Most runners think leaks are just part of the deal. Push hard enough, log enough miles, and eventually your body betrays you. But that's not how it has to be. Leaks aren't a badge of honor or a sign you're training hard—they're a signal that something's off. And if you're ignoring it, you're missing out on a fix that actually works.

Pelvic floor therapy isn't about doing endless Kegels and hoping for the best. It's about understanding what's broken, retraining what's weak, and building a foundation that holds up under pressure. Every stride should feel strong. Every mile should be yours. And every run should happen without wondering if you packed enough backup.

The Muscles That Keep Everything Locked Down

Your pelvic floor is a hammock of muscle and tissue sitting at the base of your pelvis. It holds up your bladder, supports your core, and keeps your urethra closed when pressure builds. When it's functioning right, you don't think about it. When it's not, every footfall becomes a gamble.

Running is high-impact. Every time your foot hits the ground, pressure spikes inside your abdomen. If your pelvic floor can't handle that load, leaks happen. Childbirth weakens it. Age wears it down. Even genetics can leave you with a setup that struggles under repetitive stress. The good news? Weakness isn't permanent. It's trainable.

What Pelvic Floor Therapy Actually Does

Pelvic floor therapy is physical therapy for muscles most people don't know how to control. A trained therapist evaluates how your pelvic floor moves, contracts, and holds up under load. Then they build a plan around what you need—not a generic routine pulled from a blog post.

Treatment might include strengthening exercises, breathing drills, manual therapy to release tension, or biofeedback to help you feel what's happening down there. The goal isn't just to stop leaks. It's to restore function so you can run hard, jump high, and move without second-guessing your body.

Why Runners Leak in the First Place

Leaks during running usually come down to one thing: your pelvic floor can't keep up with the demand. The repetitive impact creates pressure your muscles can't counter. But the cause isn't always weakness. Sometimes the muscles are too tight, too uncoordinated, or working against the rest of your core.

Here's what we see most often:

• Weak pelvic floor muscles that can't contract fast enough or strong enough to prevent leaks
• Overactive muscles that stay clenched and can't respond when you need them
• Poor coordination between the pelvic floor and deep core muscles
• Breathing patterns that increase abdominal pressure instead of managing it
• Postpartum changes that left the pelvic floor stretched or damaged

What Happens During Your First Session

Your first visit starts with questions. How often do you leak? When does it happen? What's your running schedule? Have you had kids? Surgery? The therapist needs the full picture before they can map out a plan.

Then comes the assessment. This might include an internal exam to check muscle strength, tone, and coordination. It's not comfortable for everyone, but it's the most accurate way to see what's going on. From there, you'll get a personalized program—exercises, breathing techniques, posture adjustments, and strategies to use while you run.

The Tools That Make Therapy Work

Pelvic floor therapy isn't one-size-fits-all. Depending on what the assessment reveals, your therapist might use several approaches:

• Strengthening exercises that target weak or underactive muscles
• Relaxation techniques for muscles that are too tight or overworked
• Biofeedback devices that show you in real time how your muscles are firing
• Core integration drills that teach your pelvic floor to work with your abs and hips
• Manual therapy to release trigger points or scar tissue

How Long Before You See Results

Most runners notice improvement within a few weeks if they stick with the program. But timelines vary. If your pelvic floor is severely weakened or you've been dealing with leaks for years, it might take longer. Consistency matters more than intensity here.

You'll need to do the exercises at home, show up for follow-ups, and apply what you learn during your runs. Skip the homework, and progress stalls. Treat it like training, and you'll see the payoff.

What You Can Do Right Now

Even before you book a session, there are steps you can take to reduce leaks and protect your pelvic floor:

• Empty your bladder before every run—don't start with a full tank
• Work on your breathing—exhale on impact to manage pressure
• Strengthen your core with planks and dead bugs, not just crunches
• Avoid holding your breath during hard efforts or hills
• Wear supportive gear that doesn't add unnecessary pressure

When DIY Isn't Enough

If you've tried Kegels, adjusted your hydration, and still leak every time you run, it's time to call in a pro. Pelvic floor dysfunction isn't something you can troubleshoot with YouTube videos. A therapist can identify whether your muscles are weak, tight, uncoordinated, or dealing with scar tissue or nerve issues.

They'll also catch problems you didn't know existed—like a diastasis recti or hip weakness that's throwing off your entire system. The sooner you get assessed, the faster you get back to running without worry.

Common Mistakes Runners Make

We see the same missteps over and over. Here's what trips people up:

• Doing Kegels wrong—squeezing too hard, holding too long, or never fully relaxing
• Ignoring the rest of the core and expecting the pelvic floor to do all the work
• Pushing through leaks instead of addressing the root cause
• Skipping therapy because they assume leaks are normal after childbirth
• Waiting years to get help, making the problem harder to fix

Why This Matters Beyond Running

Fixing leaks isn't just about running without a pad. A strong, functional pelvic floor supports your entire core, improves posture, reduces back pain, and protects you from prolapse down the line. It's foundational work that pays off in every movement you make.

And it's not just for women. Men deal with pelvic floor dysfunction too, especially after prostate surgery or with chronic straining. The principles are the same: assess, retrain, rebuild.

Taking the First Step

Leaks don't have to be your reality. Pelvic floor therapy gives you the tools to rebuild strength, restore control, and run with confidence. It's not a quick fix, but it's a real one. And it works when you commit to the process.

If you're tired of cutting runs short or planning routes around bathrooms, find a pelvic health therapist and get assessed. Your miles are waiting. So is the version of you that runs without worry. For more information about our services, visit our pelvic health FAQ page.

Ready to Run Free?

We know how frustrating it is to have your runs interrupted by leaks, and we believe you deserve to move with confidence again. Let’s work together to get you back on track—stronger, steadier, and leak-free. Give us a call at 305-967-8976 or request an appointment today so we can help you reclaim every mile.