Pelvic Pain: A Runner’s Perspective

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Running is considered to be one of the best forms of exercises. Running can add many benefits to one’s overall health. It is great for cardio, strengthening the bones and toning the muscles. However, too much running can severely cause a great amount of harm to the body. Proper stretching and adequate amounts of hydration are essential if you want to maintain a healthy and toned body. Pelvic injuries are more commonly found in females than in men, with about 45% of female runners sustaining some level of stress fractures, which are small cracks, in the pelvic region. For many female runners, they go on a restrictive diet which can stop women from menstruating. Menstruation produces the female hormone, estrogen. This is significant because when a female lacks estrogen this weakens the bones in their bodies.  However, it is important to note that men are capable as well of sustaining a stress fracture. This article cowritten Eddy Mihai and curated by Diana Rangaves, PharmD, RPh, serves to outline the many symptoms, causes and the treatments available as they pertain to runners who experience pain in the pelvis region.

What is Runner’s Pelvic Pain?

Runners pelvis injury is the injury felt in the pelvic region that comes from excessive running. The runner’s pelvic injury is a major injury that affects runners who run on tough terrain and for those individuals who run excessively.

groin-injury-groin-pull-groin-tear-groin-anatomy

The areas throughout the hip where the pain is felt and is the cause of the injury to arise in people are:

  • Anterior Hip Pain: This form of pain comes from the hip flexors or the hip joints.
  • Lateral Hip Pain: Pain can be felt in the iliotibial band or more commonly known as the IT band bursitis.
  • Posterior Hip Pain: Pain and tightness are felt in the piriformis muscle.
  • Groin Pain: Pain comes from an inguinal hernia.

Symptoms

Any pain you experience while trying to run is a sign that you may have developed some form of pelvic injury. There are a few symptoms that one can spot to figure out if they have sustained a pelvic injury.

Conceptual human body anatomy particular pain on blue background

The symptoms of pelvic injury are:

  • Minor to severe pain in the groin
  • Minor to severe pain in the hip
  • Hip misalignment
  • Minor to severe pain felt down the leg and to the foot/or feet
  • Pain and soreness in the pelvic region
  • Bruising or swelling in the pelvic area
  • Discomfort when sitting down
  • Discomfort when standing
  • Discomfort when walking
  • Discomfort when having a bowel movement.
  • Tingling sensation in the groin area
  • Diarrhea, constipation, bloating
  • Discomfort while urinating
  • Blood with discharge
  • Pain during intercourse
  • Fever, coolness
  • Progressively painful menstrual cramps
  • Vaginal bleeding/discharge

Causes

There are many causes that can result in someone sustaining a hip injury. Hip pain comes from various sources. These sources are usually found in the bone, joint, muscle, tends and bursa. Most of the injuries are caused because of over-exertion or overtraining the body. Pelvic injuries are especially more common in women than in men.

Here are a few causes for pelvic injuries to develop in individuals:

An Injury sustained in the past: This is a common cause for an individual, especially if they are running, to develop pelvic injuries.
Poor Posture: Poor posture can happen for a variety of reason such as how we sit, if we are slouching or if we lean on a counter. Often times when we carry something we use one side, preferably our strong side, which distorts our alignment.

What does poor posture do to the body:

  • Increases stress level
  • Increase Injury
  • misaligns joints and spinal vertebrae
  • Causes headaches

Strength imbalances (or asymmetries): Favoring one side. Placing more weight on one side as we walk, sit or run.
Improper form: There is a proper way to run. If you are running on the bare bottom of your feet instead of the ball of your feet you will do serious harm to not only your hip but your lower back.
Tough surfaces: The surface you are running on can also cause a great deal of stress to your spine.
IT band bursitis: Causes severe lateral hip pain that happens when someone runs. The pain that the person is experiencing can cause people from being able to run.
Piriformis syndrome: This is a common cause for posterior hip pain in many runners. This syndrome causes severe pain that occurs when running and the person can feel pain starting from the posterior that starts to travel down the back of the legs.
Sacroiliac Dysfunction: The Sacroiliac is the joints where the pelvis and the lower back join.
Arthritis: Is a disease of the bone.
Hip Misalignment: Hip misalignment can cause severe hip injuries and soreness. Along with affecting the muscles in close proximity to the hip.
Pelvic stress fracture: this is a hairline type fracture that is found in the large pelvis bone. This is caused as a result of a repetitive impact. For those who suffer from this, the often feel pain in the groin or hip.

In this article, we are focusing on the pelvic pain that is related to running, therefore, correlated with injuries and strains. It is equally important to understand that pelvic pain can have completely other causes, not related to overuse injuries, such as spine, organ, and nerve disorders, infections, lesions, fractures, tumors, and so on.
Pelvic pain is a common symptom of many health problems such as the following:

  • Appendicitis is the inflammation of the appendix near the large intestine that causes pain in the lower right side of the abdomen.
  • Bowel spasm/constipation caused by irritable bowel syndrome, bowel obstruction, medication, diet variations, and other.
  • Inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.
  • Peritonitis is the swelling of the peritoneum, a layer of tissue inside the abdomen, that causes serious pain that needs to be treated as soon as possible.
  • Urinary tract infection is an infection that can cause pain when urinating which can transfer to the pelvic pain.

