway I ran with this for a while then thought - sod it - as I could feel it was preoccupying me and I knew I couldn't run properly and also I was so worried it would just fall out!!! So I stopped for a sec, yanked at it, and all those little gel crystals, like in a disposable nappy, just went everywhere!!! Managed to salvage most of it, chucked it in the hedge (sorry, course marshalls!), and ran on. Didn't notice until the end of the race but throughout I still had a bulge over my right knee which resulted in a shower of gel crystals again when I took my leggings off. Mortifying.
I was still sub-50 - squeaked in at 49:58!! But, I am just sooooo depressed by this.
Anyway later today I have an appointment with urology at the hospital as the state of my PF has been getting me down so much that GP referred me. Just wondering if anyone has any advice as to what help / intervention I should ask for?
I have been assessed for TVT before but consultant said things weren't bad enough and also I was too young at 34 as the op needs to be repeated every 10-15 years and that would be a lot of repetitions in my lifetime.
Reading the message above I'm thinking I probably need to cut out caffeine entirely - am on de-caff tea and coffee and only have 1 cup of either per day, otherwise herbal tea and rooibos - but maybe this is still too much?
Any help or advice appreciated!

CorrieDale Sun 16-Mar-14 19:03:26

Ah yes. Caffeine. I love coffee but avoid it on taekwondo days. The GP i saw about my prolapse told me to drink plenty of fluids but not tea or coffee because 'they make you wee differently'. Not sure what she meant but coffee does make me leak more. I have my tea very weak so my PF tolerates it better.

Bollard Sat 15-Mar-14 21:01:19

This thread is great smile. I have a problem with stress incontinence. I had specialist physio which improved the strength and tone, but didn't translate into solving the problem. I was booked in for a TVT a couple of years ago but chickened out at the last minute. In the past 6 months I've tried other ways of dealing with it. I find that if I drink virtually no caffeine I'm much better. I also did the C25K plan and was pleasantly surprised to find that, so long as I was careful, the problem because much better. I still need pads but it's a huge improvement and I'm now running 5K (quite slowly) a few times a week.

However, there are times in my cycle when the problem gets loads worse, usually mid-cycle. I went out for a run on Friday and had to walk home as I was so pissy sad. I've been eating more sugary food than I should (cutting down on sugar seems to help) but even so, it was really bad.

I don't think I'm prepared to accept the risks of a TVT. For an op that isn't life-saving, the risks seemed too high and too scary. I'm really trying to listen to my body about what exercise works for me, and was prepared to not pursue the running, but now love it and would hate to give it up, and apart from Friday I generally feel as though it's fine. It's been v bad today as well, much worse than usual. Loads of peeing, loads of leaking...

CorrieDale Sat 15-Mar-14 20:44:47

So glad to have stumbled across this thread (obviously leaking a bit as I fell!)

I had a uterine prolapse after acquiring a bout of bronchitis 3 weeks after giving birth 6 years ago . I saw a physiotherapist and she gave me some exercises and info, and scared the dickens out of me about how doing the exercises wrong was worse than not doing them at all! Anyway, I did them and things improved. The coil has helped because it was worse when I had my period. Losing 3 stone really helped too. Obviously, once everything was pretty much back where it belonged, I let the exercises slide (not that I go on the slide myself of course because I dribble wee as I pick up speed.)

I now do Taekwondo and the white suits coordinate very poorly with my weak pelvic floor - otoh, you can hide a hammock under the baggy trousers so it isn't all bad! But it's hard to kick effectively around a hammock! This thread has made me believe there is a better way... Giving up Tkd isn't an option so I started with 10, 10, 3 yesterday and have even set phone reminders so I don't let things slide once my PF improves a bit.

I did check out iPhone apps. There's an NHS one that looks good but I am allergic to paying for apps! And they seem obsessed with discreet reminders - I am pretty open about my saggy pelvic floor and if doing the exercises brings about any improvement I shall be even more open!

RunRunRuby Tue 11-Mar-14 08:58:45

Ooh a badge. That's almost as good as stickers.

I may have ahem overexercised the other day, I now understand what you meant. Will be more careful in future! I was on a long car journey (as a passenger) and bored so thought I'd use the time productively.

