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Peeing with Running – Ditch the Pad!

I’m getting ready for my run. I put on my favorite bright leggings and throw on my new running shoes. Gotta make sure I have my water bottle and earbuds for this longer run. Better go to the bathroom before I leave. I grab a thick pad and… HOLD UP! Is a pad part of your running wardrobe? Guess what – it doesn’t have to be!

Peeing with running is far too normalized. You may have been told it just happens once you’ve had kids or as you get older. Peeing with running is actually a sign from your body that some part of your core system is not functioning correctly. Let’s dive into why peeing with running happens and how you can resolve it.

Why am I Peeing with Running?

There are a lot of things that can contribute to peeing with running. Here are some of the most common reasons:

1. Pelvic Floor Tightness or Weakness

Did you know that pelvic floor tightness is just as problematic as weakness? Both can cause peeing with running. Think of a tight pelvic floor as a trampoline with no give. That’s not going to withstand pressure for very long before it won’t function well. You also need good endurance in your pelvic floor muscles for running, as it’s a longer activity. When those muscles start getting tired, they can’t hold your sphincters shut all the way and you pee your pants. And yes – you can have both tightness and weakness!

So how do I know if my pelvic floor muscles are weak or tight? Really the only way to truly know is through an exam from a pelvic floor physical therapist, especially because many of their symptoms overlap. Fixing your pelvic floor tightness and/or weakness can make a HUGE impact on resolving peeing with running.

2. Poor Intra-Abdominal Pressure Regulation

Ok, what does that even mean? Think of your core as a soda can. The top of our can is our diaphragm, the bottom is our pelvic floor, and the sides are your deep stabilizing abdominal and back muscles. These muscles all work together to regulate the pressure in our abdomen.

If all of these muscles are functioning like they should, your core is like a full unopened soda can. It’s stable and strong! (Think about it – an unopened soda can is not strong because it has super thick walls. It’s strong because of the pressure in the can.) As soon as a part of your core is not functioning properly, that soda can is now opened. It isn’t very stable any longer. An opened soda can is easily dented or crushed. That’s when things can go wrong (like peeing your pants).

Breathing Correctly is Vital to Manage Pressure

One of the biggest components in regulating that pressure is proper breathing. Mind blown – something so simple? Yes! During breathing in, our diaphragm and pelvic floor both move downwards in order to regulate that pressure in our abdominal cavity. When breathing out, our diaphragm and pelvic floor both move up. If you don’t have adequate movement in either of those areas, it can create more pressure in the abdomen than what your pelvic floor is capable of withstanding, and you will be more likely to pee your pants.

Because of this, you really want to engage your entire diaphragm when breathing. It should feel like your ribs are an umbrella opening and closing with each breath. Avoid shallow breathing (chest rising) or only belly breathing (no lateral rib movement). Check out the video below that walks through how to use your entire diaphragm and breathe properly.

3. Poor Posture or Running Form

Good running form and posture can also make a big difference in the efficiency of your core muscles and pressure regulation. Picture your rib cage and pelvic floor as two bowls facing each other. For your core system to function well, those bowls need to be stacked on top of each other.

Here are some other tips to focus on while running:

• Focus on staying tall.
• Lean forward. This does NOT mean slouch or round your back. Lean forward slightly like you’re running uphill.
• Keep your arms next to your body with a good arm swing.
• Avoid ab gripping or keeping your core too tense while running.
• Land lightly.
• Try a midfoot or forefoot strike instead of a heel strike. This places less impact on your pelvic floor.
• Take smaller strides and increase your cadence. This also helps decrease the impact as your foot strikes the ground.

You Don’t Have to Stop Running!

Let’s be real – we runners are going to continue running. We’re not going to stop running while we’re working on our pelvic floor function (I didn’t!). So how can I continue to run without peeing my pants while I’m working on my pelvic floor? Here are a couple strategies and tricks.

Run/Walk Intervals

Running is much higher impact than walking and is more of a challenge for our pelvic floor. Adding in a bit of walking throughout your run can give your pelvic floor a nice rest break and allow it to recharge. Picture yourself doing sets of heavy squats. Let’s say after doing 10 reps you don’t think you can do any more – your legs are so tired! You give yourself a couple minutes to rest, and now you CAN do another set of 10. That’s basically what the walk intervals are doing for your pelvic floor.

Depending on your specific pelvic floor function, you may want to start with more walking than running (2:1 or 4:1 ratio). If that feels easy for your body, try a 1:1 ratio or more running than walking (2:1 or 4:1 ratio). Find the sweet spot for your body – where you feel challenged, but don’t leak. Check out this blog post to learn how to then progressively load your pelvic floor and achieve your running goals.

Use a Tampon

Placing a tampon while you run can also be like a crutch for your pelvic floor to limit peeing with running. It places a little extra pressure on your urethra and assists your pelvic floor in keeping things closed off. HOWEVER, this is not something you want to be doing for an extended period of time. It can be used while you are working on addressing the reasons WHY you are peeing with running. As your pelvic floor function improves, you should wean yourself from using a tampon during running. It can be a nice, short-term assist though!

Finally Resolve Peeing with Running

If these tips and tricks don’t fully resolve your peeing with running, it’s time to give your pelvic floor physical therapist a call and find the root cause. This can be fixed! It’s time to ditch those pads and end peeing with running once and for all!