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What causes pain "down there" after running and high impact sports?
Pain after running is often a result of weak pelvic floor muscles. Your hips, sacrum, butt, hamstrings, and core are all tied to the pelvic floor, and a misalignment or weakness in any of these areas can make your most intimate muscles hurt. The constant pounding when running, a naturally high-impact activity, magnifies the problem and further weakens an already weak pelvic floor.
Tips on preventing pelvic floor pain after running
Strengthen your pelvic floor, core, and butt! Start yoga, work with a physical therapist, do what you can to learn how to safely build tone and endurance "down there." It may be worth it to back off of running for a few months and focus on strengthening, then gradually get back into your bouncy, high-impact runs.
Learn proper breathing techniques. Many people don't take full breaths or will suck in their tummies on an inhale. Stop doing that! Breathe deeply and allow the chest, ribs and belly to move so that the pelvic floor experiences its full range of motion.
Don't focus on keeping the pelvic floor lifted as you run. This is a common problem, especially for people living with prolapse. You may think it's good to keep the organs up the entire run, when it's better to allow the pelvic floor to naturally move and flow with you.
Here are two exercises that target the muscles you need to strengthen:
*In both of these exercises, breathe continuously and deeply. Don't hold the breath, and ALWAYS get the permission of your doctor before attempting this or any other exercise.
Squat: This strengthens the legs, butt, and pelvic floor. To do this safely for the pelvic floor, keep the knees behind your toes, stick our your booty, pull your tailbone toward the back of the head, and maintain a straight back. Staying down helps stretch the pelvic floor and moving up (tucking the tailbone under slightly) helps build strength. Bonus - working on holding down and then coming up also helps strengthen the muscles around your tailbone, which can be another pain point for runners.
Bird-Dog: This builds core strength without the added pressure to the pelvic floor that you experience in crunches. Maintain hip-distance with the knees and feet. Kneel down and maintain 90 degrees in the hips and knees. Extend one arm straight out as you also extend the leg on the opposite side. To keep the pelvic floor safe, keep the hips constantly pointed toward the ground, level with the floor. If it's too much to extend arms and legs, just extend one at a time (one arm then one leg). The act of maintaining the position of the hips while extending your limbs with a straight back is what is helping build your core strength.
Do you have to stop running if you have pelvic floor problems?
Only you and your doctor can decide this, but in my experience it is possible to prevent pelvic floor pain after running or jogging. I live with prolapse and spent a little over a year slowly and consistently strengthening my core and pelvic floor before I was brave enough to get back into running. I have lost my passion for long-distance running, but know increasing the distance is possible now that I'm strong enough.
The key is to be methodical in your approach, not jumping right into running without first strengthening the right muscles. My solution has been to do pelvic floor yoga (which often includes some pilates) three times a week, but there are lots of other strengthening options out there.
Pelvic Floor Yoga
If you're looking for a place to start and want to explore yoga videos that are focused on the pelvic floor, check out https://www.yogabelowthebelt.com There are weekend streamed classes available and a lot of videos in the growing catalog that will help you get started on your pelvic floor health journey.