When to start massaging your caesarean scar, what it should feel like, and a simple three-stage approach - plus a free downloadable guide from our women's health physios.
Returning To Running Postpartum - 6 Evidence-Based Tips That Can Help (And When to See a Pelvic Floor Physio)
If you notice urine leakage when running, you’re not alone. Leaking during high-impact exercise is incredibly common, particularly after pregnancy and birth, but it does not mean you have to give up running.
The good news? There are several evidence-based strategies that can reduce symptoms and help you run with more confidence. Below are six practical things you can try, plus guidance on when it’s time to see a women’s health physio in the Sutherland Shire for tailored support.
Why does leakage happen when you run?
Running is high impact. Every foot strike creates a burst of pressure through the abdomen and pelvic region. If your pelvic floor muscles, hips, or connective tissue support system can’t manage that load yet, you may experience leakage, often called stress urinary incontinence.
This is especially common (but not normal) for:
Postnatal runners returning to exercise
Women with pelvic floor weakness, reduced endurance or poor coordination
Women with connective tissue laxity or pelvic organ support changes
1) Strengthen your pelvic floor and hips
Pelvic floor muscle training is one of the most effective first-line strategies for leaking with running. Aim for at least 3 months of progressive training that targets:
Endurance (long holds)
Coordination (quick pulses and timing)
Strength and tone
A well-conditioned pelvic floor helps “clamp” the urethra closed during moments of increased downward pressure, like impact at foot strike.
Just as important is hip and glute strength. Your glutes and pelvic stabilisers help control pelvic alignment and reduce strain on the pelvic floor during running. Single-leg strength work, progressively loaded, is especially helpful.
Postnatal physio tip: If you’re not sure you’re contracting the pelvic floor correctly, a pelvic floor assessment with a women’s health physio can make training far more effective.
2) Adjust your running technique (small changes can help)
Tiny posture and form tweaks can offload pressure from your pelvic floor.
Try:
A slight forward lean from the ankles (not bending at the waist)
Stacking ribs over hips to improve alignment at impact
Looking straight ahead or slightly down (especially if you tend to look up)
These adjustments can reduce unnecessary pelvic and spinal strain and help your body absorb impact more efficiently.
3) Don’t brace your abs or “hold” your pelvic floor while running
This surprises a lot of runners.
Actively squeezing your pelvic floor or heavily bracing your abs while running can actually make leakage worse. During running, the pelvic floor needs to move and respond naturally to impact. Think springy, not stiff.
When you hold tension:
Downward pressure on the pelvic floor can increase
The “core canister” can’t function optimally
Shock absorption reduces (your body gets rigid)
Instead, aim for relaxed, responsive muscles that can react and rebound with each stride.
4) Progress gradually (your pelvic floor needs load management too)
Your pelvic floor is a muscle system like any other. If you overload it too fast, it won’t cope.
A graded plan, like a walk-run “Couch to 5K” style progression, gives your pelvic floor time to build:
Functional strength
Endurance
Coordination under impact
Slow, steady progress is the goal, especially if you’re returning to running after birth.
5) Increase your cadence slightly
Cadence is the number of steps you take per minute.
A small cadence increase, without increasing speed, often means:
Shorter stride length
Lower impact force per step
Reduced load through the pelvic floor
Many runners describe this as running feeling lighter. It can be a simple and effective change if leakage happens mainly on harder strides, downhill sections, or faster paces.
6) Consider a pessary (a game-changer for some women)
Sometimes leakage while running is not only about muscle strength. It can be related to connective tissue or ligament support, especially after pregnancy, birth, or hormonal changes.
If you’ve tried strength work and technique changes and you’re still leaking, a pessary may be a great option.
A pessary is a soft silicone support device inserted into the vagina. It can act like a “backstop” for the urethra and bladder support system, essentially assisting structures that are currently under-supported. For many women, it’s an absolute game-changer that allows them to run comfortably and confidently again.
A pelvic floor physiotherapist (women’s health physio) can help determine if this is appropriate and guide you through options.
When should you see a pelvic floor physio in the Sutherland Shire?
If you’re leaking regularly when running, or it’s affecting your confidence, it’s worth seeing a pelvic floor physio for an individual assessment. A tailored plan is especially important if you have:
Leakage that is not improving
Vaginal heaviness, dragging, or bulging symptoms
Pain (pelvic, hip, lower back) with running
Postnatal concerns (core recovery, prolapse symptoms, return-to-run guidance)
Frequent urgency, or leaking on the way to the toilet
A women’s health physiotherapist can assess:
Pelvic floor strength, coordination, endurance and timing
Hip and trunk control
Running load and technique contributors
Whether support options (like a pessary) could help
Final thoughts
Leaking urine when you run is common, treatable, and not something you have to “just put up with.” With the right combination of pelvic floor rehab, hip strengthening, technique changes, graded progression, and support tools, many women can return to running symptom-free.