 

Risk Factors

Pelvic injuries are extremely painful and can cause a severe problem in the long term if not treated immediately and effectively. It has been thoroughly researched and studied that women are much more prone to developing a stress fracture while running. They are twice as likely to develop a stress fracture as their male counterparts are.

 

This comes as a result of women having less muscle mass than men. As a result, women have a higher risk of fracturing not only the pelvic region but other parts of the body. It is recommended that females keep the estrogen levels up by intaking the right amount of calories. As it has been researched and proven that when women eat less they produce lower levels of estrogen and this is what causes them to have weaker and more brittle bones.

Women are more prone to pelvic pain because sometimes, the pain is linked to problems with the female reproductive system such as:

Prolapse of the uterus is when the human uterus collapses from its original position which can cause pelvic pain and discomfort.
Fibroids are tumors that develop near the uterus.
Ovarian cyst is an excrescence full of fluid that grows on an ovary that can cause serious pain.
Pelvic abscess refers to an accumulation of pus near the uterus and vagina.
Adenomyosis and endometriosis are conditions in which the uterus develops abnormally, causing an array of symptoms including pelvic pain.
Acute pelvic inflammatory disease is caused by a bacteria that affects the ovaries, fallopian tubes, and/or the uterus.

Diagnosis

There are many ways to determine whether you have developed pelvic runner injury. Pelvic injuries are notoriously difficult to find early on. This is because early on when the pain begins it is misinterpreted as just a simple muscle pull. This misinterpretation of the pain causes the injury to become that much worse later on and develops into a much more severe injury.

Herniated-Disc-back-examination

The best way to determine if you have developed some form of a pelvic injury is to speak with a sports medical physician or a physical therapist.

A physical exam

In the case of checking for hip misalignment many individual visits a medical professional who will perform a physical examination. During this assessment the medical professional has the patient lie down and have their knees extended fully up so that the professional and the patient can see the knee position.

If the knees are not in unison with one another then this can greatly show the hip misalignment. Hip misalignment is a cause for pelvic injury.

  • As said before, if your pain does not originate from an injury in the pelvic region, the doctor will eventually search for other things such as signs of tenderness, abnormal growths, tense pelvic floor muscles, or infections. While the exam is proceeding, the patient should eventually refer any discomfort and pain. Further exams consist of:
    – a lab test to eventually confirm the existence of infections.
    -a blood test to examine your blood cells.
    -a urinalysis to make sure that the cause is not a urinary tract infection.
    -an ultrasound for detecting eventual abnormal growths.
    -a Laparoscopy is a surgical procedure that involves the insertion of a tiny camera inside the abdomen to look for any suspicious abnormality.

X-Rays

X-Rays may not be able to see the severity of the pelvis injury unless it is a stress fracture. X-rays are more commonly used to find fractures and cracks in the bone. However, pelvic injuries are not caused primarily by fractured bones. As a result of the X-rays limited ability. CT scans and MRI’s are much more preferable than an X-ray.  X-rays use a small amount of radiation to look for cracks or fractures in the bone. X-rays are very useful in this scenario as they will be able to spot the fracture in the bone.

CT Scan

CT Scans are also capable of determining whether there is a fracture in the pelvic region or if the pain is a result of blood vessels and nerves. However, like X-rays radiation is involved but in small amounts.

Spondylolisthesis-spine-mri

MRI

MRI’s can offer a greater amount of information as it pertains to the pelvic area. MRI’s will be able to spot the fracture but will also be able to find the cancerous cell, which could also be the reason for the pain in the pelvis region.  MRI’s are especially more useful and helpful because of the fact that it is a painless procedure and it also doesn’t use any form of radiation.  There are many ways to receive a diagnosis’s on the injury that may have ben sustained. MRI’s are perhaps the best way to discover how bad the injury is and can potentially find the cause of the pain if it is not caused by a fracture.

Treatment

Pelvic Injuries are quite common and the pain associated with it can keep many runners off the track for weeks to months. But, fortunately, there are ways to treat this injury. Pelvic injuries are most commonly associated with the hip but can be a source of pain in other parts of the body. Such as the lower back and down the back of the leg to the foot.

There are treatments that can help to align the hip back in its proper state. For most fractures in the pelvis, the best treatment is simply resting. However, there are some injuries that are so severe that they require crutches, weeks of extreme rest and in some cases, surgery is necessary because of the severity of the injury.

