Are you experiencing leaking when running?
Running provides a relatively cheap way to get active and for many it provides more than physical activity. It delivers an escape from the everyday and much needed headspace to cope with the demands of our busy lives. But many women experience leaking when running and think it’s something they
(a) just have to put up with or
(b) would be told to stop running if they sought help.
If you’d prefer to watch a video on my best practices to reduce leaking when running then please watch below – or if you’d rather continue to read, just scroll down past the video for the rest of the blog:
First up, it’s more common than you may think – even amongst athletes.
Studies into the effect of marathon running on our pelvic floor are relatively few but studies range between saying just over 30% of non-professional female marathon runners experience stress urinary incontinence (SUI)[1]and 50%[2]of active women.
So at least 1 in every 3 female runners, if not every 1 in 2 will experience pelvic floor issues at some point. Eeek!
When women experience incontinence they reduce their activity levels, around half resort to using pads and many are simply unaware of available treatment (2)
Isn’t it just women who’ve had babies that get stress incontinence you may wonder?
Well no.
Women who haven’t had children and even elite athletes may also encounter SUI.
All women will go through menopause at some point in their lives. This hormonal transition has a direct effect on core strength and pelvic floor resilience for many women.
The amount & type of training you do has a direct effect on potential pelvic floor dysfunction. High impact activity having an almost 5-fold impact on incontinence symptoms[3].
It’s not reserved for older women either, as SUI in early life is a strong predictor for incontinence in later life[4].
So incontinence does not discriminate – between women who have & have not had children, between recreational runners & elite athletes, between young and old.
What does that mean for your running practice?
Running is not the ideal activity for those with any form of pelvic floor dysfunction – but it is something that’s positive for your heart health, bone health and mental health too. Wherever possible I support clients who are experiencing leaking when running to continue doing what they enjoy, while we work on supporting their pelvic floor.
Where we decide together that a break from running is required we focus the training on getting back to running. We focus on what she can do without leaks, and what will support a graduated return to running.
Why does leaking when running happen?
Running is a high-impact sport – the degree of impact depends on a number of factors including your gait, foot pattern on impact, speed of running[5], terrain, duration & more.
The pelvic floor feels the force of that impact on EVERY step.
So here are my tips to attempt to manage the impact on your pelvic floor:
1. Seek the support and advice of a female health physiotherapist.
Where dysfunction exists it’s important to understand the type and scale of issue affecting You and treat it specifically. It’s not always just about lift & squeeze.
There’s a presumption that all pelvic floor issues, including leaking when running or at other times is due to weakness. Not necessarily!
Interestingly, a pelvic floor that is “holding on” too tightly or too much can exhibit similar symptoms to a weak pelvic floor – so it’s important that we identify what your body needs.
Doing further ‘strengthening’ work on a pelvic floor that needs to let go may make the situation worse.
A female health physio can support your understanding using biofeedback and advise on suitability of at-home support trainers such as Elvie or pessaries/continence devices to support your pelvic floor during your run.
At the time of writing, we’re in “lockdown” due to the Covid-19 virus and so in-person visits to female health physios are not possible. Some private physios may be able to offer virtual support.
Additionally, trained coaches such as myself and fellow Holistic Core Restore® coaches may be able to guide you through appropriate measures to support you, until an in-person appointment is viable. Please click here to get in touch for further information.
2. Include other forms of training in your plan to support your desire to run.
Programmes such as my Core Confidence®, Stronger Mummy® & Holistic Core Restore® courses[6], coach you to manage the pressure within your abdomen for everyday occurrences such as coughs, laughs and sneezes as well as building your core & floor strength and fitness for movement.
The specialist training I offer may also improve your overall running performance, support weight loss as well as reducing any symptoms of pelvic discomfort, low back pain or leaking when running. To learn more please click here.
3. Invest in supportive footwear
If your trainers have been around for more than a year, it’s worth investing in care for your feet and pelvic floor. Talking to specialist running shoe specialists can ensure a good fit with the right support for the terrain and distances you may be running, as well as for your gait or running style.
4. Choose appropriate clothing:
Incontinence pads may offer some dignity if you are experiencing leaking when running but please remember they are not a long-term solution. Taking action to support your pelvic floor through the measures outlined above represent the gold standard in women’s health care.
