Running and Your Pelvic Floor:
What’s Ok and What’s Not?

There’s something primal about running. It’s like it’s in our DNA. In a way, it is—scientists believe our evolutionary history of long-distance running literally shaped the anatomy of modern humans.¹ Is it any wonder, then, that many of us have an inexplicable urge to hit the pavement (or trail, or beach)?

Running has plenty of benefits, too. It strengthens your muscles, lungs, and immune system. It’s a natural stress reliever. It increases bone density. It’s a great cardiovascular exercise to help keep blood pressure under control. And, it’s great for weight control.

If you’re a woman who lives to run (and chase the elusive runner’s high—it’s a thing, really), you might be wondering if it’s safe for your pelvic floor muscles (Kegel muscles), the hammock like system of muscles and ligaments that stretches across your pelvis and keeps your uterus, bladder, and bowel snugly in place.

When Is It Ok to Run, and How Do I Know If I Should Avoid Running?

The short answer is that if you experience urine leaks or pelvic pain while running, this and other high-impact exercises (like CrossFit) are not ideal choices. Leaking urine means your pelvic floor isn’t functioning like it should. Until you improve your pelvic floor function (pelvic floor exercises can help), it’s best to opt for lower-impact cardio and strength training exercises.

It helps to know what happens internally when you run. First, running increases intra-abdominal pressure by as much as 2.5 times. Second, each time your heel hits the ground your pelvic floor muscles contract to absorb the force. Over time, the increased pressure and force can weaken your pelvic floor muscles.

The good news is there are running techniques to help soften the blow to your pelvic floor. These include:

• Breathing into your belly: This helps you release tension in your abs, which can strain your pelvic floor over time; practice by taking deep breaths and allowing your rib cage to widen as you raise your hands to the ceiling.
• Letting your pelvic floor drop: This also helps you release tension in your pelvis; practice by allowing your glutes, abs, and inner thighs to relax while breathing naturally.
• Leaning forward while you run: This position allows you to breathe into your belly; running up hills can help get you in the right position.

Is It Ok to Run While Pregnant and After Giving Birth?*

Yes, with some caveats. Pregnancy and childbirth can take their toll on the pelvic floor, even for women who had strong muscles before becoming pregnant. Pregnancy can also weaken your core-stabilizing muscles. It’s important to retrain these muscles after giving birth before jumping into a heavy-duty running routine. Swimming is a good low-impact choice.

If you decide to run while pregnant (with your doctor’s approval), it’s critical to exercise pelvic floor awareness. That means intentionally engaging the pelvic floor muscles with proper breathing and running form. And it means doing Kegel exercises regularly to keep your muscles strong. If you notice any pelvic or abdominal discomfort or pain while running, stop immediately and see your doctor right away.