Pelvic compression garments alter running biomechanics, perceived support and fear of symptoms in postpartum women with pelvic floor dysfunction. Preliminary observations from an exploratory, randomized, repeated-measure crossover design

Grainne M. Donnelly^1,2*Celeste E. Coltman³Rebecca Straker^4,5Hans Christian Von Lieres Und Wilkau^4,6Carly L. Brantner^7,8Isabel S. Moore²

• ¹Pelvic Obstetric and Gynaecological Physiotherapy, London, United Kingdom
• ²Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
• ³Research Institute for Sport and Exercise (RISE), Faculty of Health, University of Canberra Faculty of Health, Canberra, Australia
• ⁴Cardiff Metropolitan University School of Sport and Health Sciences, Cardiff, United Kingdom
• ⁵Intensive Rehabilitation Unit, UKSI, Bisham Abbey National Sports Centre, Marlow, United Kingdom
• ⁶Red Bull Athlete Performance Centre, Thalgau, Austria
• ⁷Duke University Department of Biostatistics and Bioinformatics, Durham, United States
• ⁸Duke University Duke Clinical Research Institute, Durham, United States

Introduction: Pelvic compression garments are an emerging adjunct for the management of pelvic floor dysfunction (PFD) yet research investigating their efficacy and mechanism of action is limited, especially in the context of returning to running postpartum. Proposed theories for how pelvic compression garments assist postpartum women during running include alterations to running biomechanics, perception and to pelvic floor support. It is also theorised that these factors could be influenced by levator hiatus distensibility. Methods: An exploratory, randomized, repeated-measure crossover design recruited 13 postpartum runners with self-reported symptoms of PFD. Participant pelvic floor function and structural support were assessed. Each participant underwent two 7-minute self-paced running trials in randomized order wearing their own shorts (control) and a pelvic compression garment (experimental) while biomechanical and accelerometer data were collected. Perceptual data for pelvic support and perceived symptoms were recorded following each running trial. Results: The pelvic compression garment significantly decreased peak pelvic jerk, low frequency pelvic shock attenuation and area under the peak acceleration curve. A significant decrease in left pelvic rotation excursion and increase in axial trunk to pelvis rotation was also identified during late stance. The pelvic compression garment significantly increased perceived pelvic floor support, perceived core support and reduced fear of experiencing pelvic floor symptoms. No difference was observed between conditions for self-reported symptom experience following the running trials. Levator hiatus distensibility did not significantly interact with any biomechanical or perceptual variables. Discussion: Wearing a pelvic compression garment appears to alter running biomechanics in postpartum women with PFD in a way that produces a smoother running gait and restricts transverse pelvis motion, promoting trunk and pelvis coordination that is akin to healthy runners. Additionally, wearing a pelvic compression garment increases perceived core and pelvic floor support and decreases fear of experiencing PFD symptoms compared to a control condition. Levator hiatus distensibility does not appear to interact with how symptomatic postpartum women respond to wearing a pelvic compression garment and therefore offers limited predictive value. Future studies with higher power are needed to further investigate the biopsychosocial effect of pelvic compression garments.