I've started walking every morning. It's a nice way to start the day anyway and easier to motivate myself to get out of bed for a walk than for a run!

Will ask bowel nurse about specialist physio, she must be fed up of me requesting things I've read about on the Internet grin

Will the continence physio be okay seeing me given that I haven't had any continence issues? Presumably they're still the best person as have extensive knowledge of that area and hopefully experience of this op. I feel like a bit of a fraud but I don't want issues when I'm older. Especially as my medical team are planning for me to have twins which I'm sure will test my pelvic floor strength grin I had to wear those big Tena pants in hospital after my first surgery as I was bleeding and they wouldn't give me sanitary pads instead angry it was absolutely the most humiliating experience of my life and I never want to wear one again!

I've been promoting pelvic floor exercises to everyone, including several strangers in Aldi who may have overheard me instructing my sister on the techniques and their benefits blush

Thank you, you are fabulous grin

gussiegrips Thu 06-Mar-14 12:20:20

Yep, get a specialist. It's common to get trigger points in the muscles (pelvic floor dysfunction) they can cause the pain you describe. Similar to the post-whiplash pain folk get in their neck/shoulder. Works with a bit of prodding, so, finger up the fanjo/jacksie stuff, but, it does work. You can do it yourself, and there's some "interesting" looking gadgets to help that.

Speak to specialist bowel nurse, tell her you've chatted to a random stranger about your sore arse, show her the posts, and ask her to refer you to a continence physio. The problems you describe don't sound insurmountable.

Am really pleased you're so motivated. In fact, I'm considering making badges a la Blue Peter to distribute to people who earn them. Getting one earns you free entry to your own vag.

RunRunRuby Wed 05-Mar-14 19:43:49

Thanks gussie no continence nurse as I've not had any issues, it's more that they wanted to check my pelvic floor was alright and teach me the exercises so that it holds up in the future! smile I have a specialist bowel nurse who can advise on things and refer me for stuff etc.

Last physio was attached to GP surgery so walls thankfully but not a specialist. Will ask bowel nurse if she can recommend one.

The nerve pain is in my bum (lovely, I know) it's been investigated a bit but don't think there's anything they can do. I've just started on gabapentin so hopefully that'll do the trick. It's not exactly related to running but running, and walking sometimes, triggers spasms in my pouch and then that sometimes triggers the nerve pain. It happened earlier when I ran to cross a road hmm so definitely going to take a break from running from now! But when I was running three times a week it gradually happened less which is why I thought running might be helping everything, hopefully if I just walk instead it'll have same effects smile

Thank you for all your advice!

gussiegrips Wed 05-Mar-14 19:22:21

Yep, you'll be best off with a specialist continence physio - pee and poo are bread and butter to us. A musculo-skeletal physio will be comfortable dealing with pelvic floors and cores, but, possibly less confident in talking about keech. Besides which, you're usually only separated by a curtain in an outpatients department, and for this stuff you really need a room with actual walls so you don't scare the poor patients listening in.

The nerve pain's worth having investigated too, especially if it's a running related thing. Sometimes the nerves get kind of tethered by scar tissue. It can be easily corrected, but, like all things pelvic, if it's ignored then it can worsen and becomes intractable after years. Again, common after big abdo surgery, and, you don't need to put up with it, particularly if it's going to interfere with your exercise regime.

Totally agree, get your core sorted and then you'll be fine to do whatever exercise you like. PM me where you are, if you like, I'll possibly know someone in your area or which department you're looking for.

I presume you've got access to a continence nurse? They can refer in some areas too.

Happy to help. x

RunRunRuby Wed 05-Mar-14 14:43:19

Brilliant, thank you gussie I will try and get a referral to a physio. Yes I still have my sphincter but much more dependent on my pelvic floor. My previous physio looked horrified when she realised it wasn't wee that I was worried about sad so I think I will ask my specialist nurse if she can recommend one who is more used to bowel surgery patients smile

I've had a bit of a break from running due to nerve pain but it did feel a bit ummm wobbly(?) when I was running so assuming I don't have good muscular support grin I mistakenly thought that the running would help strengthen everything but really I need to be stronger first!

I will be careful to avoid fanny fatigue grin and will look into foofoo fun club!

