Running after childbirth can be tricky enough, as you navigate what feels like a new body and new schedule. Leaking urine when running can make postpartum running an even more frustrating experience. However, you do not need to stop running – or accept wet running shorts as the new norm. This article covers what you need to know about running and pelvic floor, including how to stop leaking urine when running.
While this article focuses on leakage when running and pelvic floor concerns after childbirth, the advice can apply to other phases of life. The pelvic floor can weaken with age or other causes.
Your pelvic floor is a group of muscles and ligaments that support the uterus, bladder, and bowels. The two main muscles are the levator ani (a larger muscle spanning the whole pelvis) and the coccygeus (a smaller muscle). The pelvic floor muscles work with your core musculature to support your organs and control bathroom movements.
When you leak urine when running, your pelvic floor muscles are not doing their normal work. Pelvic floor dysfunction contributes to urinary incontinence when running, as well as other symptoms such as pain, constipation, or urgency. If you regularly leak or pee yourself when running, chances are you are experiencing problems with your pelvic floor muscles.
If you experience any pelvic floor weakness or complications such as prolapse, running will not strengthen your pelvic floor. Unfortunately, running could even worsen pelvic floor issues if they are not resolved. Running simply does not apply the proper amount of mechanical tension to result in increased strength in the pelvic floor muscles.
In order to strengthen your pelvic floor muscles, you want to follow a deliberate pelvic floor strength routine. This type of strength routine will look drastically different than a normal lifting routine. Pelvic floor strength routines will often involve breathing exercises, activation exercises, and strengthening exercises.
When one thinks of pelvic floor exercises, Kegels are the first to come to mind. Kegels are contractions of the pelvic floor muscles, done for either a number of reps or held for a certain number of seconds. Kegels can strengthen the pelvic floor muscles and reduce leakage, if they are appropriate for the individual.
Kegels can be a beneficial exercise for athletes with weak pelvic floor muscles. However, there are two caveats before you start doing fifty kegels per day to fix leakage when running. First, you want to ensure you know how to properly do a kegel. Secondly, Kegels are only one pelvic floor exercise – not the whole solution. To fully strengthen your pelvic floor, you will likely need to include other exercises, such as diaphragmatic breathing.
For some female runners, the problem is not a weak pelvic floor – rather, they experience problems due to a tight pelvic floor. Their pelvic floor muscles are overactive and tight. This can result in similar symptoms as pelvic floor weakness, but the treatment will be different. Kegels may not be the most appropriate approach for someone with pelvic floor tightness.
Your birth experience will impact your return to run timeline. Some runners may be ready to resume a gradual run-walk program at six to eight weeks postpartum. However, if you experienced a birth injury (such as severe tearing) or you have symptoms of pelvic floor dysfunction, you may want to wait until ten to twelve weeks postpartum (or longer).
If you experience any pelvic floor pain or urinary incontinence with daily activities, you are not ready to start running postpartum. If this is your scenario, you first want to seek guidance from a pelvic floor physical therapist.
Importantly, do not rush back into running if you do not feel ready. It is okay to take time off if you are struggling with sleep or do not feel ready to run postpartum. Running will be there when you are ready.
Related: How to Start Running Again Postpartum
If you leak urine when you run, you likely are experiencing some form of pelvic floor dysfunction. In such a scenario, it is recommended to work with a pelvic floor physical therapist or to undertake a pelvic floor strengthening routine from a certified professional.
Importantly, do not skip hydration if you experience incontinence when running. Withholding fluids does not actually fix the problem – and poor hydration can cause other problems.
Finally, establishing a routine before running can aid in stopping the urge to pee during a run. Create a routine where you drink the recommended 8-12 oz of fluid about one hour before a run, which will help it pass through your body. Use the restroom right before you head out on your run, even if you do not urgently feel the need to go.
Pelvic floor exercises focus on both the pelvic floor muscles and the muscles of your core. To strengthen the pelvic floor, you can do pelvic floor physical therapy, special postpartum programs, or Pilates.
Pelvic floor physiotherapy is remarkably effective. I’ve seen athletes go from being unable to run 5 miles without stopping for the bathroom to being able to run a marathon without issues, all thanks to pelvic floor physiotherapy. Science supports pelvic floor physiotherapy; a 2020 study in the Journal of Clinical Medicine found that athletes saw significant improvements in urinary incontinence when they did physical therapy.
If you experience pelvic pain when running or are wondering how to stop leaking urine when running, your best bet is to visit a pelvic floor physical therapist. The PT can diagnose the root cause and prescribe pelvic floor exercises for runners.
The ReCore Fitness Postpartum program is a reputable online downloadable program for postpartum athletes. Its creator is a post-natal trainer and ACE Medical Exercise Specialist. The first ReCore program is recommended for early postpartum women and is safe to use after both vaginal delivery and a C-section (once cleared to resume exercise). Additionally, the ReCore 2 program is intended to progress after completing ReCore.
(I have no affiliation with ReCore; this is not a sponsored post or affiliate link. I did use this program successfully to return to running after having my baby in 2019!)
While the conclusion is not yet definitive, some evidence suggests that Pilates may reduce urinary incontinence. Pilates does work the pelvic floor and core muscles, as well as trains diaphragmatic breathing that can reduce leakage.
A 2023 study in the Journal of Bodywork and Movement Therapy found that women who did Pilates during pregnancy were less likely to experience severe urinary incontinence after childbirth. Likewise, a 2021 review in the International Journal of Environmental Research and Public Health found that prenatal Pilates can reduce risk of pelvic floor injuries during childbirth.
However, Pilates may be best for preventative pelvic floor strengthening or for mild cases of pelvic floor dysfunction. A 2020 review in the Journal of Bodywork and Movement Therapy concluded that Pilates was not as effective in rehabbing pelvic floor dysfunction compared to traditional pelvic floor exercises.
If you experience any pelvic pain or leakage when running after childbirth, you are not alone. More importantly, you do not need to accept leaking or discomfort as your new norm. A careful return to running and pelvic floor exercises can help you build back to comfortable, leak-free miles.
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