
During a recent chat with a fellow runner, she shared something that really stuck with me. She’s 10 months postpartum and has been training for a marathon. Her long runs? Going great—no heaviness, no leaking, no discomfort. But when it came to tempo and interval sessions, she started noticing occasional leaking. Naturally, she was wondering—why was this happening?
What’s Going on With the Pelvic Floor During High-Impact Workouts?
The pelvic floor is like any other muscle group—it needs to adapt to different levels of demand. Long, steady-state runs are lower-impact and allow for sustained but moderate engagement of these muscles. But when you introduce sprinting or tempo workouts, things change. These workouts bring higher intra-abdominal pressure and explosive movements that require a different kind of pelvic floor control (Bø & Nygaard, 2020).
Here’s why this might be happening:
Increased Intra-Abdominal Pressure (IAP): Sprinting and high-intensity training increase IAP significantly, requiring the diaphragm, core, and pelvic floor to work together seamlessly.
Breath Holding and Core Stiffness: Many of us instinctively hold our breath during tough efforts, putting extra downward force on the pelvic floor.
Fast-Twitch vs. Slow-Twitch Muscle Activation: The pelvic floor has both slow- and fast-twitch muscle fibers. Long runs rely more on endurance-oriented slow-twitch fibers, but sprinting demands quick-reacting fast-twitch fibers—which might not be firing optimally postpartum (Ashton-Miller & DeLancey, 2007).
What Can You Do About It?
The good news? There are plenty of ways to help your pelvic floor handle these high-impact demands. Here are a few research-backed strategies:
Pre-Activation Techniques – "The Knack"
Think of "The Knack" as a warm-up for your pelvic floor. It’s a quick contraction just before coughing, sneezing, or in this case, sprinting. Research shows it can improve fast-twitch muscle response and reduce leakage (Miller et al., 1998).
Strengthening Beyond Kegels
Your pelvic floor doesn’t work alone—it relies on support from the surrounding muscles. Strengthening your hips, glutes, and core can make a huge difference. Squats, lunges, and bridges have been shown to activate pelvic floor muscles just as well as Kegels (Sapsford et al., 2001).
Pelvic Mobility and Flexibility
A tight pelvic floor isn’t necessarily a strong one. Many runners unknowingly have overactive pelvic floor muscles, which can contribute to issues like leakage. Stretching the hips, thighs, and lower back can help balance things out.
Running-Specific Drills
If your training includes sprints and tempo efforts, preparing your pelvic floor with explosive drills can help. High knees, skips, and bounds gradually expose your body to impact and improve neuromuscular coordination (Dufek, 1991).
Final Thoughts
Hearing my friend’s experience reminded me how important it is to tailor postpartum training to the body’s changing needs. If you’re dealing with similar challenges, know that you’re not alone—and that your body is incredibly capable of adapting with the right approach. With intentional strengthening, proper breathing, and thoughtful progression, you can build the confidence to tackle any workout, leak-free.
References
Ashton-Miller, J. A., & DeLancey, J. O. L. (2007). Functional anatomy of the female pelvic floor. Annals of the New York Academy of Sciences, 1101(1), 266-296.
Bø, K., & Nygaard, I. (2020). Is physical activity good or bad for the female pelvic floor? A narrative review. Sports Medicine, 50(3), 471-484.
Dufek, J. S. (1991). Biomechanical factors associated with injury during landing in jump sports. Sports Medicine, 12(5), 326-337.
Miller, J. M., Ashton-Miller, J. A., DeLancey, J. O. L. (1998). A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. Journal of the American Geriatrics Society, 46(7), 870-874.
Sapsford, R., Hodges, P., Richardson, C., et al. (2001). Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourology and Urodynamics, 20(1), 31-42.
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