Leakage with Running

This blog post is inspired by my Instagram @midmopelvichealth. I haven't posted a blog in over a year since most of my efforts have been spent on developing/growing the IG account and creating content over there. I recently had a 3 part series on leakage with running, that I'm going to combine that info into this blog post. Enjoy!

Leakage with running can be caused by MANY things. Sometimes it’s purely weakness or decreased endurance. Oftentimes, it’s more complex than that. Here are 3 causes that have nothing to do with a weak pelvic floor:

• pressure management

• cadence

• hip weakness

Do you leak any other time? Or just higher impact activities like running or jumping?

Pressure Management

If that’s the case, it may very well be a pressure management issue. Your pelvic floor is unable to match the pressure generated up above in your abdomen…hence leakage (or vaginal pressure felt).

There are a couple of tips you can try:

• Lean forward rather than upright and stiff - this places your pelvic floor at a biomechanical advantage to work like it was designed

• Soften/quiet your steps - this reduces the ground reaction forces your pelvic floor has to absorb with each step

• Don’t put on the brakes when going downhill - see above about absorbing impact from the ground/treadmill, except to a much higher degree

Cadence

Cadence is how fast your feet are moving. The faster they are moving, generally the smaller your stride length is. Ideally, cadence is recommended around 170-180 steps per minute.

You can videotape yourself running (treadmill is easiest) and simply count whenever you hear/see your foot hit the ground. However many times that happens in one minute is your cadence.

The shorter your step, the more likely you are to strike the ground underneath your torso. This is much less impact on your pelvic floor than hitting the ground with your heel way out in front of you (overstriding).

Think about how hard it is to hold a bowling ball with arms straight out in front of you compared to bent elbows next to your trunk.

Overstriding can not only exacerbate urine leakage, but it can increase your risk of injuries with long-distance running. There are some factors that you can’t change and that can play into your natural cadence, such as leg length.

If your cadence is too slow, try downloading a specific running playlist with 160-180 bpm (beats per minute) and just see what the difference feels like. It will feel WEIRD at first.

Hip Weakness

If you have a video from behind, watch for any pelvis/hip dipping or one knee caving in. These can be a sign of hip weakness.

Does your ponytail only sway to the right/left and not evenly to both sides? You can also check the bottoms of your shoes. Are they worn unevenly in the right vs left. These can also be a sign of an asymmetry.

💢Your pelvic floor attaches onto the bones of your pelvis and spine, but it also attaches onto connective tissue and muscles from your hips. If you have hip asymmetries, that can create an uneven demand/pull/sagging on the right vs left and lead to leakage.

As always, seek out an individualized assessment from a pelvic health therapist for better guidance.

Other thoughts…

When you start to leak plays a role in determining the cause.

• with every run?

• only on tempo runs?

• only 3+ miles into a long, slow run?

• only in the evening vs the morning?

• only up or down hills?

• only when you’re constipated?

• only when you use gels with caffeine?

The devil is definitely in the details when it comes to leakage with running. Sometimes it’s purely a mechanical issue and your running mechanics change depend on the type of run you’re doing. Sometimes it’s more of a nutrition issue, which is easier to tweak. But you won’t be able to figure it out until you really start paying attention to your symptoms and keeping a log.

Don't let leakage stop you from running, just know your options and that it CAN get better. Now get out there!