Thank you again, I'm really grateful to have found this thread and your great advice otherwise I would've carried on doing ineffective stomach exercises and straining my poor pelvic floor smile flowers

gussiegrips Wed 05-Mar-14 13:19:36

Ruby, first, glad you are well.

Second, glad you're doing your exercises! I've not got loads of experience with post-surgery, mostly they land up with colleague who's a dab hand with chronic pelvic pain. My understanding is that you'll still have your sphincter, but, the pf muscles function will help maintain continence.

Sounds to me that you need to strengthen your core a bit before doing plank etc. Plank and all that you're doing are fantastic exercises, but, if you don't have the core control you'll cheat, and that spikes your intra-abd pressure and that will lead to stress on your pf.

And, yep, exercise for folk like you is medicine. Well, it's medicine for all of us, really. So, I'd advise you to get a referral to a physio, or, if your pilates instructor's good, get her to have a look at your core control. You'll be free to do impact activities, as long as you have good muscular support.

So, you want to be assessed to make sure you are able to engage your TA and multifidus, that you can lift and lower your pf and that you can hold the lot in when you do movement or hold a position.

don't suppose you're near a foofoo fun club? I met Jenny at the weekend, these are really good classes (not an employee or affiliated!)

Do as many exercises as you like. There's no real limit, as long as you're not wearing yourself out! You know that stiff feeling you get in your leg muscles the day after a hard session at the gym? Want that in your fanjo? <shudder> So, no fatigue, but, otherwise, repetition is good.

x

RunRunRuby Mon 03-Mar-14 23:08:33

Wah. I don't leak wee but something made me click on this thread and now I've realised I've probably been doing all the wrong exercise! sad

I haven't had children but just over a year ago I had surgery for bowel cancer. I've had my colon and rectum out, which involved an incision from belly button to just above pubic bone, so right through my stomach muscles. I now have an ileo-anal pouch which is a pouch made from my small bowel, I'm not 100% sure how the muscles work but it relies on pelvic floor more than a normal rectum. The surgery rather weakened my pelvic floor, but I haven't had any leakage possibly because the catheter has done something weird to my bladder.

I have an Aquaflex, but got out of the habit of using it as I've been having nerve pain elsewhere and didn't want to aggravate it. I also find it quite hard to get it into position. I'm pretty sure my um lady bits slope to one side. Is this possible? And is it a problem? It's only since the surgery. I don't think I have a prolapse as I saw a gynae to have my eggs frozen and I think she would've mentioned it if she'd seen one while she was in there. I saw a physio about pelvic floor exercises, she recommended the Aquaflex, but she didn't examine me and I only saw her twice. I was then told by my medical/surgical team to just exercise however I wanted.

So I've been running and also doing the seven minute workout every day including push ups, crunches, star jumps and the plank sad I had been meaning to ask my surgeon about the plank etc. as when I do it my tummy bulges downwards, even when I'm sucking my muscles in really hard it has little effect, whereas I can suck them in quite effectively when I'm standing. It sounds like this is actually a sign that the exercises are not appropriate blush

Cycling and swimming are not currently options for me, so is walking the only exercise? I don't want to do anything to jeopardise my pelvic floor but my oncologist told me the only thing I could do to reduce my risk of recurrence was to exercise so I'm keen to do something smile

On the subject of pelvic floors in labour, for those who have mentioned it, my Pilates instructor has recently changed the instructions in our class when we tighten our cores, now she says not to pull up on the pelvic floor itself as apparently if your pelvic floor is too tight it can make it difficult to give birth as the muscles don't relax enough to let the baby out. I ignore this as I will never be able to give birth naturally and my pelvic floor needs all the help it can get.

I do my exercises every day. Is it okay to do all three lots of each in one go or am I meant to do them at three different times during the day? I do bonus ones when I'm bored in lectures or whenever I remember grin

One last thing, for anyone who finds themselves suddenly desperate to go, when I first had my surgery it often felt like I couldn't hold on and I'd end up rushing to the bathroom, which is what prompted me to see a physio. The absolute best advice she gave to me was to breathe out. It's really hard to force yourself to breathe out at the time as you instinctively hold your breath but breathing out reduces the pressure on your pelvic floor and it honestly does help. It also reduces the panicky feeling.

