May 14 2025

Are Your High-Waisted Leggings Really Hurting Your Pelvic Floor?

Are Your High-Waisted Leggings Really Hurting Your Pelvic Floor?
What the Research Actually Says—And Why Postpartum Runners Deserve Better Than Fear-Mongering Headlines

You’ve seen the reels. The dramatic sighs. The finger-pointing. Maybe even that Runner’s World article implying your favorite high-waisted leggings are slowly crushing your pelvic floor like a boa constrictor.

And if you’re a postpartum runner—already second-guessing every sneeze, sprint, and squat—this might’ve sent you spiraling: “Wait… is my wardrobe ruining my recovery?”

Let’s unpack this. Clinically. Honestly. Without the clickbait.

🧵 What the Runner’s World Article Got Right

To be fair, the piece wasn’t totally off base. It raised important questions about how external compression from leggings—especially those beloved high-rise styles—could affect breathing mechanics, intra-abdominal pressure (IAP), and the pelvic floor.

It even quoted a pelvic health PT who shared her concerns:

Constrictive waistbands might make it harder to breathe diaphragmatically
That can increase downward pressure into the pelvis
And if your pelvic floor is already vulnerable (👋 postpartum moms), that could potentially contribute to symptoms like pressure, leaking, or heaviness

(Appreciate the nod to PFPT, but wish they’d asked one who specifically has experience with postpartum runners)

All possible. All worth exploring.
But here’s the problem:
The article subtly implies that high-waisted leggings are inherently dangerous, especially for women with pelvic floor concerns.

That part? Not backed by evidence. At least not yet.

📚 What the Research Actually Says

Let’s look at the data. Real data. Not just reels.

🩺 Kipp & Leahy (2024) – The Effect of Waistbands on Intra-Abdominal Pressure

Ten nulliparous (never pregnant) women completed bodyweight squats, lunges, and planks in both high- and low-waisted leggings. (This paper wasn’t specifically looking at runners either)
High waistbands increased IAP during isometric squats (176 cmH₂O vs. 156 cmH₂O, p=0.032)
Surprisingly, they also reduced work of breathing in dynamic squats
No major effects on breathing during lunges or planks
🧠 TL;DR: High-rise leggings might increase pressure during certain exercises—but not always. And no pelvic floor symptoms were tracked.

💨 Kipp et al. (2024) – Sports Bra Pressure & Breathing Mechanics (Listen to my chat with Shalaya Kipp, PhD talking about this EXACT paper on The Active Mom Podcast!)

Nine elite female runners ran in bras with tight vs. loose underbands.
Tighter bands increased work of breathing and decreased breathing efficiency
Participants reported discomfort and reduced ventilatory economy
🧠 TL;DR: Chest compression can impact breathing—but again, this was a nulliparous group of elite athletes, not postpartum moms.

💩 Takasu et al. (2000) – Girdles & Gut Motility

Six women wore girdles over four days (NOT high waisted leggings circa 2025)
Result: Delayed gut transit time and less fecal output
🧠 TL;DR: Clothing pressure affects digestion. Fascinating, yes. Applicable to postpartum pelvic floor rehab? Not directly.

⚠️ But Here’s the Catch…

None of these studies included postpartum women.
None. Zip. Zero.

Not women with pelvic organ prolapse.
Not runners with stress urinary incontinence.
Not moms recovering from C-sections with that familiar waistband scar sensitivity.

None of these studies looked at pelvic floor symptoms.
None. Zip. Zero here too.

So when articles like Runner’s World suggest these garments are inherently “bad” or dangerous for women with pelvic floor symptoms, we’ve got to take a big, collective breath and ask:

Who are they talking about? Because it’s not us.

(I”m all good at taking information we have from other areas of practice and applying it to our postpartum pelvic floor population. It’s where we experiment, get creative and problem solve…but you have to disclose that information. We don’t inherently KNOW that high waisted bottoms are inherently dangerous for runners…but man does it check the click-bait button for RW!)

🧘‍♀️ The Real-World Clinical Takeaway (for Postpartum Athletes)

You don’t need to toss your leggings.
You don’t need to run in boyshorts.
You don’t need to live in fear of a waistband.

But you do need to be aware of:

How your clothes feel during movement
Whether you’re holding your breath or clenching unconsciously
And how your symptoms respond to different clothing, activities, and strategies
Know that some people might have increased sensitivity to tight bottoms, but that doesn’t automatically mean they’re dangerous for EVERYONE.

Clothing can influence your pressure system—but it doesn’t control it.
Your breath, strength, mobility, and rehab strategies matter more than any waistband ever will.

That and we’re all an n=1, trying to find out what works for each of US!

✅ Practical Recommendations for Postpartum Runners

If you’re experiencing…	Try this:
Pelvic pressure or heaviness	Be aware of any sensitivity to high waisted bottoms. It’s ok to ditch them if you’re symptomatic, keep them if they’re not.
Pressure while holding your breath during workouts	Practice exhaling before AND during efforts with lighter lifts, monitor pressure & ensure good bracing with heavier lifts where you NEED to hold your breath or use a belt. Don’t try to breathe to coincide with when your foot hits the ground when you run.
Clothing digging into C-section scar	Opt for soft, wide waistbands or biker shorts that sit higher or lower than the incision. This is temporary.
General pelvic floor tension	Incorporate breath-focused mobility and progressive strength—not just stretching

You don’t need a wardrobe overhaul. You need context.

👟 High-Waist Isn’t the Enemy—Oversimplification Is

Look—I’m all for getting people curious about how their bodies work. But suggesting that high-waisted leggings are inherently risky for all postpartum women or pelvic health in all runners?

🚨 That’s a leap.
🚨 That’s not science.
🚨 That’s lazy fear-mongering wrapped in spandex.

Let’s advocate for more research that actually includes postpartum women. Let’s get curious, not panicked.

And most importantly: let’s remind moms that they can trust their bodies and their breath again—leggings and all.

💬 Have you noticed symptoms shift based on what you wear to work out? Did this article change how you think about compression and breath? Let’s talk about it below.

#PostpartumRunning #PelvicFloorPT #HighWaistedLeggings #PelvicHealthAwareness #MomRunner #PelvicOrganProlapse #PostpartumFitness #RunningWithProlapse #PelvicHealthMyths #IntraAbdominalPressure #DiaphragmaticBreathing #RunnerMom #EvidenceBasedPT #WomensHealthPhysio #RunningPostpartum #LeggingLove #PostpartumSupport #paglianorunning #paglianopostpartum

References:

Kipp S, Leahy MG, Sheel AW. Sports Bra Restriction on Respiratory Mechanics during Exercise. Med Sci Sports Exerc. 2024 Jun 1;56(6):1168-1176.

Leahy MG, Kipp S, Sheel AW. The Effect of Waistbands on Intra-Abdominal Pressure and Respiratory Mechanics During Bodyweight Exercise. J Strength Cond Res. 2024 Aug 14.

MacHose M, Peper E. The effect of clothing on inhalation volume. Biofeedback Self Regul. 1991 Sep;16(3):261-5

Petruny, Morgan. High-Waisted Bottoms Are Hot Right Now. But Should You Be Running in Them? https://www.runnersworld.com/gear/a64512101/running-in-high-waisted-bottoms/

Takasu N, Furuoka S, Inatsugi N, Rutkowska D, Tokura H. The effects of skin pressure by clothing on whole gut transit time and amount of feces. J Physiol Anthropol Appl Human Sci. 2000 May;19(3):151-6.