When Running Feels Like a Pelvic Floor Nightmare Part 2

More Real Talk on Leaks, Pain & Running Strong Again

Ever found yourself mid-run, mentally mapping out every single bathroom on your route just in case? Or maybe you’ve avoided certain workouts (hello, jump squats & jumping jacks) because your pelvic floor has decided to betray you? If you’ve ever felt like your body is working against you when you run, this one’s for you. Let’s get into more of the real questions you’ve been dying to ask but maybe felt too awkward to Google.

6. Will Kegels Fix Everything?

Oh, if only it were that simple. Kegels are like the avocado toast of pelvic floor advice—everyone talks about them, but not everyone actually needs them. And just like too much avocado toast, too many Kegels without proper guidance can make things worse. (IYKYK)

Here’s the deal: If your pelvic floor is weak, Kegels might help (when done correctly). But if it’s tight and overactive (which is super common in runners), Kegels are like throwing gas on a fire. You could end up with more tension, making symptoms like leaking, pain, and urgency even worse.  If you’ve DIY tried kegels recently and you noticed it made you feel worse, you’re not wrong…this might actually be a sign of a high tone or “tight” pelvic floor that needs the opposite first…to learn to coordinate and relax THEN get strong AF.

Instead of defaulting to Kegels, pelvic floor PTs help you figure out what’s actually going on down there and what exercises will actually help YOU—because guessing and hoping is not a strategy.

7. What’s the Deal with Running and Prolapse?

Ah, prolapse—the word no one wants to say out loud but way too many runners are secretly stressing over. If you’ve ever felt like something is falling out down there or like you’ve got a bowling ball chilling in your pelvis, prolapse might be on your mind.

(If you’re reading this and can’t relate…move on to the next question, trust me; you don’t want this!)

Can you run with prolapse? YES. But it has to be done right AND with intention. Running is high-impact, and if your pelvic floor and core aren’t ready to handle that impact, symptoms can get worse. Here’s the kicker; it’s NOT ALWAYS your pelvic floor that’s the problem, even though that’s where it sure feels like it is.  A running informed pelvic floor PT can look at the big picture, help you strengthen the right muscles, improve pressure management, help you navigate progressive impact management and find strategies that let you keep running without feeling like your organs are rebelling.

8. Can I Strength Train Without Making My Pelvic Floor Worse?

Yes, please do. Strength training is basically the secret sauce to running stronger, preventing injuries, and keeping your pelvic floor happy. The key? Doing it right.

Some things to consider:

• Breathing matters. Holding your breath while lifting light things? Not great for your pelvic floor. Instead, exhale before AND during the effort (like when you’re lifting the weight) to manage pressure. (If you’re a heavy weight lifter you’ll work back to those breath-holding strategies that help you lift super heavy, we just don’t need to start there)
• Modify as needed. Some exercises (looking at you, heavy squats and deadlifts) normally increase pressure on the pelvic floor. That doesn’t mean you can’t do them—it just means you might need to tweak your form, weight, or stance so that you’re supporting your pelvic floor.
• Core stability is key. If your core isn’t pulling its weight (pun intended), your pelvic floor is going to pick up the slack, which is a recipe for symptoms. Strengthening your deep core and glutes can make a huge difference, and also help you avoid back pain with lifting.

(Caveat…if your strength training is making your symptoms worse, your DIY project might need the help of a PFPT! Runners need to be able to strength train to be injury free, get faster & run longer!)

Bottom line: Lifting heavy doesn’t have to mean peeing yourself or making symptoms worse—just make sure you’re doing it smart.

9. What Shoes Are Best for Pelvic Floor Health?

Bet you weren’t expecting to be questioning your shoe choices today, huh? Turns out, your footwear can actually play a role in how your pelvic floor functions.

Here’s why: Your feet affect your posture. Your posture affects your pelvic alignment. And your pelvic alignment affects—yep, you guessed it—your pelvic floor.

A few things to keep in mind:

• Time for new shoes. Your feet might be a little wider if you’re post pregnancy and you don’t want to be returning to running with something that doesn’t fit or help support your fresh new feet!
• Minimalist shoes aren’t for everyone. Super flat shoes can be great for some runners but disastrous for others, especially if you have tight calves or weak foot muscles. Don’t make big changes for fashion! Watch the high-stack shoes like HOKA; they look like they have a high heel drop & cushion but they’re actually pretty flat at a 4mm heel drop v. something like a Brooks Ghost (wider toe box for any of you with a neuroma!) have a 12mm heel-toe drop.  Making big changes puts you at risk for Achilles injuries you don’t need when you’re already navigating pelvic floor issues!
• Find what works for you. The right shoes will support your running form and keep everything working together smoothly—so if you’re struggling, a gait analysis in your new postpartum body might be worth looking into with your running informed PFPT or your local run shop.

10. How Do I Know When I’m Ready to Push My Running Intensity?

The million-dollar question. If you’ve been holding back because of symptoms, fear, or just not knowing what your body can handle, it’s time to talk about when to level up.

Signs you’re ready to push the pace:

• You can run at least 20 minutes at an easy pace without leaks, heaviness, or pain.
• You’re not bracing your core when you run like you’re about to take a punch, just to keep yourself together
• You’re recovering well and not feeling wrecked after every run…no pelvic floor, hip, back or lower leg symptoms.

Signs you might need to pump the brakes a little longer:

• You’re still leaking, feeling pressure, or having pain. (This ISN’T something you have to accept if you don’t want to!)
• You finish runs feeling worse, not better.
• Your body is screaming at you with new aches and pains that aren’t going away (listening to your body isn’t just a cute phrase—it actually matters).

The key is progression. You don’t go from 0 to marathon overnight (or at least you shouldn’t). Build gradually, listen to your body, and don’t be afraid to get help if something feels off.

Final Thoughts

Running should make you feel strong, not like you need a bathroom map or a post-run ice pack. If you’re dealing with pelvic floor struggles, you don’t have to just “deal with it” or hope it magically gets better. Getting the right help (hint: pelvic floor PT) can make all the difference.

So tell me—have you ever held back from running or training because of pelvic floor issues? Or are you still out here avoiding jump squats & jumping jacks like the plague? Let’s talk in the comments over on Instagram! #MomRunner #PelvicFloorPT #RunningPostpartum #LeakingWhileRunning #BackToRunning #RunnerMom #PelvicHealth #MarathonTraining #RunningTips #PostpartumFitness #paglianorunning