Hey Reader,

If you’ve been following along, you know we are stepping through my four-point assessment designed to help you determine the primary contributing factors behind your pelvic floor symptoms. I shared the first point yesterday and will step through the rest, with one each day, now through Thursday this week.

OR you just can get it all in one shot, experiencing, seeing and feeling it in real time. That’s why I’ve also created 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. ​

Still, this email will give you a solid overview of how the pelvic floor integrates with the rest of your body and how pelvic floor health connects with your movement, strength training, and running mechanics. This is not about lying on the floor doing isolated breathing exercises. It’s about understanding how the pelvic floor works as part of a whole-body movement system.

Each of these areas plays a role in how your body absorbs and produces force during running.

2- Finding Length in the Back

The second point in the Pelvic Floor Audit looks at your ability to find length in the backside of the pelvis.

Before diving into the assessment itself, it helps to understand why this matters for running.

Absorbing and Rebounding in the Running Stride

During the stance phase of running, we can think of the movement in two phases:

1. Absorbing (loading)
2. Rebounding (propelling)

From the moment your foot lands until you reach mid-stance, your body is absorbing force. This loading phase occurs through internal rotation of the pelvis and hip.

Once you move past mid-stance, the body transitions into external rotation, which helps propel you forward.

This internal-to-external rotation sequence is essential for efficient running mechanics.

If you look at studies measuring pelvic floor muscle activity during running (1), you can clearly see two important patterns.

First, pelvic floor activity stays elevated above baseline throughout the entire run. Like any other muscle group, the pelvic floor experiences progressive load and can fatigue.

This means that if you notice pelvic floor symptoms toward the end of your run, it may simply reflect a need to build more strength, endurance, and capacity in that system.

The second pattern is even more interesting (to me at least).

Pelvic floor muscles actually show pre-activation before the foot even hits the ground.

If you look at the graph of muscle activity, the pelvic floor would remain above baseline (the horizontal orange line) the entire time. Activity is lowest at toe-off, but immediately after toe-off—before the opposite foot even strikes the ground—the activity begins increasing again.

It then reaches its maximum activity at mid-stance, when the body is in its deepest internal rotation and producing the greatest ground force.

Why Does This Pre-Activation Happen?

My hypothesis and professional opinion is that rotation plays a major role.

As you move from toe-off into the next step, your body begins transitioning from maximum external rotation toward internal rotation on the stance leg. That rotational movement starts before the foot ever contacts the ground.

The pelvic floor naturally lifts during internal rotation! This lift doesn’t come from consciously squeezing the muscles. It’s not a Kegel. Instead, it occurs because internal rotation creates length in the back portion of the pelvic floor, and that length produces a natural lift.

This is why the ability to find length in the backside is so important. When the pelvic floor can’t lengthen especially in the back, it can’t respond properly to the demands of running.

Using the Toe Touch and Toe Touch to Squat Assess Posterior Length

We can return to the toe touch test from yesterday’s email to evaluate backside length as well.

If you cannot touch your toes at all, that’s often a sign that you struggle to shift your center of mass backward and access length through the back of the ribcage and pelvis.

And we can take it a step further.

The Toe Touch to Squat Test

From the toe touch position:

1. Bend your knees while holding onto your toes.
2. Squat down as far as you can without falling over.
3. Keep your heels on the ground.
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If you cannot squat down fully in this position, it’s another indication that you may struggle to find length in the back side of your body.

There’s another practical clue many runners notice in the gym.

If you perform squats and only ever feel your quadriceps working, but never feel your glutes, that’s often a clue that you’re not accessing proper length in the back side.

When the system is working well, squats involve the glutes, hamstrings, and posterior chain, not just the quads.

Sore glutes after a heavy squat session is a signal that the pieces are connecting well. And this isn’t just about pelvic floor symptoms. It’s about moving efficiently everywhere—in running, in squats, and in strength training.

That’s all for now. Tomorrow we’ll move on to point 3 in the assessment.

Stay tuned and/or sign up for the Pelvic Floor Audit now!

Your Coach,
Alison

References:

1- Williams AMM, Sato-Klemm M, Deegan EG, Eginyan G, Lam T. Characterizing Pelvic Floor Muscle Activity During Walking and Jogging in Continent Adults: A Cross-Sectional Study. Front Hum Neurosci. 2022 Jun 30;16:912839. doi: 10.3389/fnhum.2022.912839. PMID: 35845247; PMCID: PMC9279930.

* I created my own smooth curve from the data in this paper as the visual shown above.

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