When Running Feels Like a Pelvic Floor Nightmare Part 4

Even More Answers to Your Awkward but Important Questions

You lace up, you hit the road, and within minutes, your body reminds you that your pelvic floor has its own agenda. Maybe it’s a leak, maybe it’s a weird pressure, or maybe it’s just a general feeling of what the actual hell is going on down there? If any of that sounds familiar, you’re in the right place. Let’s dive into more of your burning (sometimes literally) pelvic floor running questions.

16. Can Strength Training Help My Pelvic Floor and Running?

Short answer: YES. Long answer: ABSOLUTELY YES.

Your pelvic floor doesn’t work in isolation—it’s part of a whole system. If you want to run stronger (and, let’s be real, without leaks or pain), you need to support that system. Strength training, especially for your core, glutes, and hips, is key. Think:

• Deadlifts & Squats → Teach your pelvic floor to handle load and impact.
• Single-Leg Work (lunges, step-ups) → Mimics the demands of running.
• Core Stability (planks, dead bugs) → Helps manage pressure and support your pelvis.

These are all a great start if you’re not doing anything.  If you’ve already mastered the basics and you’re STILL having problems, it’s worth taking a step back to see if you can actually pass a run readiness screen, look for any run-specific gaps in your strength, impact management or balance and level up your run-specific strength programming.

(Your running informed pelvic floor PT can be a huge asset in helping identify exactly what YOU need so you’re not spending hours completing that CVS-receipt-length list of exercises that might not actually be right for YOU!)

Strength = stability, and stability = happier pelvic floor & you’re also going to be faster too!

17. Why Does My Pelvic Floor Feel Worse After Long Runs?

Ever finish a long run and feel like your insides are playing a game of Jenga? It’s quite possibly your pelvic floor (and deep core) telling you they’re tired.

Long runs mean more repetitive impact, and if your pelvic floor isn’t up to the task, it might struggle to keep up. This can lead to:

• Heaviness or pressure (hello, prolapse symptoms)
• More leaks than usual
• General pelvic discomfort

If this sounds familiar, take a look at:

• Your form—Are you overstriding or collapsing into your hips?
• Your strength training—Is your core and glute strength up to par?
• Your recovery—Are you stretching, hydrating, and not running on fatigue?

Your pelvic floor is a muscle, and muscles get tired. The goal is to train smarter so it can keep up.  There’s plenty of ways to fatigue your system and then train tired WITHOUT having to put in hours of work to GET tired.  Your running informed PFPT can help you with HOW you train so you’re building endurance, getting the results you’re looking for but don’t have to take all day to do it.

If you’ve got the basics covered and you’re still having issues, time to get expert eyes on your run!

18. How Do I Know If I’m Breathing Right When I Run?

Oh, breathing. The thing that EVERYONE thinks they have to control when they run…and they don’t.  How you breathe with a dynamic movement like running is NOT the same is how you control breath with slow repetitive exercises or weight lifting.

If you’re trying too hard to control your breathing when you run, your pelvic floor might be paying the price. Signs you might need to ease up on your breath control:

• You’re trying to breathe a specific way to coordinate with your foot strike
• You’re gripping your abs for dear life the entire run (also not efficient).
• You feel extra pressure or leaks the second you pick up the pace.

Try this instead:

• Chill out— just breathe. There’s no “right way” to breathe when you run other than to have your breathing match the task.  Going fast? Yes, this SHOULD be more shallow.  Unless you’re in an all-out sprint, your eyes should be in a relaxed gaze forward, neck in neutral (not tilted back) and breathing should feel comfortable and easy.
• DO NOT try to sync breath with movement—DO NOT try to think about exhaling on exertion (like when your foot strikes the ground). (Please don’t do this…you’re not meant to think about every little thing when you run.  It’s not efficient nor is it necessary, but there’s people out there telling you (falsely) to do it)
• Ditch the shallow breathing—if you’re not throwing it down and running fast, it should be easier to stay out of those short shallow breaths. Try and keep your breathing as relaxed as possible when your efforts are supposed to be just as easy.

NOT overcontrolling your breath when you run = better pelvic floor function = happier, drier runs.

19. Should I Be Doing Kegels While I Run?

In theory, it sounds great—engage the pelvic floor and problem solved! But in reality? Nope. 

I BEG YOU, PLEASE DON’T DO THIS.

Your pelvic floor is supposed to respond automatically to running, not be forcefully squeezed with every step. We were never meant to consciously try to control every single muscle with something as dynamic as running…it’s just not efficient or helpful.  Remember, your pelvic floor works like a dimmer switch, NOT an on-off switch. It’s job is to anticipate when and how much to work AUTOMATICALLY.

Over-recruiting those muscles mid-run can actually make things worse, leading to:

• Increased tension (which = more leaks, not less)
• Less shock absorption (which = more impact on your joints)
• Straight-up exhaustion (because clenching for miles is not sustainable)

Instead of Kegels-on-the-go, focus on:

• Pre-run activation—Get your core and pelvic floor firing before you head out with an active warm up like bouncing in place, curb hops or a single leg curb switch.
• Incorporate impact drills—If you’re not doing drills in your active warm up or included in your run-specific workouts, you’re missing out on a great opportunity to build impact tolerance, bone and tendon strength as well as training your pelvic floor to work dynamically. If you’re skipping out on impact because of symptoms of leakage, pelvic pressure or pain, it’s worth a chat with a running informed pelvic floor physical therapist.  Even if you’re running without symptoms but ONLY HAVE THEM with jumping or drills, this might be an early indicator of symptoms to come if you don’t address them sooner than later.
• Post-run relaxation—Because a tight, overworked pelvic floor is just as problematic as a weak one. Either finish with low belly breathing on the floor or relax with your legs up the wall.

20. Can I Just Ignore My Pelvic Floor Issues and Keep Running?

I meant this in all seriousness…it’s up to YOU.  Sure! If you’re cool with:

• More leaks.
• More pressure.
• More frustration.
• More time spent mapping out bathroom stops.

Not everyone has the time or resources to spend on addressing these issues and short term use of incontinence products may be the best solution right now for you, and that’s ok (Weird hearing this from a pelvic floor PT, right???)  Just because you may not be able to work on these symptoms right now doesn’t mean you’re doomed for life.  It’s never too late to work on any pelvic floor issues like leakage, pressure or pelvic pain.

That said, Ignoring pelvic floor issues typically won’t help them go away—it can make them worse. But here’s the good news: you don’t have to stop running, you just have to train smarter.  And that option will always be there.

Pelvic floor issues are fixable. Whether it’s strengthening, mobility work, breath training, or seeing a pelvic floor PT, there are actual solutions that will get you back to running confidently.  If now’s not the right time, don’t forget the little things you do to help can add up in good ways!

Final Thoughts

Running should feel strong, free, and leak-free. If your pelvic floor is holding you back, there are options other than ignoring it—we know more than ever about how to get you running WITHOUT symptoms. If you can, your future self (and your leggings) will thank you.

So tell me—what’s been the biggest surprise about your pelvic floor and running? ? Let’s talk in the comments over on Instagram!

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