Support clothing is also available, such as EVB shorts and leggings (evbsport.com). These specially designed clothing items help to activate and support your pelvic floor to keep you feeling comfortable and supported during your run.
5. Vary the terrain you run on:
Opt for surfaces with a little more give (such as grass) wherever possible. You may also choose to vary your stride length (cadence) to see what effect, if any, this has on how your body feels and reacts during your run.
6. Build your distances gradually
Those running longer distances may notice that it’s towards the end of their run that “issues” start to occur. Work to where your energy levels (and pelvic floor) are on any particular day and stop if it doesn’t feel right for You.
There are actually 2 types of muscle fibres within your pelvic floor – fast response (twitch) and slow twitch (endurance) fibres. Each requires a different approach. Take note of how far into your session you start to encounter leaking when running. This will provide a good insight into what may be going on for you.
7. Listen to your body
A medal for completing a run is pretty shallow if your confidence has been robbed by the incontinence it has caused. Be aware of when symptoms occur and back off from there to manage your training without symptoms.
Also be aware that if you are tired, so is your pelvic floor. You may notice that your pelvic floor symptoms differ according to the time of day that you go for your run. Generally speaking, your pelvic floor will be more tired towards the end of the day so perhaps try running earlier in the day and see if this makes any difference for you.
Plus, your pelvis and pelvic floor will feel different at different times of your cycle. What feels fabulous in the first half of your cycle (post-period) may not feel so good during the latter half – to read more about how to vary your training through your menstrual cycle please click here.
8. It’s not just about your pelvic floor
Support your pelvic floor through your nutrition and lifestyle –alignment, constipation, hydration & body weight all have an effect.
Pelvic floor exercises on their own are unlikely to provide the solution – understanding how other areas of your life impact on your pelvic floor AND how to integrate more movement into your day that supports, activates and releases your pelvic floor is important.
This is the approach I take within all my courses. An upcoming blog describes how different areas of your everyday life, and choices you are already making impact on your pelvic floor….to be sure, of seeing future blogs, please click here.
9. Get sufficient good quality sleep
If you’re not sleeping well then your pelvic floor isn’t getting chance to recover either. Check in with your energy levels (and pelvic floor) at the start of every activity session.
Remember, if you’re tired – so is your pelvic floor.
So a long run on those days isn’t going to be your best option! Tapering your run on using a mix of intervals (interspersing periods of running with fast-paced walking) may give you a way to vary and enjoy your session, without leaking during your run.
10. Increase your body awareness
Are you holding your breath for different daily tasks?
Do you clench your teeth or jaw when you need to lift something heavy?
We can’t treat the pelvic floor in isolation, it needs to be a cohesive part of the whole body, working in tandem with the diaphragm, abdominal wall and alignment.
Understanding how we use our body, releasing areas of tension and establishing a good connection through our “Core 4” can yield wonders for your running time and whole life experience!
Special considerations for pregnant and post-natal athletes
Pregnancy and post-natal periods are times of exceptional change and pressure on our pelvic floor. Post-natal period extends far beyond the 6 weeks post-birth that most assume it to be.
Your body takes at least a year to recover from pregnancy and childbirth.
All of the above applies during these periods. Additionally, consideration and care needs to be given to the changing status of your body and pelvic floor during these times.
So whilst some MAY be able to safely return to running without long-term effects within 6 months of childbirth, other people may require much longer.
Lisa Gimenez-Codd is a Women’s health Coach specialising in supporting women through mindset, movement and nutrition, from motherhood to menopause. To learn more please click here.
Reference Sources:
[1]Abitteboul et al – Urinary incontinence in non-professional female marathon runners (2015)
[2]Brennand et al – urinary leakage during exercise:problematic activities, adaptive behaviours and interest in treatment for physically active Canadian women (2018)
[3]de Mattos Lourenco et al – Urinary incontinence in female athletes: a systematic review. (2018)
[4]Bo (K) & Sundgot-Borgen Are former female elite athletes more likely to experience urinary incontinence later in life than non-athletes?(2010)
[5]Luginbuehl et al – Pelvic floor muscle electromyography during different running speeds : an exploratory and reliability study (2016)