Why Do We Leak When Running? And How Pelvic Floor Physical Therapy Helps!
Running is an incredible way to stay active—it boosts your heart health, strengthens muscles, increases bone composition, and does wonders for mental well-being. That runner’s high? It’s real! And what about the sense of accomplishment after a run or intense cardio workout—there’s nothing quite like it.
But what happens when running, jumping, or HIIT-type workouts with jumping jacks, burpees, and squat jumps cause you an unexpected and unwanted leak? If you’ve ever experienced urinary leakage while running, jumping, or even laughing, you’re not alone. This is a common condition called stress urinary incontinence (SUI), affecting up to 40% of women—and it is nothing to be embarrassed about.
How the Pelvic Floor Muscles Are Involved
Your pelvic floor is made up of a group of muscles that span the bottom of your pelvis, from the pubic bone to your tailbone. These pelvic floor muscles support your bladder, uterus, and bowels and help you control your bladder so that urine comes out only when you want it to.
When working properly, your pelvic floor muscles should contract or “brace” to prevent leaks when pressure increases in your abdominal or pelvic region. When they aren’t functioning correctly—which can be due to muscle tightness or weakness—you may experience leaking with high-impact activities like running or jumping.
Because muscle tightness is a possible reason you are leaking, Kegels might not be the solution—in fact, they could make things worse. While many assume leaking is purely due to weak pelvic floor muscles, this is not true. If your pelvic floor is too weak, it may lack the strength and tone needed to properly support your bladder under impact, leading to leakage. However, muscles that are too tight can also be a problem. When overly tense, these muscles may struggle to contract effectively when needed or could be putting excess pressure on the bladder or sphincters, contributing to leaks.
It’s also important to note that core training alone isn’t the answer. While a strong core can help with pelvic floor function, it doesn’t address the underlying issue if muscle imbalance is present.
More Factors That Cause Leaking While Running or Jumping
Pregnancy & Postpartum Changes – Carrying and delivering a baby puts stress on the pelvic floor and can lead to increased muscle weakness or tightness.
Hormonal Changes – Perimenopause and menopause bring hormonal shifts that can affect muscle tone, tissue elasticity, and bladder control.
Core Coordination – Your pelvic floor doesn’t work alone; it’s part of your core. Your abdominal and glute muscle strength work together with your pelvic floor to create stability at the spine, hips, and pelvis.
Breathing Patterns – Poor awareness and control of your breathing patterns can increase pressure and lead to leakage.
Pelvic Organ Prolapse – If your bladder is lower than normal due to childbirth or menopause, this can contribute to leakage.
Running Technique & Impact – A heavy heel strike or excessive downward impact while running can increase pressure on the pelvic floor and bladder. Adjusting cadence, midfoot striking, and overall running mechanics can help lessen this strain.
How Pelvic Floor Physical Therapy Can Help
Contrary to popular belief, the solution isn’t always just to do more Kegels. Treatment should be highly individualized and may include:
Pelvic Floor Muscle Training – This goes beyond Kegels. An internal pelvic exam is recommended to assess your pelvic floor muscles and develop a personalized exercise program. You may need strengthening, relaxation, coordination training, or all three.
Proper Breathing Mechanics – Your pelvic floor works in coordination with your diaphragm. Understanding how to breathe with your diaphragm in all positions and learning proper breath coordination while running is essential in stopping leaks.
Core Muscle Coordination – Your pelvic floor therapist will ensure you are engaging all of your core muscles correctly, including your pelvic floor, deep abdominals, and hip muscles like the gluteus maximus, medius, and minimus.
Running Technique Adjustments – A pelvic floor physical therapist will analyze your running mechanics and suggest changes in your posture, technique and form to better distribute forces and minimize pelvic floor strain.
High-Impact Muscle Training – Your physical therapist will ensure all these muscles are working correctly when challenged in running, lifting, and jumping.
Running is not performed while lying down or sitting, so pelvic floor training and additional strengthening exercises should be performed while upright and moving. Make sure you see a pelvic floor physical therapist who understands how the body moves when challenged in high level activities and sports specific training.
Taking the Next Step for Running With Confidence
Running has so many benefits—it improves heart health, strengthens bones, boosts mood, and even helps with stress relief. For some, it is the only personal time they get for themselves. That’s why addressing your pelvic health is so important.
If leakage is holding you back, know that there are solutions. Pelvic floor physical therapy can help you enjoy running without worry, so you can focus on the miles ahead—not the next bathroom stop.