Massage

Massages can help to loosen up muscles that have become tight and as result creates a soreness in the surrounding area. There is a specific kind of massage known as Active Release Technique which helps to loosen the muscle around the hip area and specifically targets the muscle that causes hip misalignment.  Along with this technique, the professionals also have other manipulation tricks to help “pop” the hip back into place.

Strength training

muscle-group-strengthening-workout-gym-runners-guide-to-it-band-syndrome

 

Strength training is very important for the body especially if you have pelvic pain or you are trying to recover from an injury in that specific area. Strength training is also a great way to help with hip alignment. A popular exercise for those who suffer from hip alignment is for:

  • Step 1: An individual to lay flat on the floor.
  • Step 2: place your feet on the wall.
  • Step 3: With power and as fast as you can thrust your “shorter leg” towards the wall and hold it for ten seconds.
  • Step 4: Relax and repeat about 9 more times.

This small exercise is a great exercise to perform before you go running. However, if you have hip misalignment this will greatly help to realign the hip. However, this will take some time. Over time the soreness and pain that an individual has been experiencing will be healed.

Here are some other exercises for strength training of the pelvic region:

1. Mini squat
You can use weights for this one, such as a kettlebell or dumbells, but you can also do it without weights and still get an awesome workout. You should feel it in your glutes, quadriceps, and calves.

  • Step 1: Start by standing tall while holding some weights. The key is to have your weight well distributed onto your feet but specifically on your heels.
  • Step 2: Lower yourself down and really use those glutes to get low. You don’t have to lower yourself too much, just a little bit.
  • Step 3: Come back to your initial position and exhale.
  • Step 4: Repeat this exercise for several times until you can feel your legs nice and warmed up. Again, you can use no weight, warm up and then add some dumbells, but you don’t have to struggle too much, especially if you are trying to recover from an injury.

2. Lunges
This is a great exercise for increasing hip mobility since you have one leg forward and one in the back. You can do this with dumbells, or weights, just make sure the weight is proportionally distributed. This is also a great exercise to do with just your body weight or if you want to warm up. Repeat this exercise for 3 sets of 7 repetitions for each leg (to clear it up, that would be a total of 7x2x3=42 reps).

  • Step 1: Stand tall and hold your dumbells in both hands. Your arms should be hanging at the sides.
  • Step 2: Place one leg further and the other one in the back.
  • Step 3: Lower yourself, with your torso perpendicular to the ground, so that your legs form a 90-degree angle or just bend your knees as much as you can.
  • Step 4: Come back up and switch legs. You can also not switch legs and continue pulsing on only one leg and after a couple of repetitions switch. This second option requires some more strength because it’s harder to repeat the same movement by using the same muscles and tiring them.

3. Deadlifts
This is an exercise that works the back, the glutes, the hamstrings, and the quadriceps. You can do this exercise with just your body weight or you can add some weight, for example, you can use a kettlebell, a barbell, or two dumbells. Repeat the move for as long as you can without compromising the correct form. You don’t need a lot of space to do this exercise.

  • Step 1: Start by holding a barbell or some weights in your hands, with your feet shoulder apart.
  • Step 2: With your back straight, bend at the waist and bring the weight down below your knees, just like you are trying to pick a heavy box off the floor. Remember, lift with your legs while keeping your back straight. The knees should be slightly bent and your buttocks should stick out.
  • Step 3: Lift your weight and come back to the position.
  • Step 4: Repeat until you feel like your muscles are about to be sore, but if you are tired put the weight down and take a little break. It’s quite possible that you will get tired in your arms specifically if the weight is heavy. You can use some special straps. Usually, you can find them in your local gym, sports shop, or online.

4. Pelvic floor safe side lunge
This is an exercise that targets the pelvic floor and the legs. Again, you can do this exercise with just your body weight or you can step it up a little by using just one dumbell or a light kettlebell. This move is quite challenging if you add some weight. Repeat this exercise, alternating sides, for about 3 sets. There isn’t a precise number of reps you have to do for each leg in one set, you should just listen to your body. Stop if you feel non-muscular pain. Push yourself out of the comfort zone if you can without experimenting joint pain.

  • Step 1: Hold your weight with both hands and stand tall with your feet shoulder apart.
  • Step 2: Lower yourself on one leg (bend the knee of that leg slightly outwards) while extending the other on the other side. Lower yourself and avoid knee pain.
  • Step 3: Come back to the initial position and repeat the move on the other side. You can choose to alternate sides or you can do a couple of reps on one side then switch. The second option is quite challenging because you are stressing the same muscles without giving them some rest. This way you will have higher chances of getting sore.

5. Plank
This is a great exercise for strengthening the pelvic floor, plus, it also targets the abdomen and arms. You don’t need any kind of equipment, except your floor mat. The best way to do this exercise is without having breaks. Repeat 2 times with a break in-between.

  • Step 1: Get on all fours, lift your knees from the ground. Your hands and your feet (specifically the anterior part of the sole of your feet including toes) should be the only body parts that touch the ground. Your hands should be right under your shoulders and your legs should be straight, your elbows slightly bent.
  • Step 2: Hold this position. The key is to engage your core. Hold this for about a minute, but if you’re getting tired, drop on your knees for a couple of seconds and then come back to the plank for another couple of seconds.

6. Reversed plank
This targets the pelvic floor, the buttocks, the arms, and the abdomen. You don’t need special equipment, only a mat or rug. It is very similar to the plank, but it is reversed. Repeat 2 times with a break in-between.

  • Step 1: Sit on your mat, then place your arms behind, right under your shoulders, and your legs straight in front of you.
  • Step 2: Lift your pelvis up. Your palms and your heels should be the only parts of your body that touch the ground. Keep your pelvis up, don’t let sink.
  • Step 3: Hold this position. The key is to engage your core and buttocks. Hold this for about a minute. Feel free to rest for a couple of seconds by sitting on the mat. Progressively, you should be able to hold this position for more than a minute and don’t forget to breathe.
  • Step 4: Come back to the initial position, take a little break and then repeat.

7. Double leg lift
This exercise targets your pelvic floor and your abdomen. You don’t need special equipment, only a mat or rug. You can add some light ankle weights if you want to step it to the next level. Repeat the move for a dozen times. It is very efficient and challenging, it will strengthen your pelvic floor and abdominals.

  • Step 1: Lay on your back and place your arms to the sides, on the mad and push. Don’t place your arms underneath your tailbone, because that can compromise your form. Keep the back glued to the ground and don’t arch your back.
  • Step 2: Lift your straight pointed legs up, using your abdomen. Find a good breathing pattern to go with your movements.
  • Step 3: Lower your legs. You can leave your head on the mat or you can lift it. You can even place your arms behind your head with your elbows wide. You can bend your knees to make it easier.

P.R.I.C.E

P.R.I.C.E is a process that can stop injuries from getting worse and can also start to help the healing process begin.

ice-piriformis

P – Protect: Wherever the injury the person has sustained, it is important to protect that area with either a splint, bandage, or cast.

R – Rest: This is perhaps the most useful type of treatment as it pertains to the pelvic injury. The amount of rest is determined a great deal by how severe the injury is and where the person is feeling the pain. The timeframe of resting can be a few weeks to a few months, depending on how severe the injury is.

I – Ice: Ice therapy or also called cryotherapy is one of the most well-known therapies that many sports athletes use. The effects of cold showers alone have a multitude of benefits that can help an individual’s health in the long term.

The many benefits of cold therapy:

  • Offers a faster recovery time
  • Reduces muscle spasm
  • Reduces the risk of cell death

Cold therapy has a plethora of benefits, however, it is not a panacea. It is not a miracle cure that can heal all pains or alleviate all pains. Ice therapy, specifically ice bags are not recommended to be placed near certain parts of the body as they can damage certain nerves.

C- Compression: Applying compression to an injured area helps to minimize the pain. Compression is very useful or helping the healing process. However, the compression should be used moderately. The best way to compress a certain insured area is to wrap the area with a bandage. If the area is bandaged to tight it can do more harm to the injured area than good. It is important to bandage the area with a moderate amount of compression.

E- Elevation: Elevation allows for a gravity to drain the fluid in the injured area. elevation allows for swelling to decrease and thus allows for the injured area to experience less pain.

P.R.I.C.E is a very useful therapy that many athletes undergo to help alleviate pain and to also treat any injuries that have been sustained.

Medication: Medication that can help to alleviate the pain are usually anti-inflammatory medication will be prescribed or which you can but over the counter. This is a list of medication your doctor might prescribe you.

anti-inflammatory-medication-for-it-band-complication-treatment-runners-guide-to-it-band-syndrome
Wikimedia Commons

1. Oral painkillers or analgesics
Usually, the doctor will prescribe you some medication to deal with the pain. You can buy these at your nearby supermarket or grocery store. They interfere with the pain transmission, resulting in pain and swelling reduction. Although they work very well providing pain relief, they have some side-effects like stomach pain, nausea, high blood pressure, kidney problems, liver damage, stomach bleeding and ulcers, therefore the patient must eat before taking the pill. Patients over 70 years old and patients with digestive apparatus health problems must pay even more attention to how they administer certain drugs.

Pelvic pain can be reduced by taking an over-the-counter medication, such as:
-Aspirin/ibuprofen drugs such as Advil, Motrin IB can be taken with or without a prescription and will give partial and temporary release from the pain and discomfort.
-Acetaminophen such as Tylenol for mild/moderate pain.
-Naproxen sodium such as Aleve will also deliver symptom relief.

2. Topical painkillers
There are topical painkillers such as gels, sprays, patches, and creams that can be used directly on the painful area. These painkillers, such as Voltaren, Solaraze, Bengay, or Icy Hot have mild side effects and work great for reducing mild/moderate pain.

3. Hormone treatments
In some cases, the pelvic pain in women can be caused by hormonal changes and stages of their menstrual cycle regarding ovulation/menstruation and is not caused by injuries from running. The medication to relieve pain could be, in this case, birth control pills or hormonal/steroid medication.

4. Antibiotics
In some cases, the pelvic pain is caused by a bacterial infection, therefore, the cure consists of antibiotics which kill the microbes.

5. Antidepressants
Tricyclic antidepressants have pain-relieving effects and can help reduce chronic pain even in individuals that do not have depression.

Alignment: Proper posture has a variety of benefits that are offered. There are many ways to help to correct one’s posture if their posture has gotten worse over time.

Ways to improve your alignment and poor posture:

  • Stretch your chest – Stretching your chest will be able to balance your shoulders
  • Face-pulls- Can correct postural problems
  • Pelvic tilt – will help to keep the spine neutral.
  • Strengthen your back
  • Hanging – Hanging from a pull-up bar will help to stretch the spine and relax the muscles.
  • Be mindful – Be more attentive of your posture.

Maintaining a proper posture will prove to be very beneficial in the long term. Many problems as they pertain to the joints and muscle are due to having a poor posture.

Surgery: In some scenarios, the injury that has been sustained can be so severe that the person who has sustained the injury may need an operation to heal the fracture. The surgery will either place metal pins, plates or screws in the pelvic area.

TENS: Your physical therapist might utilize a special kind of device called transcutaneous electrical stimulation (TENS) which sends electrical stimuli to nerves and muscles in a specific area.

Biofeedback:  Some physical therapists may use a psychology method to find out which are the parts where your muscles are tight and help you learn how to relax them properly, in case your pelvic pain originates from muscles and nerves around the pelvic area.

Neurostimulation (spinal cord stimulation): This technique can be very helpful if the pelvic pain is chronic and if it is connected to nerves and muscles in the pelvic area because the procedure aims to block certain nerve routes in order to block the pain from reaching your brain and actually feeling it.

Trigger point injections: If your pain is due to an injury in the past or is correlated to bones and muscles in the pelvic area, you might have some pain trigger points. Your doctor can identify those spots and can inject a long-term local anesthetic so your pain and discomfort can be reduced or eliminated at least temporarily.

Psychotherapy: This is a sort of therapy that can help you deal with the pain especially if it is additional to some other problems in your life such as depression, personality disorder, trouble marriage, family crisis, etc.

Eating: One of the best ways to treat pelvic pain and to recover from a hip injury is through diet. This is especially useful for females. As eating the right foods helps women to produce the hormone, estrogen, which can strengthen the bones. It is important that females eat healthy foods to maintain a healthy body.  Regardless of the nature of your pelvic pain, here are some types of anti-inflammatory foods that will help reduce the inflammation which is usually a cause of your pelvic pain:

  • Foods rich in omega-3 fats such as soy products, walnuts, pecans, ground flaxseed. These omega-3 fats are very useful to reduce inflammation and pain. Try to get these fats from plant sources because they are anti-inflammatory, unlike animal products.
  • Foods that contain antioxidants such as avocados, berries, beets, lentils, beans, whole grains, green tea, ginger, turmeric and all kinds of colorful fruits, vegetables, spices. The antioxidants (that can include vitamins such as lycopene, flavonoids, vitamin E, vitamin C) aid the tissues and accelerate the healing process while preventing the degradation of cells.
  • Plants that can be used as dietary supplements such as ginger root, turmeric, frankincense, cat’s claw, and devil’s claw. These plants often contain antioxidants, vitamins that might provide one with the additional dose of nutrients that will aid in recovery. They are also anti-inflammatory and have been proved to be a valid alternative to other pills.

 

Pelvic injuries can cause excruciating pain for the runners. Luckily though there are many treatments available that not only alleviate the pain but also completely cure the person of the injury they have sustained. In cases, such as these the best way to heal from the injury is to rest and let the body take it course. Proper dieting as well can also help to speed up the recovery time.

Prevention

Prevention is the best way to keep from getting an injury. It cannot be stressed enough of the benefits that come from preventing an injury. Not only does prevention save you from excruciating physical pain but also from your financial pain that will accompany you on every visit to the doctor and the medicine and surgery you may have to take as a result of the injury.

There is a myriad of preventive methods one can take in order to not develop pelvic injury:

Strength training: Strong muscles are a better shock absorber than weak muscle. And stronger muscles don’t tire as much as weak muscles do. Kegel exercises are great exercises to maintain the strength in the muscle surrounding the pelvic region.

Regular massages: Massaging before an extreme exercise or minor exercise and more importantly after an exercising will do great benefits for the person.

