Running places unique demands on the pelvic floor. With every stride, your body has to absorb force, maintain stability, and manage pressure through your abdomen and pelvis.

For many runners, pelvic floor symptoms don't show up during everyday activities. Instead, they appear when the demands increase—during a run, as mileage builds, when pace increases, or as fatigue sets in.

Urinary leaking may be common among runners, but that doesn't mean it's something you simply have to live with.

Check Out our What Is The Pelvic Floor and How Does It Work article.

Signs of Pelvic Floor Dysfunction While Running

Pelvic floor symptoms during running can include:

Urinary leaking
Pelvic pressure or heaviness
Urinary urgency
Pelvic or lower abdominal discomfort
Symptoms associated with pelvic organ prolapse
Difficulty returning to running after pregnancy

These symptoms don't necessarily mean your pelvic floor is simply "weak."

The pelvic floor needs to contract, relax, and coordinate with your abdominal muscles and breathing while responding to the repeated impact of running. Strength, coordination, mobility, running mechanics, and your current training load can all contribute to symptoms.

Often, a diagnosed or misdiagnosed Diastasis Recti can contribute to pelvic floor dysfunction.

That's also why simply doing more Kegels isn't always the answer.

Why Do I Leak When I Run?

Running is essentially a series of repeated single-leg landings.

Each time your foot contacts the ground, your body has to manage force through your legs, hips, trunk, and pelvic floor. Your pelvic floor also has to respond appropriately to changes in abdominal pressure which stabilizes your pelvis and hips.

You may have no symptoms while walking or during normal daily activities but begin leaking after 10 minutes of running, when increasing your pace, or toward the end of a longer run.

That information is useful.

Instead of simply asking whether your pelvic floor is strong or weak, we want to understand why your body is having difficulty meeting the demands of running.

Pelvic Floor Physical Therapy for Runners

A runner experiencing pelvic floor symptoms should be evaluated as a runner.

At Summit Physical Therapy, we may assess:

Pelvic floor strength, relaxation, and coordination
Hip and leg strength
Abdominal and trunk function
Breathing and pressure management
Single-leg control
Impact tolerance
Running mechanics
Training volume and progression

Treatment is then based on what we find.

For one runner, pelvic floor strengthening may be important. Another may need to improve pelvic floor relaxation or coordination. Someone else may benefit from improving hip and trunk strength or gradually rebuilding tolerance to impact.

Frequently, it's a combination of factors.

Returning to Running After Pregnancy

Returning to running postpartum is one of the most common times women begin paying attention to their pelvic floor.

Pregnancy and childbirth place significant demands on the pelvic floor and abdominal wall. Returning to running then introduces repetitive impact before these areas may have regained their previous capacity.

Rather than relying only on a certain number of weeks or months after delivery, we want to determine whether your body is prepared for the demands of running.

That may mean progressively rebuilding strength, single-leg control, walking tolerance, jumping, and impact tolerance before increasing running volume.

Your individual goals matter too. Preparing someone to comfortably run a few miles per week is different from preparing a runner for a half marathon.

Do I Have to Stop Running?

Not necessarily.

Depending on your symptoms, you may be able to continue running while working on the factors contributing to the problem. In other situations, temporarily modifying mileage, pace, hills, intervals, or run/walk ratios may make sense.

Our goal isn't to unnecessarily take running away.

It's to determine the appropriate amount of running your body can currently tolerate and progressively build from there.

Get Back to Running With Confidence

If leaking, pelvic pressure, urgency, or discomfort is affecting your running, pelvic floor physical therapy can help identify why.

At Summit Physical Therapy, our pelvic health physical therapists work with runners and active adults throughout Summit, Short Hills, Millburn, Maplewood, Madison, Chatham, Florham Park, and surrounding New Jersey communities.

Request An Appointment

Our goal isn't simply to reduce your symptoms. It's to help you build the strength, coordination, and capacity you need to get back to running.

Experiencing pelvic floor symptoms while running? Contact Summit Physical Therapy to schedule a pelvic floor physical therapy evaluation.

Pelvic Floor Physical Therapy for Runners: Leaking, Pelvic Pressure & Returning to Running