Unfortunately, hemorrhoids are quite common, with statistics suggesting that 50% of adults in the United States over the age of 50 suffer from hemorrhoids.
Certain types of exercise can worsen hemorrhoids and may potentially cause hemorrhoids in those with risk factors.
But, does running cause hemorrhoids? Can you go running if you have hemorrhoids?
In this guide to running with hemorrhoids, we will discuss if running actually causes hemorrhoids and how to run with hemorrhoids so it doesn’t put a damper on your training schedule.
What Are Hemorrhoids?
Before we look at whether running causes hemorrhoids and how to run with hemorrhoids, let’s touch upon the signs and symptoms of hemorrhoids and what they actually are.
Hemorrhoids are swollen blood vessels in the rectum or anus areas.
These blood vessels become sensitive and painful and can cause bleeding into the stool or when you wipe yourself after using the toilet.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, there are different degrees of hemorrhoids in terms of severity and site.1Symptoms & Causes of Hemorrhoids | NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/symptoms-causes
Internal Hemorrhoids
Internal hemorrhoids are located inside the outer rectal area and may not be particularly painful because there aren’t as many nerve endings in the inside of the anal canal.
However, internal hemorrhoids can bleed during a bowel movement because stool scrapes against them as it passes through the anal canal. You may notice blood when you wipe yourself or some blood on the stool in the toilet.
External Hemorrhoids
External hemorrhoids are swollen blood vessels that protrude outside of the anus.
These types of hemorrhoids are usually more painful because external hemorrhoids are in the anal area that contains many more nerve endings.
Although hemorrhoids are generally not a major cause for concern, if you experience frequent hemorrhoids or significant rectal bleeding, it is important to speak with your doctor about management and possible underlying causes.
Prolonged rectal bleeding can potentially lead to iron-deficiency anemia due to excessive loss of red blood cells.
Long-distance runners, especially pre-menopausal female runners, and vegan runners are at an increased risk of iron-deficiency anemia, so it is important to speak with your doctor, examine your diet, and look for ways to prevent hemorrhoids.
Although runners with hemorrhoids typically do not experience complications, it is important to be mindful of thrombosed hemorrhoids.
A thrombosed hemorrhoid occurs when there is a blood clot in the hemorrhoidal vein. The blood clot essentially blocks sufficient blood flow, which causes even more significant pain and swelling, particularly when walking or sitting for long periods.
It is also possible for the hemorrhoid to become infected, which would require immediate medical attention.
Can Running Cause Hemorrhoids?
Although many people worry that running can cause hemorrhoids, the good news is that doctors and medical researchers say that running does not cause hemorrhoids.
Regular cardiovascular exercise is one of the best ways to potentially prevent hemorrhoids and improve symptoms of hemorrhoids because physical activity helps increase circulation, improve the elasticity of blood vessels, and regulate bowel movements to reduce the risk of constipation.
As such, numerous studies have demonstrated that having a sedentary lifestyle and sitting for long periods are risk factors for developing hemorrhoids.
Additionally, another benefit of exercise for hemorrhoid prevention is that regular physical activity and a healthy diet can help manage body weight and prevent obesity.
Can You Run With Hemorrhoids?
Generally, it is safe to run with hemorrhoids.
Unlike certain types of exercise, such as cycling, horseback riding, or weightlifting, you can generally run with hemorrhoids without worsening the condition or causing further bleeding.
This is because, unlike forms of exercise like horseback riding or straddling a bike seat, running doesn’t put direct pressure on the rectal area, which tends to greatly exacerbate hemorrhoids (especially if you have external hemorrhoids).
Additionally, unlike with types of physical activity such as weightlifting workouts with heavy weights where you might perform the Valsalva maneuver or ab exercises like sit-ups, running (and most forms of cardiovascular exercise) doesn’t cause increased pressure in the abdominal cavity.
Heavy lifting can cause a worsening of symptoms of hemorrhoids and can lead to rectal bleeding because the increased pressure from holding your breath and the added straining of lifting heavy weights can cause the muscles in the pelvic floor to contract.
Blood flow to the rectum and anal canal can also increase whenever you are straining, whether due to weightlifting workouts, trying to have a bowel movement when you are dealing with constipation, squatting, or doing some type of heavy lifting around the house.
Increased blood flow and contraction of the pelvic floor muscles surrounding the rectum and anal canal can then aggravate hemorrhoids and cause bleeding or further enlargement of the swollen blood vessels.
