Running with Prolapse: How to Protect and Strengthen Your Pelvic Floor

Running with Prolapse: How to Protect and Strengthen Your Pelvic Floor

Pelvic organ prolapse (POP) is more common than most people realize. It occurs when the pelvic floor muscles and connective tissues weaken, allowing one or more pelvic organs—such as the bladder, uterus, or rectum—to descend or “prolapse” into the vaginal space. While prolapse can feel discouraging, it doesn’t necessarily mean giving up activities you love, like running. With the right knowledge and approach, many people safely return to running while supporting their pelvic health.

Understanding Prolapse and Running

Running is a high-impact activity. Every foot strike generates force through the pelvis, and if your pelvic floor muscles aren’t strong or coordinated enough to manage that pressure, symptoms like heaviness, bulging, or discomfort can worsen. However, research and clinical experience show that tailored pelvic floor strengthening, proper technique, and progressive training can make running both safe and enjoyable again.

Before resuming or starting a running program, it’s best to consult a pelvic health physiotherapist. They can assess your specific type and grade of prolapse, teach you how to activate your pelvic floor correctly, and design a gradual return-to-running plan.

Key Tips for Running with Prolapse

1. Start with Low Impact. Begin with walking, cycling, or swimming to rebuild endurance before transitioning to short jogging intervals.

2. Focus on Breath and Posture. Avoid breath-holding (which increases intra-abdominal pressure). Try exhaling gently on exertion—like when pushing off the ground.

3. Check Your Alignment. Keep a slight forward lean from the ankles (not the waist) to reduce downward pressure.

4. Build Core and Glute Strength. A strong, coordinated core—especially deep muscles like the transverse abdominis—helps stabilize the pelvis.

5. Use Support if Needed. Some people benefit from a pessary or supportive shorts for extra comfort and confidence during runs.

Best Pelvic Floor Exercises for Runners with Prolapse

Here are a few pelvic floor and core-friendly exercises that can help you rebuild strength and control. Aim for consistency—just a few minutes daily makes a big difference.

1. Pelvic Floor “Lifts” (Kegels with Breath)

• How: Sit or lie down comfortably. Inhale to relax the pelvic floor; exhale and gently draw up and in, as if stopping the flow of urine or lifting a marble.

• Reps: Hold for 5 seconds, relax for 5 seconds. Repeat 8–10 times.

2. Quick Flicks

• How: Quickly lift and release the pelvic floor muscles.

• Why: These help your muscles react to sudden impact (like foot strikes during running).

3. Heel Slides

• How: Lying on your back, gently slide one heel away from your body while engaging your pelvic floor and lower abs. Return and repeat.

• Focus: Keep breathing and avoid doming through your stomach.

4. Bridge with Exhale

• How: Lie on your back, knees bent, feet hip-width apart. Inhale to prepare, then exhale as you lift your hips, gently engaging your pelvic floor. Lower down on the inhale.

• Progression: Add a resistance band around your thighs to engage your glutes.

5. Wall Sit with Pelvic Floor Engagement

• How: Lean against a wall in a half-squat. On each exhale, gently lift through your pelvic floor and lower belly.

• Why: Builds endurance and coordination in a functional position.