Pelvic Floor Physical Therapy for Runners: Preventing Common Injuries
Running is one of the most enjoyable and accessible forms of exercise, requiring little more than a good pair of shoes. It's a favorite activity for millions around the world, whether for fitness, competition, or pure recreation. Many people are drawn to running not only for its physical benefits but also for the mental boost it provides—thanks to the release of endorphins, the "happy hormones" that elevate mood and reduce stress. While runners often focus on leg strength and cardiovascular endurance, few recognize the vital role the pelvic floor plays in supporting core stability, improving movement efficiency, and boosting overall performance. A strong, well-functioning pelvic floor can be a game-changer for runners of all levels.
Fortunately, pelvic floor physical therapy can both prevent dysfunction in runners and effectively treat existing symptoms. In this blog, we’ll explore why pelvic floor health is essential for runners and how the expert care at Lilly Physical Therapy can help you stay strong, supported, and symptom-free.
Why are Runners Prone to Pelvic Floor Dysfunction?
While strong pelvic floor muscles can enhance endurance and performance in runners, they’re also vulnerable to dysfunction—especially when not included in regular training and recovery routines. Running is a high-impact, repetitive activity that places significant stress on the pelvic floor. Over time, this can lead to muscle spasms, pelvic pain, stress incontinence (involuntary urine leakage), prolapse, low back/hip pain, and other forms of pelvic floor dysfunction.
Runners may be more prone to pelvic floor dysfunction during times of hormonal change. For instance, postpartum recovery can weaken or injure the pelvic floor, making high-impact activities like running more problematic. Similarly, hormonal shifts related to menopause or menstrual cycle fluctuations can increase the risk of pelvic floor issues in women who engage in running or other intense physical activities.
Running Injuries Associated With Pelvic Floor Dysfunction
Contrary to popular belief, pelvic floor dysfunction does not only cause bladder or bowel issues. It can also trigger a range of musculoskeletal conditions that affect your movement patterns and overall stability. The following are some of the most common injuries that runners may experience if they suffer from pelvic floor dysfunction:
- Low back and pelvic pain: Pain and discomfort in the lower back and pelvis is one of the most common conditions associated with pelvic floor dysfunction. Runners suffering from pelvic floor dysfunction may experience muscle imbalances and increased strain, limiting body parts that facilitate movement.
- Hip and Groin injuries: Pelvic floor dysfunction may overwork the hip muscles due to overcompensation, leading to strains, tendinopathies, or impingement in the hip adductors and flexors, or the groin region.
- Hamstrings Strain: Pelvic floor physical therapy can aid hamstring strain recovery by addressing the interconnected muscles and fascia of the pelvis, hips, and hamstrings. Therapists use targeted techniques such as manual therapy, soft tissue release, and neuromuscular re-education to reduce tension, improve blood flow, and restore proper movement patterns. By correcting pelvic alignment and strengthening supporting muscles, therapy promotes faster healing, prevents re-injury, and improves overall lower-body function.
- Sciatica: Pelvic floor physical therapy can help relieve sciatica by addressing muscle imbalances, tension, and pelvic misalignment that may compress or irritate the sciatic nerve. Through manual therapy, gentle stretching, nerve gliding, and core stabilization exercises, therapists reduce pressure on the nerve, improve mobility, and restore proper body mechanics—promoting long-term relief and preventing flare-ups.
- Knee Pain: Pelvic floor physical therapy can help resolve knee pain caused by pelvic instability by restoring balance and control in the core, hips, and pelvis. When the pelvis is unstable, it alters leg alignment and places excessive strain on the knee joint. Therapy focuses on strengthening the deep core and pelvic muscles, improving alignment, and retraining movement patterns—reducing knee stress and supporting lasting relief.
- Stress urinary incontinence: Runners suffering from pelvic floor dysfunction may experience involuntary leakage of urine while running, due to weak and poorly coordinated pelvic floor muscles that are unable to support the bladder and urethra.
- Prolapse: Running can contribute to pelvic organ prolapse, especially when combined with tight hip flexors from prolonged sitting. Tight hip flexors can alter pelvic alignment and limit proper core and pelvic floor engagement, increasing strain on already stressed pelvic tissues. This, paired with the repetitive impact and pressure of running, can raise the risk of pelvic organs shifting downward, leading to symptoms like heaviness, pressure, or bulging.
- Overuse injuries: Since the pelvic floor muscles are responsible for core stability, alignment, and shock absorption, pelvic floor dysfunction can disrupt these functions and affect the lower body’s biomechanics, leading to instability. Pelvic instability leads to compensation in the knees, feet, and other body parts, increasing your risk of developing overuse injuries like patellofemoral pain, IT band syndrome, shin splints, etc.
How Does Pelvic Floor Physical Therapy Help Runners?
Pelvic floor physical therapy is a specialized form of physical therapy that is focused on evaluating, repairing, and strengthening the muscles and connective tissues of the pelvic floor. Pelvic floor physical therapy can be preventive or corrective, i.e it can prevent common running injuries associated with pelvic floor dysfunction or treat and manage PFD and its symptoms. The following are some of the common components of pelvic floor physical therapy:
Assessment and Diagnosis
This is the first step involved during pelvic floor physical therapy. At this stage, your physical therapist will perform a complete evaluation to determine the cause of dysfunction and the best treatment approaches. During pelvic floor physical therapy, you may undergo internal and external pelvic floor exam (to assess your strength, endurance, coordination, muscle tone, etc), gait and running analysis, functional movement screening, and other tests to determine the severity of your condition.
Treatment Techniques
Your physical therapist will design a comprehensive treatment plan based on your assessment results to address your treatment needs and goals. Some of the most common treatment plans that you may undergo during pelvic floor therapy include:
- Pelvic floor strengthening and relaxation exercises (kegels, deep squat, etc)
- Core stabilization exercises
- Hip and glute strengthening
- Neuromuscular re-education and biofeedback
- Pelvic floor re-training with electromagnetic field therapy
- Manual therapy to release tight muscles
- Postural and breathing training, etc.
- Expert running analysis and re-training
- Softwave therapy to speed up healing by activating stem cells and eliminate pain +inflammation
Patient Education and Lifestyle Modifications
During pelvic floor physical therapy, physical therapists also educate runners on habits and lifestyle choices that may affect their pelvic health.
Conclusion
Pelvic floor health is very important and can determine your performance as a runner. Therefore, pelvic floor dysfunction can open the door to several other running injuries, impacting your performance as a runner. If you suffer from pelvic floor dysfunction affecting your performance as a runner, you should consider undergoing pelvic floor physical therapy at Lilly Physical Therapy for corrective and future preventive care.
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