Katie Florio sought treatment from Claire Todd, PT, DPT, PRPC to help build pelvic floor strength while pregnant and training for marathons.
“This is it, this pain is going to force me to stop training,” Katie Florio thought to herself while training for the Philadelphia Marathon—at 16 weeks into her pregnancy.
The pelvic floor pain manifested at the worst possible time, threatening her training regime ahead of the Olympic Trials and the Philadelphia Marathon. But that’s when Florio met Claire Todd PT, DPT, PRPC, a Penn Medicine physical therapist and an endurance runner and running coach herself.
With Todd's help, Florio more than met her goals. She not only ran at the Olympic Trials, but won the marathon in November 2024, 13 months after her son's birth.
“Her work was integral in making sure I could keep going—keep training. I was planning on running throughout my whole pregnancy.” Florio said there was real concern that she wouldn’t be ready. “Claire got me back on track.”
Helping runners during and after pregnancy
Katie Florio with her husband and son Nico at the Olympic Trials.
Todd is a physical therapist at Good Shepherd Penn Partners Rehabilitation (GSPP Rehabilitation) who works with all types of patients, although she has a specific passion for helping pregnant and post-partum mothers keep their running pace.
Florio and Todd started meeting once a week—emphasizing pelvic floor-strengthening exercises and modifying her training schedule when necessary. With these changes, Florio was able to resume running pain-free up until 35 weeks pregnant.
After giving birth to her son Nico in October 2023, Florio had to kick her training into high gear. The Olympic Trials were only four months later. She started adding on mileage, but Todd encouraged her to take it slow to avoid injury. Florio says because Todd is also a runner, she was able to give feedback on her training regime. “She just understood it,” Florio said.
Finding her career niche
Eric and Claire Todd, who are both physical therapists at GSPP Rehabilitation.
Todd’s passion was sparked several years ago by a personal running client who happened to be pregnant at the time, and she wanted to make sure she was taking appropriate care of this patient. She started doing her own research and quickly realized there was a lot to learn about pelvic floor health during and after pregnancy.
The pelvic floor muscles help support multiple systems in the body including the urinary, bowel, and sexual function. Pelvic floor dysfunction can be caused by multiple things including pregnancy, childbirth, prostate cancer treatment, obesity, and chronic constipation. With the help of pelvic floor therapy, the muscles can recover and work as a team with the rest of the body.
Now when Todd is working with and training pregnant and post-partum athletes, her focus is pelvic floor function and recovery after vaginal delivery or C-section. “Runners are repetitively putting about three to four times our body weight on one leg when we're running, so I’m making sure that their pelvic floor is ready for that pressure after childbirth,” she said.
Todd says pelvic floor health was not a major topic in her physical therapy training. She became curious as she worked with clients and thought about her own health. That’s what drew her to work for GSPP Rehabilitation starting in 2021. “I knew they had a really good pelvic health program, and this is also when I got my Pelvic Rehabilitation Practitioner Certification (PRPC).”
When discussing the importance of caring for one’s body after childbirth, Todd said, “Patients are getting physical therapy after a knee or hip replacement—why aren't they getting physical therapy after this huge event for their bodies?”
Chasing after big goals
Katie Florio, women’s winner of the 2024 Philadelphia Marathon
In her own running journey, Todd’s first big race was the Philadelphia Marathon in 2014. She said she got into the sport because she wanted to push herself to do hard things; it’s a goal that gets her out of bed every morning, and it simply brings her joy. “Running has brought me to new places and helped me do things I never could have imagined.”
Todd now runs ultra-marathons, including a 100-mile race in Virginia right before starting at GSPP Rehabilitation, and now her next goal is to run a marathon in under three hours.
The right mix of Todd's focus on helping pregnant women and new moms, and Florio's focus and drive, delivered the right treatment to cross the finish line.
After months of training, Florio was able to compete in the Olympic Trials and ran the marathon. She was only the second woman from Philadelphia to win the Philadelphia Marathon since 1988—and she did it with a 13-month-old son to cheer her along.
Florio said, “Being able to continue to train during pregnancy was key—I would not have seen such success this year without it.”