There are many types of massages that can help to alleviate any pain felt in the body:

  • Trigger target massages – This massage, as the name reveals, targets a certain area of the body and helps to alleviate the pain in the target area.
  • Deep massage – This massage uses deep and slow massages techniques that target certain areas and helps to heal damaged muscles.
  • Sports massages – These messages are great for those who engage in any kind of athletic field.

Massages are great ways to help damaged muscles and can help to greatly heal any plans that are experienced.

Running on appropriate surfaces: Running on a certain surface have both negative and positive effects on the body. There are certain surfaces that are best to run on because they will add less stress on the muscles and the bones.

  • Asphalt roads – These are considered to be some of the best surfaces to run on. They are flat and are designed for walking. For those who run on asphalt roads, it is best to run with the traffic and to always be aware of the drivers.
  • Trails – These are also another great environment to run on. However, it is important to not run on this kind of surface if you suffer from ankle injuries, as many trails have rocks, uneven surface, and tough terrain. There are trails that are made of asphalt and they are considered much easier on the bone and muscle.
  • Track – Tracks are great options for running. You can find these primarily at your local high school or nearby park.
  • Grass – Is a GREAT alternative especially for those who have just recovered from a fracture. For those who have sustained a pelvic fracture this is a perfect surface for them to start back up again.
  • Treadmills: These are perhaps the most common and most used kind of surfaces to run on. As Treadmills offer an environment where you can just run and not have to worry about traffic or outdoors environment.
  • Sand: Running on sand will help to strengthen the muscles and the bones. However, sand can cause for ankle sprains and ankle damaged because of the uneven surface.

The surfaces that we run on all have their own kind of benefits and disadvantages. It is important to know the condition of the terrain before running as to prevent injuries.

Correct posture: Keeping a proper posture has a myriad of benefits that are greatly overlooked. Maintaining a proper posture will not only help to keep the hips aligned and to keep a strong and flexible back but tools help with the tea and many other benefits.

  • Prevents a backache and muscular pain
  • Keeps joints and bones in proper alignment
  • Decreases the stress of the ligaments holding joints to spine
  • Give a good appearance

Having a proper posture is extremely beneficial in the long run. Proper posture not only helps to keep the body aligned but also allows for better flexibility and mobility in the body.

Mindful of your patterns: If you favor one side. For example, if you carry heavy objects on one side all the time you will be misaligning your hip. Misalignment is so easy to develop for many runners. Adding this will only speed up the develop of the pelvic runner’s injury.

Stretching: It is important to stretch before and after running. There are a number of stretches that one can do to prevent pelvic injuries. Sometimes a pelvic injury can be a result of not stretching and causes the muscles to cramp and swell. Stretches are extremely beneficial as they allow for more ability and a wider range of motion which can help to alleviate or eliminate pain in the pelvic region. Here are a few stretches for runners to start out with and to finish with.

Hip-Dislocation-Injury-Running-bridges-stretches

Butterfly

The butterfly stretch targets the inner hip and helps to loosen the muscles in the hip region.

  • Step 1: Sit down on the floor
  • Step 2: Bring the bottom of your feet to face one another
  • Step 3: Bounce the inner hip so that you can get the side of the knees to touch the floor.

For an advanced stretch.

  • Bring you feet closer to your groin area.
  • Try and bring your head to your feet.

Supine Frog

This stretch targets the inner hips and allows gravity to help assist in realigning the hips.

  • Step 1: Get a mat and lay it out on the floor.
  • Step 2: Place your knees on the mat and slowly open the hip.
  • Step 3: Once you have open the hip place your forearm on the floor.
  • Step 4: Hold position from about 15- 20 seconds.

Alternate Version

  • Step 1: Lay down on your back.
  • Step 2: Open up your hip. Allow gravity to press down on your open hip.

This form of supine grog stretch is much easier and can help to prepare you for the more advanced version of Supine Frog stretch.

Supine Hip Rotation

This stretch targets the glutes and the hip flexor.

  • Step 1: Lie down on the ground wth your back to the ground.
  • Step 2: Bend your knees with your feet flat on the floor.
  • Step 3: Bring the knees inward without allowing your feet to move or come off the ground.

The benefits of stretching before and after running will offer a plethora of benefits that can help to prevent many injuries.

Split Stretch

  • Step 1: While you sit on your mat, push your back and head against the wall so that you have contact with it, then spread your straight legs away from each other so you can feel your thighs and groin muscles stretching.
  • Step 2: Try to bring the soles of your feet together while letting your bent knees drop outward as close to the floor as comfortable.
  • Step 3: While bending at your waist, stretch your arms forward and try to bring your shoulders as close to the ground as you can.
  • Step 4: Hold this position for thirty seconds or more, while trying to keep stretching the muscles. Don’t forget to breathe. Repeat this move for about 3-4 times more.

This move is a perfect stretch for your back, arms, groin area, and thighs.

