Hey Reader,

If you’ve been following along, you know today is the final piece of my 4-point pelvic floor assessment for runners.

Don’t forget, you just can get it all in one shot -- experiencing, seeing and feeling it in real time through The Pelvic Floor Audit. It’s a FREE virtual workshop for female runners who want to enjoy running without worrying about their pelvic floor all the time. The visuals, interaction, and live feedback during the workshop make the process much clearer.

The Pelvic Floor Audit will be held live this coming Sunday, March 22 at 12pm EST.

​Click here to learn more now. ​

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4 - The Feet

The final point in the Pelvic Floor Audit looks at something many runners don’t immediately associate with the pelvic floor: the feet. But the connection is incredibly important.

During the running stride, the body moves through a coordinated chain of rotational movements. As you land and move toward mid-stance, the body moves into internal rotation and the foot moves into pronation.

Pronation is essentially internal rotation at the foot and lower leg, allowing the body to absorb force and load the system.

At midstance in the stride:

• The foot reaches maximum pronation
• The hip and pelvis reach maximum internal rotation
  ​Pelvic floor activity reaches its highest level

From there, the system transitions into external rotation as the foot moves into supination.

At toe-off, the foot becomes a more rigid lever:

• The foot is supinated
• The big toe moves into dorsiflexion
• The body uses that rigid lever to push off from and propel forward

This cycle—pronation to supination—mirrors the absorption and propulsion phases of running.

Assessing Static Foot Pressure

The first step in evaluating the feet is simply observing how you stand.

Stand naturally and pay attention to where you feel pressure in your feet. It can help to close your eyes while doing this.

Ask yourself:

• Do you feel more pressure on one foot than the other?
• Do you feel more pressure toward the front or back of your feet?
• Do you feel more grounded on the inside edges or the outside edges of your feet?

These sensations can reveal important clues about how your body moves.

For example:

• If you feel more pressure on the balls of your feet, it often means you struggle to shift your center of mass backward and find length in the posterior chain.
  If you feel more pressure along the outside edges of your feet, you may have a more supinated, rigid foot, which can make it harder to move into pronation and absorb force.
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Remember that pronation is linked with internal rotation up the chain, which in turn supports the natural lifting and loading pattern of the pelvic floor.

Assessing Dynamic Foot Movement

After evaluating static pressure, the next step is to look at how the feet respond during rotation.

1. Stand with your feet about hip width apart.
2. Cross your arms across your chest.
3. Rotate your torso to one side, then the other, as far as comfortable.

As you rotate, pay attention to how the pressure shifts across your feet and notice whether your feet maintain a tripod connection with the ground.

The tripod consists of three points:

• The heel
• The ball of the foot under the big toe
• The ball of the foot under the pinky toe

Ideally, these three points stay connected as you rotate.

If you notice that rotating to one side causes the big toe side of the foot to lift, or the opposite side of the foot to lose contact, it suggests that the feet are not rotating properly.

Instead of moving through pronation and supination, the foot may simply be tipping side to side in inversion and eversion.

That might sound like a small distinction, but it’s a big deal. When the foot tips rather than rotates, it can change the way force is distributed along the entire chain.

It might seem surprising, but the feet can often be the missing puzzle piece for runners who have tried everything else to improve pelvic floor symptoms.

If you’ve already worked on finding length in the posterior chain and improving hip movement but still struggle, the feet may be the last piece of the system that needs attention.

Bringing the Four-Point Assessment Together

The Pelvic Floor Audit looks at four key components of the movement system:

1. Stack and pressure management
   • Rib cage mobility and pelvic positioning
2. Length in the back side
   • Ability to create length in the back of the pelvis and glutes creates a natural lift of the pelvic floor
3. Hip rotational capacity
   • Internal and external rotation that coordinates the pelvic floor quadrants
4. Foot rotation
   • The ability to move through pronation and supination while maintaining a stable tripod

You may notice something important about this process.

None of these assessments directly test the pelvic floor itself.

You can absolutely work with a pelvic floor physical therapist for an internal assessment, and that can be incredibly valuable. Those evaluations often reveal tightness or restrictions that correlate with the movement patterns we’ve discussed here.

For example, if you struggle to find length in the back of the pelvis, it’s common to also have tightness in the back portion of the pelvic floor.

Pelvic floor physical therapists can help address those issues with manual therapy and targeted treatment. But ultimately, the improvements still need to be integrated with movement.

That’s where this audit becomes powerful. It helps bridge the gap between isolated pelvic floor therapy and the dynamic demands of running.

An Invitation to the Pelvic Floor Audit Workshop

Again if you’d like to work through this process in real time, I’m hosting the Pelvic Floor Audit Workshop on March 22 at 12 p.m. Eastern.

This is a free virtual workshop designed specifically for female runners who want to enjoy running without constantly worrying about their pelvic floor.

During the 90-minute session, we’ll walk through the entire four-point assessment together. You’ll see the movements visually, feel them in your own body, and receive guidance on how to interpret your results.

By the end of the workshop, you’ll have identified the main contributing factors behind your pelvic floor symptoms and will leave with a clear action plan for addressing them.

Remember, if you’re leaking while running, you’re likely losing power in your stride as well.

Improving pelvic floor function isn’t just about symptom management. It’s also about running more efficiently. It’s about a stride that feels more fluid and free.

Imagine finishing a race without worrying about leaking during your final kick. Imagine pushing hard on a downhill without fear of losing control. Imagine running routes based on what you enjoy—not where the bathrooms are.

Instead of relying solely on breathing drills, squeezing exercises, or isolated pelvic floor strengthening, the goal is to identify the root cause and address it as part of a system.

When you register here you’ll receive:

• Supporting resources sent via email
• A one-page assessment tracker so you can record your results and observations
• And the link to join the live workshop when it’s time

On March 22, you’ll join live, work through the assessments together, and connect the dots so you can move forward with a clear plan instead of simply managing symptoms on the surface.

If this information resonated with you, or if you know another runner who might benefit from it, forwarding it could help someone else finally connect the dots between their pelvic floor symptoms and their running mechanics.

Your Coach,
Alison

Alison Marie Helms, PhD Certified Personal Trainer and Running Coach Unlock your full running potential through physics and physiology. ​Work with me.​