Pelvic Floor Dysfunction in Runners: Causes & Treatment (2025)

Pelvic floor dysfunction occurs when the muscles in the pelvic area do not function properly. These muscles provide stability and control for core movements, bladder and bowel function, and support for the spine and hips. Dysfunction can arise due to muscle weakness, overactivity, or improper coordination, leading to discomfort and performance issues, especially for runners.

Both male and female runners can experience pelvic floor dysfunction, though women—particularly those who have given birth—may be at a higher risk. When the pelvic floor muscles are weak, tight, or uncoordinated, it affects running posture, biomechanics, and the ability to absorb impact, leading to compensatory movements that strain other muscle groups. This can result in pain, instability, and reduced performance.

If you’re a runner experiencing any of these issues, your pelvic floor might not be functioning optimally:

Urinary leakage

Leaking urine, especially during sprints, jumps, or long runs

Hip instability

A feeling of lacking control in one or both hips

Lower back pain

Persistent discomfort or tightness in the lower back that worsens with running

Weak or Overactive Pelvic Muscles
Pelvic floor muscles need the right balance of strength and flexibility. Weak muscles fail to provide sufficient support, leading to leakage and instability, while overly tight muscles lack the ability to relax efficiently, causing pain and dysfunction.

High-Impact Stress from Running
Running generates repetitive impact forces that travel through the legs, hips, and pelvis. If the pelvic floor is not strong enough to absorb this force effectively, it can result in weakness, pain, or worsening dysfunction over time.

Poor Running Form & Posture
Misalignment in running mechanics—such as excessive forward lean, overstriding, or poor core engagement—places extra strain on the pelvic region. Learning to maintain a neutral pelvis and stable posture can prevent additional stress on these critical muscles.

Breathing Mechanics & Core Engagement
Proper breath control plays a huge role in pelvic floor function. The diaphragm, core, and pelvic floor work as a unit to stabilize the body. Shallow, high-chest breathing can create excess pressure in the abdomen, leading to pelvic floor weakness. Training diaphragmatic breathing helps maintain proper balance between these muscles.

Postpartum & Hormonal Changes
Pregnancy and childbirth stretch and weaken pelvic muscles, making postpartum runners more vulnerable to dysfunction. Additionally, hormonal fluctuations, particularly in menopause or postpartum recovery, can affect muscle tone and strength.

Runners should monitor for these key indicators of pelvic floor dysfunction:

Urinary incontinence

Leakage during or after runs, especially with high-impact movements

Pelvic pain or discomfort

A heavy, dragging feeling in the lower abdomen or groin area

Lower back pain or tightness

Discomfort that persists despite core training

Feelings of pressure around the pelvis

A sensation of bearing down, like your insides are falling out

Hip pain or instability

Noticeable imbalance, particularly after long runs

Reduced core control

Struggles with engaging core muscles effectively, affecting overall balance and performance

A weak core and glutes can lead to compensatory movements that stress the pelvic floor. Incorporate exercises targeting these muscle groups to improve running dynamics.

- Dead bugs - Engage the core while coordinating limb movement
- Glute bridges - Strengthen the posterior chain and promote pelvic stability
- Paloff presses - Enhance rotational core control

Runners should pay attention to their body positioning to avoid unnecessary pelvic pressure.

- Keep a neutral pelvis instead of tilting forward or back.
- Avoid overstriding, which increases impact pressure.
- Maintain an upright posture with a slight forward lean from the ankles.

Pelvic Floor Physical Therapy
A physical therapist specializing in pelvic health can assess muscle function and develop a customized plan that includes hands-on therapy, movement retraining, and functional strengthening exercises.

Manual Therapy, Dry Needling, and Biofeedback
Some treatment approaches include:

- Manual therapy – Hands-on techniques to relieve tightness
- Dry needling – Targets muscle knots contributing to dysfunction
- Biofeedback – Uses technology to measure and retrain muscle activation

Proper Running Gear & Footwear
Wearing supportive shoes that absorb impact can prevent excessive stress on the pelvic floor. Opt for footwear that matches your gait and provides proper cushioning.

Strength Training for Hip, Core & Posture Muscles
Improving foundational strength in these areas offers long-term benefits:

- Hip strength: Side leg lifts, clamshells, and banded lateral walks
- Core engagement: Active plank variations, dead bugs, and bird dogs
- Postural endurance: Seated posture drills and thoracic mobility work

Lifestyle Modifications
Supporting pelvic function involves more than just exercise:

- Stay hydrated – Proper fluid intake promotes bladder health.
- Maintain good nutrition – A balanced diet supports muscle recovery and hormone regulation.
- Manage stress – Chronic tension contributes to pelvic floor tightness; relaxation techniques help.

It’s time to consider professional support if:

- Symptoms persist despite consistent self-care efforts.
- Pain interferes with your daily life or running routine.
- Post-pregnancy changes have altered your running performance.
- You need a personalized rehabilitation plan to restore function.

Pelvic floor dysfunction in runners is a common but healable condition. Targeted strengthening, proper mechanics, and professional guidance can help you restore strength, stability, and confidence in your running journey.

Running should be enjoyable, not painful or frustrating. If you’re experiencing pelvic floor dysfunction, don’t ignore the symptoms—early intervention is key. Strengthening your core, improving your posture, and working with a specialist can help you run stronger and pain-free.

Take the first step by trying simple pelvic exercises today or consulting a pelvic health expert to build a recovery plan that works for you.