Spinal twist

  • Step 1: Sit with your back flat on the floor.
  • Step 2: Bring your bent knees close to your chest, on your right side, so you form a 90-degree angle between your torso and legs.
  • Step 3: Twist your head to the left side and place your right hand on the left leg’s knee, while your bent left arm rests on the floor at the level of your shoulder.
  • Step 4: Hold this position for 30 seconds or more, you can close your eyes while you breathe. Repeat on the other side.

This move is a perfect stretch for your back, hip muscles, and for the abdomen.

Cobra

  • Step 1: Lay on the mat, on your belly.
  • Step 2: Place your palms right beneath your shoulders, keep them flat
  • Step 3: Lift your torso by using your arms while keeping the hips to the ground and your arms straight. Your legs should be straight and the quads should be on the floor. The back of your head should make contact with your back, so you can have your forehead facing the ceiling. Your ears should not be in touch with your shoulders.
  • Step 4: Hold this position for 30 seconds or more, while inhaling through the nose and exhaling through the mouth. Keep your buttock’s and leg’s muscles relaxed while you stretch.
  • Step 5: Slowly and gently come to your forearms as you exhale, then repeat this move a couple more times.

This is a perfect stretch for the muscles of the pelvic, for the abdomen, the anterior side of the hips.
You can also choose to do an easier version by lifting your torso just a little bit without straightening your arms and locking your elbows.

Pelvic floor deep squat

  • Step 1: Stand tall with your legs hip-width apart. Point your toes slightly to the outside.
  • Step 2: Lower yourself like you are almost doing a sumo squat, keep your buttocks as low as you can. You can move your fit and hips while sitting down in order to find the most comfortable and natural position.
  • Step 3: Bring your palms together and your elbows quite high, like you would pray.
  • Step 4: Bring your arms between your knees until you feel a stretch.
  • Step 5: Hold this position for about a minute or more and don’t forget to breathe.
  • Step 6: Return to the initial position and don’t forget to repeat a couple of times.

This is a move that is quite challenging because you have to keep your balance by pressing the soles of your feet against the floor, or by using an external support such as a wall or chair. It is a move that helps your hips and the pelvic floor stretch. You can also find a pillow or a yoga block to put under your buttock if you don’t feel quite comfortable in this position.

Proper nutrition: Vitamin D and calcium are extremely beneficial for many runners because of the benefits they have when it comes to making the bones stronger. Proper diet is always important in maintaining the health of any individual. For many who consume an unhealthy diet, they are much more prone to sustaining not only injuries but a chronic condition that only increase the severity of an injury.

Unhealthy diets slow the healing process, speed up the aging process, assist in the developing of a chronic condition and so much more. For athletes, and people in general, it is important to consume the right foods. For runners, it is important that they consume foods that can strengthen the bones and muscles.

Foods that will help o build strong bones and help to heal the muscles:

  • Vitamin D
  • Calcium
  • Dark Greens
  • Magnesium will help to relax muscles and to maintain a healthy recovery time.
  • Water
  • Whole wheat pasta
  • Bananas (Considered to be runner’s favorite food)
  • Wild salmon
  • Cherries
  • Kale
  • Skim Milk
  • Soy milk for women as it will help to produce higher levels of estrogen
  • Oatmeal
  • Green Tea (Antioxidants that can relax the muscles and also great for the mind)
  • Tomatoes

Depending on the severity of the pain, treatment can take a few days to a few weeks to completely heal. In more severe cases it can take months to heel. It is important to always stretch well before you run and especially important to stretch after you have run.

Yoga: Yoga is a very good method to strengthen your pelvic floor while relaxing the muscles and your mind. Here are some yoga moves you can try at home.

Chair pose
Just stand tall and with your feet close to each other. Then, lift your arms straight so that they are perpendicular to the floor or to the ceiling. Breathe while you do this. Next, lower yourself like you are about to sit in a chair, almost like in a squat but don’t lower yourself too much otherwise you will get tired and your muscles will become sore before you know it. Close your eyes and hold this position for another couple of seconds. Breathe loudly and you can even repeat your mantra, your motivational phrase along the way or you can have some relaxing music. This is a move that is going to strengthen your legs and buttocks. You can repeat this a couple of times.

Utkata Konasana: The Goddess pose
Start by distancing your legs from each other to the sides. Slowly lower yourself until your knees are bent and they form a 90-degree angle. They should be lateral to your body. Next, keep your torso straight while you place your arms to the sides, then bend your elbows so that they form a 90-degree angle. Hold this position for a couple of seconds while you breathe loudly and profusely. You should be able to feel the stretch in your thighs and your buttocks.

Standing split pose
Start by standing tall with your feet together, then slowly bend at the waist and touch the ground using your fingertips. Breathe through the whole process. Lift one leg up perpendicularly to the ground or lift it as high as you can. Hold this position for 30 seconds or more. Breath loudly and, again, you can close your eyes and recite your mantra. You should be able to feel it in your legs and back. When you think you are done with one leg, gently come back to your initial position. Be careful not to have a blood rush! Repeat on the other side.

