Tina Muir’s Postpartum Advice: Don’t Neglect The Pelvic Floor

Those who paid close attention to running world news last year will remember Tina Muir’s sudden departure from the professional circuit, a personal decision that was inspired by her years-long struggle with amenorrhea and desire to become a mother. Not long after making her official exit, Muir announced her first pregnancy—and, in January of this year, she gave birth to her daughter, Bailey. Women’s Running has been touching base with Muir ever since for updates on how she’s adapting to life as a new mother, learning a little more each time about the struggles Muir has faced thus far and her interest in returning to professional running in the years ahead.

Last week, Muir reported that she recently had to take another break from running in response to an injury that cropped up this spring. That injury inspired much of what she wanted to discuss for this interview, as well as the message she hopes to pass along to other mothers: the often underestimated importance of postpartum pelvic floor strengthening.

How have you been since we last spoke in March? How is Bailey?

She’s getting to that point where she’s starting to teethe, and that’s the point where they start getting a little fussy. She’s growing well, and I’m getting to know her more.

For myself and running, I’ve had to eat some humble pie. I was given a few slices and I didn’t listen, and now I haven’t run in about two weeks. I neglected the one thing that everyone was telling me to do: strengthen my pelvic floor. That was the thing I want to come across: I’m really a big advocate for strength training. I did go to see a pelvic floor therapist, but all she really found wrong was the endurance of my pelvic floor. I had a relatively simple birth and bounced back quickly, and I was able to do a kegel correctly and tighten my pelvic floor correctly to activate it—but I wasn’t able to hold it. I arrogantly thought, What does endurance for the pelvic floor really matter? So I did go see her every week, but since my husband’s season got busy, it gave me an easy way out. I stopped going, and sure enough, a month later, an injury popped up, which I’m almost positive was a result of the pelvic floor endurance not being able to hold my core and pelvic floor together, which led to an injury.

I’ve had to eat my words. I’ve had a lot of people kindly reach out to me, giving me their advice, but I didn’t take it seriously. This is where I’ve landed, taking two weeks and now one more off, then I’ll try again. I was thinking it might be a fracture, but I’ve come away from that now; I think it’s just an aggravation. As much as it’s all great and good to say, “Just get an MRI,” at certain points, you maybe can’t afford that or have to put other things first and accept that your body will be ready when it’s ready. Sometimes it’s best for your family and life if you take it as a sign that you pushed something too fast or overdid it. Rather than look for an exact answer, you take that time to really understand what you did wrong and where you’re going to go from there. I’m going to start completely over again. The fitness will probably come back quicker than it did last time, because I did have a couple of months of running, but it’s definitely a reality check. I’ll be encouraging other women to check with a pelvic floor therapist. It really isn’t fun to make it four months down the road and have to stop again—especially since I thought I’d gotten away with it.

What advice have other pro runners offered you for returning to the sport?

I’ve been documenting my feelings in a journal-like process on Strava. I’ve found that therapeutic for me, and I’ve had people reach out to me, saying it’s caused them to rethink their decisions if they’ve had a niggle or something in their gut to get it looked at. I’ve been documenting, knowing it’s helping other people. Individually, I’ve messaged a few people on Instagram who I know are either starting to run again or are a few months behind me, who may be making the errors I made. The issue wasn’t with the first month or so—it was once things started to get to a more “normal” running routine. That was when it was easy to get carried away. You’re cautions in the beginning, but then you start to feel cocky, like you’ve made it through to the other side.

I’m being completely honest with people, literally turning on the microphone and talking through the way I’m feeling, and I’ve gotten some good feedback.

As you take this short break from running, what other activities are you doing to reclaim your fitness?

The woman I see in town is booked pretty solid. To me, that shows how important it is, and how it is starting to become recognized as important. That’s an exciting sign that women are realizing how important [pelvic floor therapy] is. Otherwise, I was cross-training, I was on the elliptical, I was swimming and pool running, but I found that everything was aggravating my glutes, so I decided to take at least a week, if not two, to completely rest. I also had mastitis this week, which was more proof to me that my body’s feeling a bit run down. Even though mothers postpartum might feel like they’re not doing anything, you aren’t realizing how many things your body’s doing.

During pregnancy, my dietitian said to me, “You’re doing couch exercises.” At first, I took that as an insult. But now I’m essentially doing breastfeeding and motherhood exercises. As a runner, you’re so used to getting a sweat on and feeling that tired burn in your legs. It can be easy to discount this ginormous change that your body is going through in recovery from having a baby and what it has to deal with day after day. You’re holding this weight in your arms all day long, giving it so much of you. It can be easy as runners to think that’s nothing and not enough, because you’re not building up a sweat, but your body is working in some ways harder than it ever has. I’m sleeping eight to nine hours every night, and I’m still waking up feeling tired.

When we last spoke in March, you said that running was the activity you were enjoying most. Was that still the case, up until your injury?

It was still a source of enjoyment, but I would be lying if I said the pressure from myself hadn’t started to creep in: the need to feel like I was out to prove something, that I was going to get back into shape quickly. It wasn’t initially that I started to waver; it was after the first few months. That’s when you start to see a little glimmer of who you use to be, and you get carried away with it. Getting within the realm of normal was too much of a temptation not to push it. To the new mothers out there: Everyone is just impressed that you’re able to get out of the house, leave your child for a few minutes and get out to exercise.

Are you still feeling that pressure?

Not since I’ve completely stopped all exercise. In the first few days after the injury, I was still strength training and cross-training and I wasn’t enjoying the cross-training at all. I was just doing it because of my ego and not wanting to lose fitness, which we as runners often resonate with. If you’re training for a race, that’s one thing, but I was just doing it because I felt like I had to—even though I was looking at the clock every two minutes, wondering if it was time to be done. Since then, I’ve backed off and allowed myself the time to reset. Maybe that pressure was what was causing this in the first place. It was giving me too much pressure to push myself.

What other difficulties have you encountered as a new mother runner so far?

There have been so many moments of joy. I heard Bailey giggle for the first time a few days ago, which was the best sound I’ve heard in my life. Every day with a baby, once you get over the initial hump of the first few months, every day brings something to make you smile. You might have a bad night or a bad day, but they’ll do something that makes it all melt away.

She does like being in the swimming pool. As a parent, it allows your imagination to run wild: She’ll be a swimmer! Or, the fact that she’s already strong on her legs—will that mean she’ll be a runner?

The mastitis this week was tough, and it wasn’t what I’d expected. I had flu-like symptoms hit me like a ton of bricks. That was tough, and hard to accept that you body is not quite ready for a lot of activity. Even the day before, all I’d done was stayed out for one feeding. That was maybe too much for me and my body. I feel like, at four months, I should be back to my normal life, but I’m not. That’s been difficult to accept. As a runner, you expect to be sore for five days after a marathon, and then it’s easy to jump back into training. With motherhood, it’s the same kind of thing: You feel like, after the first few months, you should have everything under control, when in fact it’s okay not to.

What message are you most eager to pass along to other new mother runners?

The pelvic floor: I didn’t take it seriously enough, and that’s what I believe caused this injury. I was doing my strength training. I thought, I’m a strong runner. I do my lifting, therefore I don’t need a pelvic floor therapist. But I did, and I think most, if not all, postpartum women do. Even or especially if someone’s had a baby years ago and something doesn’t feel quite right or they’re feeling issues in their hips and back.

Related:

An Update From Pro Runner Tina Muir On Her Postpartum Journey

Meet The Elite: Our Q&A With Tina Muir

Tina Muir’s Heartbreaking Blog Post Is A True Runner’s Story