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.