If you’d like personalised guidance, seeing a women’s health pelvic floor physiotherapist in the Sutherland Shire can help you get a plan that’s realistic, evidence-based, and built around your body and your goals.
Your body isn’t broken, it just needs the right support. 🏃♀️💪
Sources:
Donnelly, G. M., et al. (2020). Returning to running postnatal: Guidelines for medical, health and fitness professionals managing this population. Journal of Women’s Health Physical Therapy, 44(2), 71–79.
Dumoulin, C., et al. (2018). Pelvic floor muscle training versus no treatment for urinary incontinence in women. Cochrane Database of Systematic Reviews, 2018(10), Article CD005654.
Heiderscheit, B. C., et al. (2011). Effects of step rate manipulation on joint mechanics during running. Medicine & Science in Sports & Exercise, 43(2), 296–302.
Woodley, S. J., et al. (2020). Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 2020(5), Article CD007471.
Sutherland Shire Women’s Physio: Your 6-Week Postnatal Check - What to Expect
Why book a postnatal physio check?
The first 6-12 weeks after birth are a big change for your body. A postnatal women’s physio check helps you recover confidently - assessing pelvic floor function, abdominal separation, C-section scar mobility, posture, and safe return to walking, Pilates or running. If you’ve been searching for a Sutherland Shire women’s physio, this guide explains what happens in your appointment at Flow Physio Co.
When should I come in?
Anytime from 4-8 weeks postpartum (later is fine too). Come sooner if you notice heaviness, leaking, pain, or persistent back/hip/pelvic pain.
Quick note: This article is general info only. If symptoms worry you, please book an assessment with a qualified women’s health physiotherapist or speak with your GP.
What happens at your 6-week postnatal physio check
1) Chat & goals
We’ll discuss your birth, recovery so far, feeding positions, daily loads (hello pram lifting!) and what you want to get back to - pain-free walking, Pilates, gym, running.
2) Pelvic floor assessment (gentle)
Understanding strength, endurance, and relaxation. We teach cues you can actually feel (no guesswork) and give you a simple plan you can do between feeds.
3) Abdominal wall check
We assess abdominal separation (DRAM) and core strategy - how your body manages pressure when you stand, lift, cough or carry bub.
4) C-section scar or perineal care (if relevant)
Tips for comfort, massage, desensitisation and positions that make feeding and settling easier.
5) Posture & daily movement tweaks
Pram height, baby-wearing, lifting technique and set-ups to reduce strain on your back and pelvic floor.
6) Personalised plan
Clear reps/sets, how often, and when to progress - plus check-ins if you’d like support as you return to longer walks, classes or running.
Gentle starter exercises (safe basics)
These are general; stop if you feel pain/heaviness and get assessed.
Breath + pelvic floor connection: Exhale gently as you lift the pelvic floor; inhale to let it relax.
Heel slides or marches (slow): Keep breathing; focus on control, not bracing.
Short supported walks: Build up gradually (e.g., 10–15 mins), good shoes, pram at elbow height.
Rest positions: Side-lying with pillow support to ease lower-back/pelvic load.
Signs to book sooner
Pelvic heaviness/dragging
Leaking urine or bowel changes
Pain with intercourse
Bulge at the tummy that domes with sit-ups
Ongoing back, hip or pubic pain
Why choose Flow’s Sutherland Shire women’s physio team?
Specialist care: Pelvic floor, pregnancy and postnatal expertise.
Private rooms & baby-friendly: Feed or settle during your session.
Convenient Shire location: Our Sutherland & Woolooware clinics are easily accessed for residents in the Sutherland Shire.
Health rebates: HICAPS available; EPC/Medicare referrals accepted where applicable.
Ready to feel supported?
Book your 6-week postnatal check with our Sutherland Shire women’s physio team today. Same-week appointments available.
-
No referral is required to see a physiotherapist.
-
Yes - babies are welcome and we’ll work around feeds and naps.
-
It depends on your delivery, symptoms and goals. We’ll map a gradual plan and let you know when you’re ready for Pilates, strength or running.
-
If you have extras cover for physiotherapy, yes - use HICAPS/Healthpoint to claim on the spot.
