The Pelvic Floor and Running: What Every Runner Should Know
Running challenges the entire body—not just your legs and lungs. One of the most critical yet overlooked components? Your pelvic floor. Whether you’re a seasoned Boston marathoner or a new Somerville runner logging your first miles, understanding how these deep core muscles impact your performance (and comfort) can be a game-changer.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, and connective tissues that form a “hammock” at the base of the pelvis. These muscles help:
Support the pelvic organs (bladder, uterus, rectum)
Maintain continence
Stabilize the pelvis and spine
Transfer load between the trunk and legs
Coordinate with the diaphragm and deep core during movement
In short: your pelvic floor is working behind the scenes during every stride, jump, or lift. And for runners, it needs to be strong, responsive, and well-coordinated.
How the Pelvic Floor Responds to Running
Every time your foot hits the ground, your body absorbs impact forces up to 3–4 times your body weight. The pelvic floor reacts with reflexive contractions—activating automatically to help:
Stabilize your pelvis
Support your organs
Maintain continence
Absorb and transfer load
In fact, studies show pelvic floor muscle activity during running can exceed 100% of your voluntary contraction capacity. Translation: it’s working hard, even if you’re not consciously engaging it.
At our clinic in Somerville, MA, we frequently see Boston-area runners whose symptoms improve dramatically once pelvic floor coordination is addressed.
Short-Term Effects of Running
For healthy runners, research shows that typical training runs don’t cause pelvic floor fatigue or weakness. The muscles respond well to load and recover quickly—similar to other well-trained muscle groups.
However, if you're leaking during a run, feel pressure or heaviness, or experience discomfort in your pelvic region, it could be a sign your pelvic floor isn’t meeting the demands of your training.
Long-Term Impact of Running on the Pelvic Floor
Here’s where things get more nuanced.
The good: Regular physical activity, including running, may improve pelvic floor endurance and coordination over time.
The not-so-good: For runners with underlying pelvic floor dysfunction, running can aggravate symptoms like leaking or heaviness.
Studies estimate that 10–40% of female runners experience stress urinary incontinence. Running doesn’t cause these issues—but it can expose them.
When to Seek Help from a Pelvic Floor Physical Therapist
Your pelvic floor may be working hard behind the scenes—but if it’s underperforming or overloaded, symptoms often show up during high-impact activities like running.
Here are some signs it might be time to check in with a pelvic floor specialist—especially one who understands runners:
Leaking urine during runs, workouts, or daily activities
A feeling of heaviness, pressure, or “dragging” in the pelvic region
Pain or discomfort around the hips, pelvis, or low back that doesn’t resolve with typical care
A sense that something feels “off” or unsupported while running
Changes in performance or coordination that feel hard to explain
Recent pregnancy, postpartum return to sport, or upcoming life stage changes (e.g. perimenopause)
Avoiding certain activities out of fear of leaking or discomfort
Previous PT or strengthening efforts that didn’t fully resolve the issue
These issues are common—but they’re not inevitable or untreatable. With the right plan, most runners can reduce or eliminate symptoms and feel stronger than ever.
Can Pelvic Floor Therapy Help Runners?
Yes. In many cases, dramatically.
Pelvic floor therapy isn’t just about Kegels. It includes:
Targeted strengthening (when needed)
Relaxation techniques (yes, tight muscles can also cause problems)
Coordination and timing drills
Education around breath, posture, and load management
The key is that not every runner needs the same approach. Some may need more strength, others more control, and many benefit from better synergy between their breath, core, and stride.
Working with a specialist ensures you're addressing the right issue—and getting a plan that supports your goals.
Key Takeaways for Runners
Your pelvic floor is part of your core—and essential for performance and comfort.
It contracts reflexively with every stride to stabilize and protect.
Running doesn’t weaken a healthy pelvic floor, but symptoms like leaking or pressure aren’t “normal.”
With the right support, runners with pelvic floor dysfunction can train symptom-free.
Pelvic floor physical therapy is a powerful tool for runners—whether you’re in pain, leaking, or simply want to feel stronger and more in control.
Struggling with leaking, pressure, or discomfort during your runs?
You don’t have to power through it. At The Run Rx in Somerville, MA, our pelvic floor specialists work with Boston-area runners every day to help them move with strength and confidence—without symptoms holding them back.
👉 Book a consultation with a pelvic floor PT who truly gets runners.
References
Bérubé, MÈ., & McLean, L. (2024). The acute effects of running on pelvic floor morphology and function. Int Urogynecol J, 35(1), 127–138. Link
Bø, K., & Nygaard, I.E. (2020). Is Physical Activity Good or Bad for the Female Pelvic Floor? Sports Med, 50(3), 471–484. Link
Hamilton, H.M., Mariano, M., & Kakar, R.S. (2023). Urinary Incontinence in Female Recreational Runners. J Women's & Pelvic Health PT, 47(2), 75–89. DOI
Leitner, M., et al. (2016). Pelvic floor muscle activity during running. Neurourology and Urodynamics, 36(6), 1570–1576. Link
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