Leaking urine while running? You’re not alone. Stress Urinary Incontinence (SUI)—the involuntary leakage of urine during high-impact activities like running, sneezing, or laughing—is incredibly common in pregnancy, but that doesn’t mean it’s something you just have to “put up with.”
SUI affects up to 40% of pregnant women, and while it’s often brushed off as a “normal” part of pregnancy, leakage is a sign that your pelvic floor may be struggling to keep up with the increasing demands on your body. The combination of hormonal changes, increased weight, and growing pressure from your baby can weaken the pelvic floor muscles, making it harder for them to support your bladder. Add the repetitive impact of running, and it’s easy to see why many active women experience leakage.
However, while SUI is common, it’s not inevitable, doesn’t always worsen as pregnancy progresses, and doesn’t necessarily mean you have to stop running. With the right strategies, you can support your pelvic floor, reduce leakage, and stay active with confidence. Plus, taking care of your pelvic health now can reduce the risk of long-term issues, like persistent incontinence or prolapse after birth.
Below are some evidence-based strategies to help you run strong, leak-free, and confident throughout pregnancy. Whether you’re a dedicated runner or just trying to stay active, these tips will help you protect your pelvic floor and keep moving safely.
What your physio wants to know?
If you’re experiencing leaks while running, it’s worth paying attention to when and how they happen. Identifying patterns can help you make smart adjustments and protect your pelvic floor while staying active.
Here’s what to look out for and why it matters:
When does it start? If leakage happens after a certain distance or time, fatigue could be a factor. As your pelvic floor muscles tire, they may struggle to support your bladder effectively.
Does footstrike matter? If you leak with every step, high-impact landing forces could be overloading your pelvic floor. A softer landing or slight form adjustments might help reduce strain.
Time of day: Some women find leakage is worse later in the day when muscles are already fatigued from daily activities. Running earlier may feel easier on your pelvic floor.
Running surface: Hard surfaces like pavement create more impact stress, while softer surfaces like trails or treadmills may be gentler on your pelvic floor.
Shoes: Footwear affects how force travels through your body. Cushioned or supportive shoes may help absorb impact and reduce strain on your pelvic floor.
Pace & effort: Faster running requires more core and pelvic floor stability, which can increase leakage if these muscles aren’t engaging well under load.
Training style: Intervals and progression runs change how pressure builds over time. Shorter bursts with recovery might be easier on your pelvic floor compared to sustained efforts.
By identifying these triggers, you can make small adjustments—such as changing your pace, running surface, or footwear—to improve comfort, reduce leakage, and better support your pelvic floor. Tracking when and how leaks occur will also give your physiotherapist valuable insight into how your pelvic floor, bladder neck, and pelvis are responding to impact, helping them tailor advice and treatment to your specific needs.
Running Coaching for SUI Prevention
✅ Modify Running Technique:
Shorten stride length to reduce impact.
Lean slightly forward from the hips (not hunching) to shift pressure away from the bladder.
Increase your cadence to reduce impact per stride.
Land midfoot or forefoot instead of heavy heel striking.
✅ Interval Running to Reduce Leakage:
If leakage happens at 20 minutes, break runs into 15-minute intervals with walking or short sitting recovery.
Alternate running with walking to reduce pelvic floor strain.
Try hill running instead of flat running (less impact, better glute activation).
✅ Reduce tension and intra-abdominal pressure:
Ensure your breathing isnt too shallow.
Try some breathing techniques like nasal breathing
Lower your shoulders
Soften the jaw
Ensure you are allowing your tummy to relax "let go"
✅ Footwear & Surface Considerations:
Choose cushioned, shock-absorbing shoes to lessen impact.
Run on softer surfaces (eg treadmill) instead of pavement.
✅ Pelvic Support
Try supportive clothing to help support your pelvis.
Try a pelvic support belt for your runs.
Pelvic Floor Physio Advice
✅ Pelvic Floor Strengthening and Rehab
Squeeze and lift your pelvic floor for as if your stopping yourself passing wind or passing water.
There are two types of pelvic floor exercises:
Slow exercises - aim to hold the squeeze for 10 seconds and repeat 10 times. Ensure you relax inbetween repetitions.
Short Exercises - contract and relax - ensuring you get height and then full relaxation. Repeat 10 times.
If you cant manage 10 seconds ot 10 repetitions - do what you can and then slowly build up over time.
Avoid gripping the glutes or inner thighs.
Dont hold your breath - try and initiate your squeeze while breathing out, then try counting out loud as you doyour exercises to ensure you are not breath holding.
Having an assessment with a pelvic heath physio can help give you specialied advised to you. checking your technique and how to rehab.
✅ Breathing
Diaphragmatic breathing
Inhale deeply, expanding ribcage (not belly).
Exhale slowly
Should I stop running?
As pregnancy progresses, some runners may find that leakage occurs with all running or that impact feels increasingly uncomfortable. This is a sign that your pelvic floor, core, and body alignment need extra support. Instead of pushing through, here’s how to adapt while staying active and strong:
1️⃣ Reduce Impact but Keep Moving
✔️ Switch to lower-impact alternatives like incline walking, elliptical, cycling, or swimming to maintain cardiovascular fitness without excessive strain.
✔️ Try run-walk intervals instead of continuous running to give your pelvic floor breaks and reduce sustained pressure.
✔️ If you still want to run, shorten your stride, land softly, and focus on controlled movement to minimize impact.
2️⃣ Consider Strength Training Specific to Pregnancy
✔️ Strengthen your glutes, core, and pelvic floor to improve stability and support for impact activities.
✔️ Prioritise single-leg exercises (like step-ups and single-leg deadlifts) to build better control and balance. However, if you experience pelvic pain or discomfort in the symphysis pubis joint, single-leg exercises may be painful. In this case, it’s best to focus on strength work using both legs, such as squats and bridges.
✔️ Focus on breath control and deep core activation (avoid breath-holding or excessive pressure on the abdomen).
3️⃣ Remember: Adjusting Your Training is a Smart Move!
✔️ Modifying your training isn’t a setback—it’s a proactive step to keep you active while protecting your pelvic health.
✔️ Experiencing an injury or feeling like you can’t run during pregnancy—especially if you had planned to—can be a huge psychological adjustment. However, this can also be an opportunity to focus on the foundational aspects of training that support and benefit your running in the long term.
Shifting your focus to lower leg strength, core stability, breath control, and flexibility can build resilience and improve overall movement patterns, making your return to running postpartum even stronger. Plus, it can be fun to explore areas completely separate from running—like upper body strength or new forms of movement that you may not have prioritised before. Adapting your training doesn’t mean losing progress—it means investing in a well-rounded, stronger version of yourself!
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