Warrior three pose
Start by standing tall, feet together. Bend at the waist and lift one leg up so that your body is parallel to the ground (except for the leg you left on the floor). Extend your arms forward and be sure your face is facing forward. Breathe through the whole exercise. Hold this position for one second. This is a stretch and strength move that allows your leg muscles to grow and your pelvic area muscles to stretch. Come back to the initial position and repeat this move with the other leg.

The Locust pose
Lay on your mat, on your belly. Place your arms to the sides and lift your legs, your shoulders, head, and neck by using your back and let them hover above the floor. The only thing that should remain on the floor is the anterior part of your torso. This is a very good move for strengthening your core and stretching the legs. Don’t forget to breathe. Find your breathing pattern and use while you are maintaining this position for a couple of seconds, not too much unless you want to have a workout. Repeat a few of times.

The Bridge pose
Lay on your back and place your feet close to your buttocks. Place the arms on the mat, near the sides of your body and then lift your pelvis up while living the upper part of the body on the mat. Exhale while you lift. Hold this position for a few seconds then come back to the original position. Repeat this move 5 to 10 times. This is the best exercise for your pelvic region, it works and stretches the core, the buttocks, and the legs.

The Yogi squat pose
Start with your feet more than shoulder-width apart. Lower yourself down, like you are doing a Slav Squat. While you are down, keep your hips open by sending the knees away and sideways. Place your arms in a prayer sort of position and place the elbows between your knees. You can use your arms to stretch your thighs more. Hold this position and breathe deeply. You can come back to the initial position if your hips are sensitive, and if you have tight thighs, you can reduce the distance between your legs. Repeat this move until you feel satisfied.

The Supine bound angle pose
Lay on the mat, on your back. Bring your bent legs near your chest, above your pelvis by lifting them up. With the help of your hands connect the soles of the feet so they are facing each other. Now, also by using your hands, lower your legs down to the floor. The outsides of your feet should touch the ground. You should feel the stretch in your thighs and you should feel your hips opening up. Hold this position for about 30 seconds or more. If you have sensitive thighs and hips try and lower your feet on the mat. By doing this you will create a wide angle between your calves and your hamstrings, thus you will reduce the stretch in your thighs. Breathe constantly and repeat if necessary.

False Positive

It is not uncommon for reports to be misdiagnosed. A medical practitioner can make mistakes like the rest of us. And unfortunately, there are times when the injury that has been sustained will be overlooked by a medical practitioner and as a result, the pain an individual feels only gets worst over time.

If the person is not taking the necessary steps to properly heal, then they will do long term damage to their pelvis. In scenarios like this, it is important to get a second opinion, if you still feel pain after seeing your physician.  A second opinion might reveal other issues that you were completely unaware of and can help to cure the ailment that plagues you.

Wrapping it Up

The pain associated with the pelvic can vary a lot. The pain can be minor or severe and what has been a prevalent theme throughout the article is how much pelvic injuries are more common in female than men. For women, it is easier for them to suffer from a pelvic injury than that of a man.

It is important for a woman to be mindful of the amount of time that they are running and the surface that they are running on. A proper diet, adequate amounts of rest and the correct stretches can all do wonders for the body and help to prevent pelvic injuries from happening.

deep-vein-thrombosis-prevention

Gloomy as this may sound, there are cures and treatments that help. Pelvic injuries are not incurable ailments. As explained above in great detail, there is a variety of treatment available to not only help to alleviate the pain but to completely heal the injury.

For those who have sustained an injury in the pelvis, there is a multitude of ways to treat this injury. Prevention is always the best medicine and maintaining a proper posture will serve to only benefit you in the long-term.

Co-written by Edy Mihai

Curated by Diana Rangaves, PharmD, RPh

Sources used while researching for this article
The sources used for this article are listed below. These sites are respected sites with the articles written or researched by medical professionals; however, you should not take the information that has been written in this article as medical advice. Consult your doctor if you think you have sustained a pelvic injury.

Sources

  1. Andrew Gregory, M.D, Runner's Injury , Dec 03, 2015
  2. WebMD Staff, Arthritis Pain in hip , Jun 05, 2014
  3. Staff Writer, Sport's Injury, British Journal of Sports Medicine , Mar 15, 2013
  4. Staff Writer, Pelvic Fracture, Mar 08, 2017
  5. Staff Writer, Physical Exercises for Hip , May 02, 2017
  6. Jennifer Van Allen, Safe Surfaces to run on, Apr 04, 2013
  7. Nicole Radziszewski, Pelvic dysfunction, Jun 18, 2016
  8. U.S National Library of Medicine, Pelvic Injuries, Nov 03, 2016
  9. Matt Fitzgerald, Essential foods for runners, Mar 03, 2014
  10. Staff Writer, Massages for injuries , Jan 11, 2015