Why Do I Have Pressure in My Vagina After Running or Working Out?

By Dr. Christine Martirez PT, DPT on 7/11/2024

Feeling pressure through the vagina after running or working out can be a distressing experience. While occasional discomfort might be due to temporary strain, persistent pressure could indicate a condition known as pelvic organ prolapse (POP). This blog post will explore the anatomy and types of pelvic organ prolapse, its causes, and how pelvic floor physical therapy can help manage and alleviate this condition.

What is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when one or more of the pelvic organs—such as the bladder, uterus, or rectum—descend from their normal positions and bulge into the vaginal canal. This happens due to the weakening or stretching of the pelvic floor muscles and connective tissues that support these organs.

Anatomy of Pelvic Organ Prolapse

The pelvic floor is a group of muscles and connective tissues that form a sling-like structure at the bottom of the pelvis. These muscles support the pelvic organs and help maintain continence. When the pelvic floor muscles weaken or the connective tissues become stretched, the pelvic organs can drop and press against the vaginal walls.

Types of Pelvic Organ Prolapse:

1. Cystocele:

   Prolapse of the bladder into the front wall of the vagina.

2. Rectocele:

   Prolapse of the rectum into the back wall of the vagina.

3. Uterine Prolapse:

   Descent of the uterus into the vaginal canal.

4. Enterocele:

   Prolapse of the small intestine into the vaginal space, often occurring after a hysterectomy.

Causes of Pelvic Organ Prolapse

Pelvic organ prolapse can be caused by a variety of factors, including:

1. Weak Pelvic Floor Muscles:

   • Childbirth, especially vaginal deliveries, can weaken the pelvic floor muscles, making them less capable of supporting the pelvic organs.

   • Aging and menopause can lead to a natural decline in muscle strength and tissue elasticity.

2. Overly Tight Pelvic Floor Muscles:

   • Chronic tension in the pelvic floor muscles can lead to muscle fatigue and eventual weakness. Tight muscles may also disrupt the proper support and alignment of the pelvic organs.

3. Pressure Management Issues:

   • Poor pressure management through the trunk and abdomen during activities like running or lifting heavy weights can increase intra-abdominal pressure, pushing the pelvic organs downward.

   • Conditions such as chronic coughing, constipation, and obesity can also contribute to increased intra-abdominal pressure and the risk of prolapse.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy is a specialized form of therapy aimed at addressing pelvic floor dysfunctions, including pelvic organ prolapse. Here’s how it can help manage and alleviate symptoms of prolapse:

1. Comprehensive Evaluation:

   • Assessment:

     A pelvic floor physical therapist will conduct a thorough evaluation, including a review of your medical history, symptoms, and physical examination of the pelvic floor muscles.

   • Identification of Contributing Factors:

     The therapist will identify whether the prolapse is due to weak or overly tight pelvic floor muscles, poor pressure management, or a combination of these factors.

2. Pelvic Floor Muscle Training:

   • Strengthening Exercises:

     Tailored exercises to strengthen the pelvic floor muscles, improving their ability to support the pelvic organs.

   • Relaxation Techniques:

     For overly tight muscles, techniques such as deep breathing, gentle stretching, and manual therapy can help release tension and restore proper muscle function.

3. Core and Pressure Management Training:

   • Core Stability Exercises:

     Exercises to strengthen the core muscles, including the transverse abdominis, to support the pelvis and reduce intra-abdominal pressure.

   • Proper Breathing Techniques:

     Education on diaphragmatic breathing to manage pressure within the abdomen and prevent excessive strain on the pelvic floor.

4. Postural and Movement Education:

   • Postural Alignment:

     Education on proper posture to ensure optimal alignment and reduce stress on the pelvic floor.

   • Safe Movement Patterns:

     Guidance on safe techniques for lifting, running, and other activities to minimize pressure on the pelvic floor.

5. Lifestyle and Behavioral Modifications:

   • Bladder and Bowel Habits:

     Recommendations for healthy bladder and bowel habits to prevent straining and reduce the risk of prolapse worsening.

   • Weight Management:

     Strategies to achieve and maintain a healthy weight, reducing the burden on the pelvic floor.

6. Supportive Devices:

   • Pessaries:

     In some cases, the use of a pessary (a supportive device inserted into the vagina) can help support the pelvic organs and alleviate symptoms.

Experiencing vaginal pressure after running or working out can be a sign of pelvic organ prolapse, a condition that affects the support of pelvic organs due to weakened or overly tight pelvic floor muscles and poor pressure management. Pelvic floor physical therapy offers a comprehensive approach to managing and alleviating symptoms of prolapse through targeted exercises, posture and movement education, and lifestyle modifications. If you’re experiencing symptoms of pelvic organ prolapse, consider consulting a pelvic floor physical therapist to support your recovery and improve your pelvic health.

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