Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

floor exercises, but it will also include other specific exercises to correct any muscular imbalances that may be adding to the problem, for example weak glute muscles. The physiotherapist may also use a range of devices to help you identify and strengthen your pelvic floor muscles, such as electrical stimulation probes and vaginal exercisers. With perseverance and hard work, over 60 per cent of women find the treatment successful, but it can take months so don’t give up. As the issue of urinary incontinence becomes less taboo and awareness of the problems increases, there is more work being done to offer solutions to women, including pessaries to insert during exercise and sports shorts designed by a female engineer which mimic the structure and support of the pelvic floor muscles.

Real-life runners

I started running aged 56. It was when I started entering events and trying to run hard down hills that I found I was leaking a bit of urine. My GP recommended an app for pelvic floor exercises. This was great and along with more advanced exercises from a specialist physiotherapist, the problem was solved.

Margaret, runner, explorer and triathlete

Did you know?

Pelvic floor muscle exercises are also called Kegels, after the American gynaecologist Arnold Kegel. In the 1950s he invented a device called the Kegel perineometer to measure the strength of pelvic floor muscle contractions. He used this alongside Kegel exercises to help treat urinary incontinence.

Q Should runners do pelvic floor exercises and do men need to do them too?

A Yes and yes! The pelvic floor is a sling of muscles that runs from your pubic bone at the front to your coccyx (sitting bone) at the back. It supports your pelvic organs, including your bladder, bowel and the uterus in women. It has an important role in helping you stay continent, and weak pelvic floor muscles can result in both urinary and faecal incontinence. Weakness can result from excess pressure on the muscles such as strain from coughing, constipation, heavy lifting or being overweight. In women, childbirth and falling oestrogen levels of the menopause can weaken it too. You can strengthen the pelvic floor muscles with specific exercises and this will improve symptoms of incontinence in the majority of sufferers. The pelvic floor muscles are also involved with erectile function and having a strong pelvic floor might help you maintain an erection, prevent premature ejaculation and result in stronger orgasms. They’re important for everyone, male or female, and particularly important for those doing high impact sports such as running.

TRY THIS

AT HOME

Pelvic floor exercises

Be warned: identifying and controlling your pelvic floor muscles can take time and practice. With perseverance and regular practice you can expect to see an improvement in any continence problems within three months.

Identify the muscles The pelvic floor muscles loop around both your urethra (water works tube) and your anus. Imagine you are in a very important meeting where breaking wind is completely inappropriate. Try to squeeze the muscles that would keep the wind in. These are the muscles around your anus that you need to work. When you are next passing urine, try to stop mid-flow and feel how the muscles contract. These are the muscles around your urethra that you need to work. Men should see their scrotum lift upwards and their penis nod downwards a little. Don’t stop mid-flow regularly, only to help you find the correct muscles to squeeze. Squeezing these front and back muscles and drawing them up together and towards each other is what you need to do during the following pelvic floor exercises.

Work the muscles You can do these exercises sitting down (easiest way to start), standing or lying, anywhere at any time. No one will know you are doing them. Remember, you shouldn’t be squeezing your bottom, raising your eyebrows or holding your breath while you do them. The pelvic floor has both fast- and slow-twitch muscle fibres and you need to work them both.

1 Take a deep breath in, ensuring you fill your belly (see here). Your pelvic floor will relax when you do this.

2 As you slowly exhale, work the fast-twitch fibres by performing five short, sharp squeezes of the pelvic floor muscles.

3 Repeat this five times making sure you fully relax your pelvic floor while you inhale.

4 Now move on to the slow-twitch fibres. Take a deep breath in. Exhale slowly and gradually draw the front and back pelvic floor muscles upwards and together. Imagine an elevator travelling up the floors. As you get stronger you will be able to hold onto the slow squeeze for your entire exhalation. Aim for five to 10 seconds.

5 Repeat this five times, slowly relaxing your pelvic floor muscles back to complete rest while you breathe in.

Do these exercises three times a day for the rest of your life. You may only feel a flicker of movement when you first start these exercises, but don’t worry. They will get stronger with regular practice. Concentrating fully on the muscles will help you properly connect with them. If you can’t identify them, they are too weak to squeeze or aren’t getting stronger with practice, then see your GP.

Q Is it safe to run with a vaginal prolapse?

A In women, the bladder, bowel or uterus can sometimes drop down from their normal position and give a sensation of dragging or aching in the vagina, and sometimes a bulge or lump can appear. The usual cause is weak pelvic floor muscles that aren’t giving these organs the structural support they need. The symptoms experienced depend on which organs are prolapsing. If it’s the bladder that’s dropping down, then it’s called a cystocele and you may experience urinary incontinence, or need to pass urine frequently and urgently. You may also find that you don’t empty your bladder properly or that the flow of urine is blocked in some way. If it’s the bowel that’s dropping down, then it’s called a recotocele, which can make passing faeces difficult. Symptoms