New Sutherland Shire Women’s Physio at Flow: Welcome Edwina Powe
We’re thrilled to welcome Edwina Powe to Flow as our newest Sutherland Shire women’s physio. With postgraduate training and experience across hospital and private practice, Edwina supports women with pelvic floor rehab, pregnancy and postnatal care, continence concerns and complex pelvic pain.
If you’re seeking a Shire women’s health physio who combines clinical expertise with a kind, practical approach, Edwina is now accepting new patients.
What We Treated Today in the Sutherland Shire: A Physio Doug's Day Recap
A quick intro
Busy day in the clinic today, so here’s a short recap of the problems we saw and the first steps we usually focus on. This is general guidance only—your plan will be tailored after a proper assessment.
Presentations we saw today (and safe first steps)
1) ACL injury – non-operative management
Focus: swelling control, early full knee extension, quad strength, balance work; clear return-to-sport criteria.
First steps: Heel props for extension, quad sets (10×10-sec holds), gentle bike if pain-free.
When to be cautious: pivoting/cutting sports and deep twisty positions early on.
2) Cervical radicular pain (neck-to-arm symptoms)
Focus: reduce nerve irritation, restore neck movement, thoracic mobility, work and ADL tweaks.
First steps: short, frequent neck range-of-motion (pain-free arcs), chin nods, gentle nerve-glides as tolerated.
Red flags: progressive weakness, severe night pain, trauma - book promptly.
3) Post-operative foot reconstruction
Focus: protect the repair, manage swelling, regain ankle/foot mobility and strength within surgeon protocol.
First steps: elevation, compression, isometrics above/below the site, crutch technique coaching.
4) Spinal cord injury (ongoing rehab)
Focus: functional goals (transfers, sitting balance, gait where appropriate), pressure care, equipment optimisation.
First steps: customised program progression; close monitoring of skin, spasticity, orthostatic responses.
5) Fibromyalgia
Focus: education, graded activity, sleep and pacing strategies, low-impact strength/aerobic work.
First steps: start very small (e.g., 5–10 mins walking), track symptoms, add light resistance 2–3×/week.
6) Post-op meniscus bucket-handle repair
Focus: protect the repair, avoid deep loaded flexion early, regain extension, controlled quad activation.
First steps: heel slides (range-restricted per protocol), quad sets, patellar mobility, gait re-training.
7) ACL reconstruction (patellar-tendon graft)
Focus: full extension ASAP, swelling control, quad activation, progressive flexion, gait normalisation.
First steps: heel props, towel-under-heel quad sets, straight-leg raises if no lag, bike ROM as allowed.
8) Syndesmosis (high ankle sprain) – conservative
Focus: deload + protect external rotation/dorsiflexion stress; later, calf strength and proprioception.
First steps: boot/brace as indicated, crutching, isometrics, gentle ROM within pain-free limits.
9) Achilles tendon rupture – conservative
Focus: functional boot with wedges, staged plantarflexion → neutral, progressive loading.
First steps: adhere to boot/wedge plan, avoid dorsiflexion stretch early, isometrics with boot on.
How we assess & plan care
History → objective tests → diagnosis → plan. We align with surgeon protocols where relevant, set measurable milestones (pain, ROM, strength, function), and give a home program you can actually stick to. Imaging/referral only when indicated.
Quick take-home tips
Short, frequent movement beats long, painful sessions.
Swelling down = rehab up (prioritise swelling management early).
Progress load gradually; sharp increases spike re-injury risk.
If symptoms are worsening, not improving - get reviewed.
When to seek urgent care
Red-flag symptoms (progressive weakness, severe unremitting pain, night sweats/fever, unexplained weight loss, red/hot calf, new numbness in the saddle region).
Post-op concerns (wound issues, fever, sudden loss of function).
Next steps in the Sutherland Shire
Ready for a tailored plan? Book with our physios in Sutherland and Woolooware
Flow Physio Co - Musculoskeletal, ACL Rehab, Women’s Health, Clinical Pilates.
Helpful internal links
-
No. You can book directly with a physiotherapist in Australia.
-
Often 12–16 weeks if criteria are met (strength, hop tests, swelling), but timing is individual and surgeon/physio guided.
-
It can be, when the functional boot and staged loading protocol are followed closely. Your clinician will advise if it’s suitable for you.
-
Gentle, guided movement usually outperforms prolonged bed rest. Get assessed to tailor the plan and screen red flags.
Disclaimer: The content on this page is general information for education only and is not a substitute for personalised assessment, diagnosis or treatment. Always follow your surgeon, GP’s or health professional’s advice and consult a registered physiotherapist before starting or changing exercises.