Sorry for a massive rambly post blush

kentishgirl Mon 03-Mar-14 15:40:13

Thank you for the advice, Gussy

cowsarescary Fri 28-Feb-14 16:04:36

I do feel that if Gussie and Piglet John were Put In Charge Of Everything, we would all be grateful.

gussiegrips Fri 28-Feb-14 15:58:45

Kentish - see, that's where I think MN could be really helpful for folk because it can be completely anonymous. Handy if you are shy.

So, a prolapse is essentially a hernia in your vagina. Think of it like a ladder run in your tights - part of the vaginal wall is weak, but intact, so the organs above it will drop into your vaginal vault. They can do that a wee bit, a lot, or "holy crap, WTF is THAT?".

Low grade prolapses can be managed conservatively, in fact, there's a paper to be published in the Lancet tomorrow (how cutting edge am I!) about this very thing - it's a really good paper. lancet prolapse study. The findings are, do your bloody exercises

If you're having problems pooing it's possible that the rectum's sagging forwards slightly. That disrupts the mechanics and a bit of poo can get "stuck" - which is why folk land up using a bit of jiggery pokery to shift it. There is a tool you can get called a femeeze. It looks like a pink shoehorn, but, is handy if you can't quite get the pressure in the right bit. www.mdti.co.uk/Female-Health-Products/View-all-products.html It might be available on prescription, ask your GP. If not, it's made by MDTi, that link's to the shop.

Prolapse is very common. Avoid heavy lifting, straining and becoming constipated. Try very hard not to get the flu, coughing and puking won't help.

Learn to contract your pelvic floor before you go to cough or sneeze or lift, it's very helpful habit!

Take your fanny to a doctor, Kent. Get a referral to a women's health physio. do your exercises, three times a day, and don't panic.

Got one myself. It's alright. Just got to do the exercises and drink plenty water, but, they can worse if not looked after.

Well done for posting too!

kentishgirl Fri 28-Feb-14 12:58:03

Oh and I'm late 40s and had a child in early 20s, if that's relevant.

kentishgirl Fri 28-Feb-14 12:56:28

This thread is brilliant - thank Gussie.

I have these problems and I've never talked to anyone about them.

I have some stress incontinence when jumping about. And if I cough. Not usually too bad but enough that I'll wear a pad if going out dancing.And when I had bronchitis last winter I spent 3 days off work sitting on a pile of towels (as in bath towels, not knickers ones) pishing myself constantly as I was violently coughing. And when I was vomiting at a friends house for a couple of hours I also completely pished myself and all over her bathroom floor (embarrassing).

I also get what you've described as urgency incontinence - although I don't go to the loo all that much, I think I just hang about too long and with a full bladder some things act as a 'trigger'. Something to work on there - I can see it is behavioural

I always thought the exercise were a bit of a fobb off and didn't do much but now I've read this thread I'm going to start doing your 3 times a day ones religiously. Thank you.

I'm a bit confused about what a prolapse is and how you know if you've got one - and will doing the exercises help with this? Or at least to try first before seeing a doctor? The reason I wonder about it is actually when I'm doing a poo. My perenium sort of bulges downwards and I have to push it up with my hand to get the poo out.

I can't believe I've just typed all this but it's a relief (ha ha) to get it all out.

gussiegrips Fri 28-Feb-14 12:09:27

Yep, zapper thingie is great. You can buy electrical stimulation units online, but, I'd advise anyone to buy a physio assessment rather than just getting a gadget.

They are good for people who are so weak they can't initiate a contraction.

And, yep, a self reporting, broad study would be a starting point. Clarity of incidence, awareness, compliance and activity levels would be handy.

I'll get there - it's slow, but, am getting there!

afussyphase Fri 28-Feb-14 09:29:34

Thanks Gussie! Clearly some people also need support in addition to the exercises, as well as support to know exactly how to do them (I know, it sounds simple, but personally I was trying to hold for longer than the muscles could actually hold, so it wasn't very effective, and trying to do the 'flicks' too fast -- according to my NHS physio/b&b specialist). The NHS do a zapper thingy that gets the muscles strong enough to benefit from the exercises...

MN might be a good place to start but ideally you'd get a large cohort eg from pre-natal services and do a prospective study where you could get data from testing the muscles rather than relying on self-reports. Personally I don't have the skills (or the time!) though smile

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