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Got knee pain? How’s your pelvic floor strength? Did you know they could be related?

Let me tell you a story…

A common story I hear all too frequently from my patients:

“My knee has been bothering me for a few weeks. It first started when I began increasing my mileage, but would bother me mostly after my runs so it was hard to tell at first. I kept running through it, hoping it would get better as my body got used to running longer and more frequently. I thought maybe it was just workout sore instead of pain sore, but it was hard to tell. Then it started hurting during and after my runs. I rested for a few days and that kind of helped, but not fully. I tried to run on it again, but the pain was noticeable from the start of my run so I decided it was best not to push it. I haven’t been running for the last few weeks, but it still hurts, and now it’s hard to squat down, go up/down stairs, pick up things from the floor, or carry my little ones around. Now I’m not working out at all and the pain is interrupting my whole day – what gives?!”

This is when I start asking questions:

  • How many weeks had we been running, and what was the duration of these runs?
  • Were they following a training plan?
  • How are they increasing their mileage? And was it gradual enough?
  • How many strength training days vs running days were happening each week?
  • Have they noticed any urgency/frequency/leaking when on their runs?

The answers I usually get:

  • Just getting back to running after some time off or PP recovery
  • Started with 20-30min runs, and quickly started doing some longer runs
  • Not really following a plan
  • Increasing mileage by a mile a week
  • No regular strength training
  • Yes to leaking, and sometimes urgency if they don’t pee right before their runs
  • Also usually experience low back pain during/after their runs

So what does all of this mean?!

  • We need to be fit to run instead of running to get fit (?read that one more time)
  • If we’re leaking on our runs, that’s a sign our core system isn’t operating at its full capacity. This could be a strength issue, a coordination issue, or both. And when I say “core” I mean: pelvic floor, abdominal muscles, the diaphragm, and deep spinal muscles.
  • A core that’s not operating at full capacity can’t help distribute running loads well through the pelvis like it’s designed to do, which means another part of the body has to do that job → insert your knee (and low back) here!!