When I found out I was pregnant I decided that I would run as much and as often as I could throughout my pregnancy. In the first trimester this was not a big deal as I was already training for the Marine Corps Marathon and my body was adapted to frequent runs. By the time I was in the third trimester I was running at a significantly slower pace with less frequency and one additional, major change…pit stops.Don’t get me wrong, it’s not like I’ve never made a pit stop on a run before but usually it’s after 13 miles on a long run. Running pregnant, I experienced a new kind of urgent need to hit the head. I assumed the way I was carrying my baby was right on my bladder, and I was lucky if I could go a mile without having to hurry into the bushes or a porta-pot fortuitously placed along my route. When I expressed my concern to my doctor over my need to frequently relieve the pressure on my bladder she commented that it might be necessary to do physical therapy to strengthen my pelvic floor if it didn’t improve after giving birth. She also suggested I do kegel exercises, something I’d read about but not really understood. Her brief explanation of both the pelvic floor and the kegels was that doing kegels to strengthen the pelvic floor would help improve bladder control.
The Pelvic Floor
While I was somewhat gratified to know that there were exercises I could do on my own (definitely no need, in my opinion, to pay for physical therapy) to strengthen my pelvic floor and fix my constant need to pee, I was stumped that I had not really heard or read much about this before. In talking with Christine Krauth, one of my dearest best friends, who is also a pilates instructor with specialties in pre- and post-natal pilates, I became acutely aware of the lack of information out there for pregnant woman about the pelvic floor, its importance and how to maintain and strengthen it. The pelvic floor is of course critical in giving birth but is also a major muscle group that can be integral to running. Christine is sending me a full package of information about the pelvic floor and related exercises so I will write a follow-up post on this particular topic once I have learned more. But the lesson learned already is that I should have been doing more while pregnant to keep this hidden part of my body in shape.
Christine also reiterated what my doctor suggested which was to do kegel exercises during and after pregnancy. She had also given me a book on pregnancy that referenced kegels but for the life of me I didn’t understand what they were, how to do them or why they would help. In my best attempt to paraphrase (and Christine will jump on the comments and correct me if I’m wrong) kegel exercises help strengthen the pelvic floor by tightening up the muscles that became loose delivering a baby. I learned that those muscles stretch and drop when pushing a child out vaginally and that it takes time for them to get back up into place. Kegel exercises (and rest) can help this process. The more undue stress that is put on those muscles immediately after birth (like when I tried to run in the first week after delivery), the harder it is for them to reposition thereby causing long-term weakness and ongoing bladder problems.
All Christine had to do was relate the importance of the pelvic floor and the influence of kegels to running for me to understand I needed to take this seriously. So, how to do kegels? Again, Christine had the best explanation I’d heard and so I share it here: pretend that you are going to the bathroom and all of a sudden someone walks in on you and you stop your pee stream. The contracting done to stop the pee stream is a kegel exercise. The goal is to contract that muscle and hold, then release. Contract for 5 seconds, release for 5. Then hold for 10 seconds and release for 10. And so on. However, don’t do what I did and practice this while actually peeing. According to the Mayo Clinic, this could actually cause a UTI.
All this is barely grazing the surface of how to take care of the body before, during and after pregnancy but there is no doubt that the things one would do to take care of themselves as a runner directly apply to how to take care of themselves as a running mother.
And on that note, I have to go to the bathroom.