KAYLA HEGER PT, DPT, WCS
Kayla can be reached at firstname.lastname@example.org
To Go or Not To Go?
Should you “go” during a race?
If you are a runner you have most likely thought about it or found yourself in this situation before. You’re mid-run searching for a nearby bathroom.
Or do you plan your route around possible bathroom stops?
Have you found yourself contemplating using the porta-potty during a big race?
It’s all too common for runners but what really should you do?
Is it better to hold off the urge or feed into the bowel/bladder urgency?
First, let’s talk about the bladder and squash the rumor that it is “normal” to pee a little while you run. This is false, if your pelvic floor is functioning well and at full strength, you should not experience incontinence (involuntary urination) with any high or low-intensity activity including running! Some runners may decide to voluntarily go to the bathroom during their race instead of stopping to use the bathroom, but that is a personal choice. If you are having unwanted “leaking” during a race, you may want to consider visiting a pelvic rehabilitation therapist to help eliminate those accidents.
So, let’s say you are planning for a morning run, you get up and use the bathroom before heading out and about halfway into your run you feel this sudden urgency and have to urinate. Should you fight this urgency or look for the nearest restroom? Typically, when we exercise, the blood flow to our kidneys (the start of the urinary system) is decreased to help maintain blood flow and blood pressure to other working muscles. Due to this decrease in blow flow, the amount of fluid filtered by the kidneys is decreased, resulting in lower urine production.
So, in reality, if you just went to the bathroom before your run and you haven’t had much additional fluid intake your bladder should be able to hold through a moderate workout without needing to use the restroom. If you find yourself stopping to use the bathroom at the first feeling of urgency you may be teaching your bladder “bad habits”. If you routinely empty your bladder before it’s full, your bladder will signal the urge to go when less volume is present. This can become a vicious cycle, and many find issues with urgency even when not working out.
Now onto the elephant in the room, should you poop during a race?
For many, exercise can help stimulate the bowels and for those who tend to be more on the constipated side of things, exercise can be a great way to get your bowels moving.
Unfortunately, if your debate is stopping for a BM during a race or reaching a new PR, this can be a hard decision to make. Bowels can be affected by so many things including what you eat. All of us are different in how our bodies react to different foods so your best bet is to track the foods you eat even weeks or months before your race and find what foods agree or disagree with you and stick to what you know your body can easily digest before race day.
Did you know your running mechanics can also affect your digestive dilemmas?
Continuous running over a long period of time takes a lot of internal jostling on your organs which again could stimulate a BM. An easy way to reduce this trauma is by looking at your running mechanics and your vertical oscillation. A visit with your physical therapist could be beneficial to look at your running mechanics and get you on the right track.
Other considerations are your caffeine intake and getting your nervous system in check. Caffeine is a love-hate relationship but again tracking and finding what works best for your body before race day is ideal. Those stomach butterflies we all get before a race can also affect our bowels. Your gut and brain have a direct nervous connection and any added stressor or anxiety can also stimulate your bowels. Keeping those nerves in check and finding ways to suppress your nerves will also be a great addition to your pre-race routine. Ideally, if you can have your BM before your race will set you on the road to success but this may take weeks to months to attain so again, find a routine that works for you and STICK TO IT!
Use your training and practice runs to trial different things to find how your body responds. The best thing you can give yourself is time; time to eat, drink something, stretch, and allow your bowels to do their thing.
Like the bladder, blood flow is usually diverted away from the GI system during high-intensity activity, so it is best to run with less stool sitting in your system to prevent the dreaded runner’s diarrhea.
To wrap up, if you have tried all of the above and still find yourself mid-race searching for a bathroom and wondering if you should take the opportunity or not, it really is up to you. Listen to your body and how you are feeling, if you were able to use the restroom before the race (both bowel and bladder) try and see if you can distract yourself and see if the urgency suppresses. Another nice little trick is trying a couple quick “kegels” or pelvic muscle contractions to suppress the urge. It is IMPORTANT to note you need to perform the kegel correctly to be effective so it’s best to reach out to your pelvic rehabilitation PT for further guidance. In the end, if you decide to hold it in, is it really going to detrimentally affect your urinary or digestive system? No.. But if you continuously do this over time can start having effects both with exercise and your daily life, so do not let bad habits become the new norm.
Although we spend so much of our time worrying about pace, stride length, mechanics, pre-race warm-ups, and reaching that PR don’t neglect how important bowel and bladder health is not only in general life but in the running world as well.
If you have any questions feel free to reach out to the professionals at Apex Physical Therapy!
We would love to be a part of your healthcare team.
KAYLA HEGER PT, DPT, WCS