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

Introduction: Pelvic compression garments are an emerging adjunct in 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, changes in perception, and improved pelvic floor support. It is also theorised that these factors could be influenced by levator hiatus distensibility. Methods: An exploratory, randomised, repeated-measures crossover design recruited 13 postpartum runners with self-reported symptoms of PFD. Participants' pelvic floor function and structural support were assessed. Each participant underwent two 7-min self-paced running trials, in randomised order, wearing their own shorts (control) and a pelvic compression garment (experimental) while biomechanical and accelerometer data were collected. Perceptual data on pelvic support and perceived symptoms were recorded following each running trial. Results: The pelvic compression garment significantly decreased the peak pelvic jerk, low-frequency pelvic shock attenuation, and the area under the peak pelvic acceleration curve. A significant decrease in left pelvic rotation excursion and an increase in axial trunk-to-pelvis rotation were also identified during late stance. The pelvic compression garment significantly increased perceived pelvic floor and core support and reduced fear of experiencing pelvic floor symptoms. No differences were 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-pelvis coordination similar to that of healthy runners. In addition, 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 statistical power are needed to further investigate the biopsychosocial effect of pelvic compression garments.