However, this is not to say that you definitely won’t experience hemorrhoid pain or flare-ups while running if you have moderate to severe hemorrhoids.
Additionally, if you have external hemorrhoids, running can irritate the hemorrhoids and cause chafing and rectal bleeding.
Tips for Running With Hemorrhoids
Here are some tips for running with hemorrhoids to help prevent worsening the condition or causing flare-ups once your hemorrhoids have started to heal:
#1: Drink Plenty of Water
It is very important to stay well hydrated before, during, and after running in order to avoid worsening the hemorrhoids.
One of the main risk factors for hemorrhoids is dehydration because dehydration dries up stool, increasing the risk of constipation. Constipation can cause straining during bowel movements.
Dry, hard stools can irritate internal hemorrhoids as the feces passes through the rectal area and anal canal. Plus, the increased pressure causes swelling of the blood vessels in the anal canal.
Sweating during running workouts decreases your body water levels, which can lead to dehydration if you don’t stay on top of your hydration needs.
#2: Wear Loose, Breathable Clothing
Avoid any tight clothing around the abdominal area so that compression garments don’t increase pressure when you are running with hemorrhoids.
Loose, breathable clothing will help regulate your body temperature and prevent excessive sweating in the gluteal cleft (butt crack). Sweat contains salt, which can cause irritation and burning if the acidic sweat drips into irritated hemorrhoids.
Therefore, wearing breathable clothing is one of the key precautions to ensure running won’t aggravate your hemorrhoids.
#3: Wear Running Underwear
If you have external hemorrhoids, you may also want to avoid tight underwear or tight compression shorts that press on the hemorrhoids when running.
Make sure to wear underwear made for running that is breathable and fits properly.
Sweating near the groin and crotch will increase the risk of chafing around the hemorrhoids (moisture plus friction can cause chafing).
The underwear should also not be too tight that it is pressing against the hemorrhoids, but you also do not want it to be bagging or bunching under your shorts or tights, as this can increase friction and chafing.
I recommend Paradis Sport underwear and Manmade’s Boxer Briefs.
#4: Reduce the Intensity of Your Runs
It is often a good idea to reduce the intensity and duration of your running workouts if you’re dealing with moderate or severe hemorrhoids with active rectal bleeding, stinging, throbbing, or pain.
High-intensity workouts, including speed work, sprinting, hill running, or running races, can potentially bother hemorrhoids more than shorter, easy runs at a comfortable pace.
#5: Eat More Fiber
Fiber helps regulate your digestive system to prevent constipation. The USDA recommends a daily intake of 14 grams of fiber for every 1,000b calories.2AskUSDA. (2024). Usda.gov. https://ask.usda.gov/s/article/How-much-dietary-fiber-should-I-eat#:~:text=Nov%2014%2C%202023&text=Dietary%20fiber%20intake%20is%20recommended
#6: Use Hemorrhoid Treatment Options
There are treatment options, such as hemorrhoid creams and ointments, that you can apply to the affected area to help reduce swelling, pain, and itching, such as Preparation H or the natural option Bloop.
A sitz bath with warm water also boosts blood flow to the rectum and affected area, and witch hazel can shrink hemorrhoids and reduce pain and itching.3Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2017). Enlarged hemorrhoids: How can you relieve the symptoms yourself? In www.ncbi.nlm.nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK279466/
#7: Listen to Your Body
Running is a high-impact activity, so if you have large, inflamed external hemorrhoids that are very swollen or bleeding, you might find that running is too painful or seems to lead to worsening the condition.4NILSSON, J., & THORSTENSSON, A. (1989). Ground reaction forces at different speeds of human walking and running. Acta Physiologica Scandinavica, 136(2), 217–227. https://doi.org/10.1111/j.1748-1716.1989.tb08655.x
If this is the case, you may need to take a few days off from running as you wait for the various hemorrhoid treatment options to start to take effect.
Low-impact exercise such as swimming, water aerobics, brisk walking, or hiking can be some of the best types of exercise to try during a bad flare-up until you feel ready to run.
If you think about going for a run with hemorrhoids, and even the thought makes you think it’s going to be uncomfortable or make things worse, it’s definitely better to try a different form of exercise or take a rest day from your training plan.
If you do need to take a break from the impact of running, take a look at our latest hiking guides:
