Leaking While Running… Nerding Out On The How And The Why
Leaking pee while running is a very common complaint we see in our clinic. Although it is very common, it’s not necessarily a normal event. Thankfully there are many things we can do to combat it.
Looking at it from the perspective of how your body works and moves—a.k.a. biomechanics:
Running puts a much higher demand of force on the pelvis and lower body than walking alone. Our pelvic floor muscles live in the bottom of our pelvis which can be thought of as the “floor of our core”. The pelvic floor muscles require the ability to respond to forces just like any other muscle in the body. For instance, as we get moving faster by doing things like running or playing a sport, the movements our bodies make are incredibly quick—too quick for us to think about contracting and relaxing muscles throughout the process… so what do we do about that?
We can start thinking about where our body is lined up and how our bones are moving through space. The goal is that our muscles are placed in an optimal position to work to their greatest ability!
Some general biomechanics tips for running and improving pelvic floor function:
Avoid continuously contracting abs, pelvic floor and glutes to a high degree and holding them there (think whole body muscle guarding).... the muscles of the core will not be able to absorb and react to load when they are constantly in a shortened, contracted state.
Line your rib cage over your pelvis. Think about a slight forward trunk lean. What can help with this? You can gaze about 20ft in front of your body at your path ahead vs. gazing at straight ahead while you run. When we are lined up this way, we have much more access to our glutes (butt muscles) in this position so we are pushing ourselves forward vs. pulling ourselves forward. Glute muscles are best friends with the pelvic floor so by engaging the glutes we are supporting the pelvic floor.
Work on striking the ground more with your mid-foot than your heel. (See above forward trunk lean). This will allow for less force through our pelvis.
Focus on gentle right to left trunk rotation. You can imagine you have a flood light on your breast bone. As you run, the flood light is slightly shining right and left (as opposed to consistently straight forward). Trunk rotation allows for your whole body to work, and again, less force down on the pelvic floor.
Make sure you’re not holding your breath! It’s important that we can continue breathing through our diaphragm. One tactic can be to inhale for 2 steps then exhale for 2 steps. There are many different breathing techniques so you will want to find the one right for you.
As you can see, there are many ways to optimize our running patterns in order to improve force management with the goal of less or no leaking.
Some other considerations, if running seems like a high bar: you can start by walking briskly uphill. This will encourage the forward trunk lean (as above) and can increase your heart rate at the same time if you want the “runner’s high” without the running. Maybe your goal would be to transition from hill walking to running.
It is also important to remember that there are many other components of your pelvic health that can be influencing unwanted urine leakage.
Other factors (among many!) that may play a role in leaking with running:
Proper shoe-wear for your foot posture and needs
Enough and appropriate levels of water and fluid intake
Good hip strength and stability
Healthy bladder habits throughout the rest of the day
Having constipation or other bowel issues can easily lead to and/or exacerbate bladder issues
If you continue to pee a little or a lot while running, consider having an individualized assessment by a pelvic health physical therapist! Not only do we assess the pelvic floor, but we assess you from head to toe to find out what factors are contributing to your urinary leakage. We have many tricks and tools to help you conquer this unwanted problem. One of our pelvic floor physical therapists here at Insight Pelvic Health would love to be a part of your support team!