Why Do I Leak When I Run?

A closer look

Small shifts can change how you feel.

Leaking with running is a common but complex issue. It can range from a few drops to increased symptoms during uphill or downhill sections, and for some people, it may not occur until several miles into a run. While this can feel embarrassing and is often not discussed, there are many ways we can assess what is contributing and determine the cause.

The more we discuss these symptoms, the more effectively we can address them. While it may feel uncomfortable to talk about leaking, the sooner you seek treatment, the better. The first step is talking about it, then we can determine why it is happening. Several factors may be involved.

Weakness can be one contributor. While the pelvic floor is often discussed, the external urethral sphincter is frequently a primary factor in leakage. A pelvic floor therapist can assess how this system is functioning as part of a complete evaluation.

Pressure management also matters. Breathing patterns, breath-holding, or abdominal gripping can create excessive downward pressure, forcing the pelvic floor to work harder than necessary.

Foot function can influence what happens higher up the body. Proper pronation allows the feet to flatten and disperse impact. If the feet are not absorbing pressure effectively, that force can travel up the leg and place additional strain on the pelvic floor.

Hip strength and mobility are important too. If the hips do not have the strength or range of motion needed for running, the pelvic floor may compensate for that instability. And while your pelvic floor may be strong enough for short bursts, it may not yet have the endurance needed for the duration of an entire run.

These are only a few possibilities, and more than one factor is often involved. A pelvic floor therapist can perform a full assessment to identify the specific contributors and develop a strategy to help you run without leaking. Because while leaking is common, it is not normal.