When Running Feels Like a Pelvic Floor Nightmare Part 3

More Real Talk on Leaks, Pain & Running Strong Again

You know that moment mid-run when everything should feel great—but instead, you’re hyper-aware of every weird sensation happening below the belt? Maybe you’re leaking, maybe there’s a deep, annoying ache, or maybe you just feel off in a way you can’t quite put into words. It’s frustrating, confusing, and honestly? Not talked about enough, especially in postpartum.

Let’s keep breaking down the questions you might be too embarrassed to ask but need answers to.

11. Why Do I Leak More When I Run Fast or Downhill?

Ah, the dreaded speed-induced sprinkle. If you’ve noticed that leaks happen more when you pick up the pace or bomb a downhill, you’re not alone. It all comes down to impact and pressure management—both of which your pelvic floor is in charge of handling.

When you’re running fast or downhill, your foot strike is harder, meaning your body (including your pelvic floor) has to absorb more force. If your pelvic floor isn’t up for the challenge—whether from weakness, poor coordination, or too much tension—you might get some unwanted drips.

The fix?

• Stop holding yourself back. Notice how you run the downhills.  Ideally you should be able to let it fly and your body should be able to control you.  If you find yourself literally holding yourself back, this could be contributing to increased pressure your pelvic floor is feeling like it has to manage.
• Train for the downhill and the speed. This gets missed…A LOT.  If your strength training isn’t including exercises that work to control your descent, you’re NOT going to be ready for it when it comes.  Not doing quick movements?  Your body and pelvic floor will be like a deer in headlights, gripping to keep it together, not like a smooth efficient gazelle!
• Work on impact control—shorter strides and quicker cadence can help. If you’re feeling like you’re running through molasses on your slower runs, it’s time to incorporate quick impact and plyometrics to get out of the sludge!
• Breathe! Holding your breath to go faster = more pressure, which = more leaks. (And please don’t try exhale on effort here to try to coordinate when your foot hits the ground…it’s impossible to coordinate. You can’t think that fast and you’re not meant to do this.)

12. Can I Ever Jump Rope or Do Double Unders Again?

Jump rope is basically the final boss of pelvic floor control. (Only topped by the trampoline park! IYKYK!) If you’ve been avoiding it because it always ends in leaks, you’re not alone. But does that mean you should swear off jump ropes forever? Nope.

The key is building up gradually. Instead of going all in on double unders right away (and regretting it instantly), try:

• Single-leg hops—If you can’t control small hops, bigger jumps won’t go well.
• Breathing—Making sure you’re ACTUALLY breathing, especially at the start-up of your dubs can make a huge difference.
• Pelvic floor coordination drills—Sometimes, it’s not about strength, but about training your body to respond properly. If you can’t do singles without leaking, you might need to back it up to find what amount of vertical impact your pelvic floor CAN handle and then build up from there (I work with progressive drill training with A LOT of my patients who are runners or do functional fitness and it makes a HUGE difference…and BTW, just doing your drills from high school sports is usually a recipe for disaster)

So yes, you can get back to jump rope—but you need to train for it just like you would for running.

13. Why Do I Feel Pressure in My Pelvis After Running?

That heavy, dragging, “something-is-falling-out” feeling after a run? Not something that we want to be feeling.

This can be a symptom of pelvic organ prolapse (POP) or just general pelvic floor fatigue. Running is high-impact, and if your core and pelvic floor aren’t properly supporting you, you might feel the aftermath in the form of pressure or heaviness.

If this is happening, take a step back and ask:

• What have I been doing differently that now I’m experiencing these symptoms?
• Am I overdoing mileage or intensity too soon?
• Are my breath and pressure management strategies on point? (Do you even HAVE strategies or are you winging it?)
• Do I need more core and pelvic floor coordination and strength work?

A pelvic floor PT can help you pinpoint exactly what’s causing it and how to fix it—because running shouldn’t leave you feeling like your insides are playing limbo.

14. How Do I Stop Clenching My Pelvic Floor When I Run?

A lot of runners unknowingly clench their pelvic floor the entire time they run, which can lead to tightness, pain, and—you guessed it—leaks or an increase in that pelvic pressure feeling.

If you catch yourself gripping everything down there for dear life, try:

• Checking in with your breathing. If you’re holding your breath, your pelvic floor is probably clenching too.
• Relaxing your jaw and shoulders. Weird, but true—tension up top = tension down below.
• Doing a quick body scan mid-run. If you feel like you’re gripping, try to consciously release some of that tension.

You wouldn’t sprint while clenching your fists the whole time, right? Treat your pelvic floor the same way—it needs to move, not just hold on for dear life.  (Who are my ladies who remember the “hold the potato chip between your fingers when you run” cue?  Yep, we’re going back there!)

15. Can I Run Through Pelvic Pain or Pelvic Floor Symptoms, or Is That a Bad Idea?

Pain is your body’s way of saying, “Hello…pay attention.  Something’s up.” So, should you just push through it? Nope.

Pelvic pain while running can stem from tightness, weakness, imbalances, or even old movement patterns that aren’t serving you anymore. Running through the pain won’t make it magically go away—it usually just makes things worse.

Instead of pushing through, try:

• Adjusting your form—we don’t want to fix too much here or try to consciously control things like where your foot lands (that actually can make things worse). That said, sometimes over-striding, a slow plodding cadence can be the source of some symptoms.  Looking at your wearable data can tell you if your stride length or cadence has changed since having a baby.  Postpartum moms sometimes also run with less trunk rotation (kinda like they did in pregnancy).  Having a running informed PFPT that can do a video run analysis can be a great option to get expert eyes on your running, to see if there’s clues in your form that could explain your pain, leakage or prolapse symptoms. 
• Strengthening supporting muscles—Your glutes, core, and hips all play a role in pelvic stability. If you’re running even one time a week, you need to commit to at least 2x a week of run-specific strength.  Otherwise, you’re setting yourself up for a new injury or your current symptoms getting worse.
• Getting assessed by a pro—A running informed pelvic floor PT can help you figure out what’s actually going on and how to fix it.

Pain and symptom-free running is possible, but only if you listen to your body instead of trying to out-stubborn it.

Final Thoughts

Running should feel good. It shouldn’t come with leaks, heaviness, or pain that makes you question whether you should just take up cycling instead. If you’re dealing with these symptoms, you don’t have to just suck it up—there are actual solutions. And spoiler: pelvic floor PT is one of the best ones.

So tell me—what’s been the most frustrating part of running with pelvic floor struggles? ? Let’s talk in the comments over on Instagram!

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