How to Manage Urinary Issues with Running

By Dr. Brooke Meinema, DPT, FAFS

Recognize the cause

Excessive pelvic floor tension:

• Your body can only hold tension for so long before it fatigues. If your pelvic floor is too tight or holding too much tension, it will eventually fatigue and can lead to problems with leakage. If you experience large amounts of leakage (imagine a dam breaking), this may be the problem.
• If this is a problem for you, working on reducing pelvic tension and allowing for the muscles to stretch and relax can be very beneficial. You can do this by focusing on relaxation and avoiding clenching through your pelvic floor and by working on hip and pelvic opening stretches. In some cases, using dilators, pelvic wands, or internal pelvic floor massage may be very helpful (see my previous blog titled “Internal work – Pelvic Floor Massage” for more guidance on this!).

Pelvic floor weakness:

• Small amounts of leakage (dribbles here and there) can be caused by pelvic floor weakness. This is where Kegels or other forms of pelvic floor and core strengthening exercises come in handy.

Bladder irritants:

• Consuming food or drinks that irritate your bladder can lead to leakage. Things such as caffeine, carbonation, or foods/drinks that are highly acidic can irritate the bladder causing it to leak. If this sounds like you, modify your diet and slowly add back in potential irritants one at a time and assess your body’s response.

Assess your form

Problematic form:

• Forward rounded shoulders cause poor core recruitment and increase pelvic floor pressure which can lead to increased problems with leakage.
• Foot slapping can be a sign of excessive impact leading to increased strain through the pelvic floor.
• A heavy heel strike can slow your momentum and add to increased jarring and impact up through your hips and pelvis leading to a greater risk of leaks.
• Do not try to suck in your gut when you are running as this increases pressure on your pelvic floor and can make leaking worse! This can also be an issue if you wear tight pants/shorts that dig into your abdomen.

What you should focus on:

• Upright, open chest
• Shoulders are low and relaxed (not tight and raised)
• Posture is not rigid
• Slight lean forward
• Soft, smooth gait (try to avoid jarring and impactful strides)

Ways to train

Start slow:

• Train at a pace, distance, and running surface where you are able to run comfortably without leaks. Meeting your body where it is currently functioning well is a necessary step before increasing pace and miles.

Inclined running:

• If you are running on a treadmill, try increasing the incline slightly (nothing drastic, just a grade or 2). This can help achieve a better posture and recruit your powerhouse glutes to engage.

Try exercises that work on impact:

• Mountain climbers or wall-leaning running.
• Running in place with varied knee height and speed.
• Jumping in place when you feel the urge to pee to strength train your bladder to handle impact (this works on training your bladder to hold in the urine with the impact of running until you can make it to the nearest bathroom when you feel the urge to go).

Train your bladder:

• No more “just in case peeing!” If you pee “just in case,” you are training your bladder to feel the urge to go when there is only a small amount of urine. This creates a habit for your brain to follow as well as reduces the strength of the bladder itself as it only is strong enough to hold the amount of urine you allow it to hold.

For more information, call us at 616.847.1280 to schedule a free assessment with one of our Women’s Health physical therapists.