How to Handle Postpartum Leakage while Running

Something I never told my closest friends, I now share openly on social media- I used to pee my pants when I ran.

If you don’t know my story, here’s a quick rundown: A life-long runner, I ran through almost my entire pregnancy until it no longer felt “good” anymore. So I was more than eager for my first run post-baby without a giant belly, only to be greeted by a leaky bladder that made running at any pace unpleasant.

While postpartum leaking is common, affecting 1 in 3 women, it’s not normal and signals intra-abdominal pressure overloading the muscular system, leading to leaks. This prevalence increases in high impact female athletes, like runners.

At 30 years old, I found myself ‘incontinent’. As my bladder function waned so did my joy of running, as the emotional toll of dealing with an ‘embarrassing’ issue made me avoid a sport I had always loved.

At the time, I was practicing as a “generalist” physical therapist and tried interventions on my own without success. I then sought help from pelvic floor physical therapy. I saw minimal improvement initially with therapy and after my third pregnancy a surgeon told me without urethral sling surgery, I would never be able to run without leaking. Then I was diagnosed with pelvic organ prolapse on top of it and I was devastated.

Determined I had not exhausted all conservative options, I tried pelvic floor PT again. Professionally, I switched gears in my Physical Therapy career and dove headfirst into Pelvic Floor PT education and training. Through both these efforts I overcame my struggle, being able to run leak free and in the process helping other women do the same. While pelvic floor PT treatment should always be personally tailored, here are 8 tips that can be generally helpful to those dealing with stress urinary incontinence:

1. Don’t prophylactically empty: Less urine, less leaking, right? WRONG! Like Pavlov’s dog, this teaches the bladder to hold progressively less urine AND the urine becomes more concentrated which irritates the lining of the bladder, causing more urge and leaking.
2. Identify bladder triggers: MANY foods and drinks can irritate the bladder. For me it was a B12-containing pre-workout supplement.
3. Better breathing: Pelvic floor health and function is directly correlated to proper (diaphragm) breathing.
4. Running form change: forward lean, short stride, faster cadence, forefoot strike – all help align the pelvic floor with the diaphragm for improved bladder control with less force on the pelvic floor.
5. Total body mobility: In particular, loss of mobility in the back and hips affects pelvic floor function.
6. Strength training: I teach women to incorporate pelvic floor function into total body strength training.
7. Add support: Much like a bra, a Uresta pessary acts as an internal support for the bladder and urethra to stop leaks. This was truly a game changer for me, allowing me to work on running form changes without leaking.It’s way more than Kegels!
8. Realistic goals: Changing habits and building strength takes time. There are no end dates, we’re looking for life-long improvement and long-term function.

What was once my source of embarrassment and emotional pain has now become my mission in life. When I first experienced leakage, I would not even tell my closest friends. Now, I share my story with the world on social media! This is because I experienced the transformation of really applying concepts of rehab in exercise and was able to overcome my own issues- and YOU deserve to feel that way too in your life.

If you’re feeling alone or embarrassed about your struggle,I just wanted to let you know I have been there too. But there is hope. Stay consistent and committed, don’t expect quick fixes or impose strict timelines for change. 

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Cheering you on ♥️
- Caroline Packard, DPT