Leak when you run? 9 exercises to improve urinary stress incontinence.

Muscle imbalances are terribly common in runners, because when we run, our body moves mostly through the sagittal plane (forward and backward motion). In runners, you will usually find a lot of quad dominance, but the glutes just don’t get much loving. This is PARTICULARLY true of mom runners. Our glutes and core get “turned off” during pregnancy, and if we don’t take the time to really focus on them postpartum, often, they don’t return to full strength.

Many mothers love running because it is convenient, free, and totally doable with baby.  The problem is that if we don’t recapture core and glute strength, the repetitiveness of running eventually takes it toll in the form of urinary incontinence, knee pain, a lingering diastasis recti, or other aches and pains.

You can see, quite easily, why this is recipe for injury.  Postpartum runners often hit that pavement grind with a weak core, glutes, and shins, and overcompensating quads, low back, and tight hamstrings. Guess what else? Your pelvic floor, abdominals and glutes are besties, so if your glute and core strength is still on vacation, now your pelvic floor isn’t supported optimally. And when you run, pelvic floor support is critical not only to prevent leaks, but also for strength and efficiency.

First let’s talk running posture. Mom runners often fall into one of two categories.  The butt-tucker runner, who runs on her heels with her butt hiding under her.  Or…the super back archer twerker. The twerker is particularly prevalent when pushing a stroller.  The twerker arches low back, ribs flare out and chest puff forward.

So the first step is being really mindful of running posture. For the butt tucker, can you focus on leaning forward slightly, untucking your butt, and running more on the balls of your feet.

Try this squat to ski jump drill, to help train your glutes to fire and “untuck”. The other benefit of this drill is it works the front of the pelvic floor, working that hammock of muscles that help keep us from leaking!

For the back-archer twerker, I want you to think about keeping your ribs down when you run. Try this “deadmill” running drill to work on running with a stroller while keeping spine more neutral.

Being aware of the posture is the first step, but now we need to focus on strengthening the muscles that are weak and preventing us from getting into more optimal posture naturally.

GLUTES

Alright, we have to recapture glute strength! This means our glutes need some serious one-on-one love.  An important player in running because of its role in hip stability, is strengthening the glute medius (side butt muscle). Here are my two favorite glute med drills.  And you’ll notice, all of these are unilateral (one side). This is because in running, we drive off of one leg.  We want both glute muscles to be EQUALLY strong.  So training them unilaterally is extra important for runners.

Oh man, that postpartum core.  Remember, postpartum is forever, so if you have ever had a baby no matter how long ago, you want to train that deep core to fire.  If you feel your low back barking when you run, there is a good chance your core isn’t firing and supporting you. I’m not talking solely about those six pack abs…I am talking about those deep corset abs that help brace and support us. Look at that image. Your transverse abdominis wraps all the way around your torso. That is one big muscles! The transverse abdominis gets mega stretched during pregnancy, so it is imperative to help “cinch” these muscles tight again.

Try these two drills for a stronger core.

Are you hip flexors legit screaming at you all day, meanwhile your hamstrings are so tight you curse when you drop a pencil? Well, first of all, we sit a lot and that can cause that muscle to shorten and weaken, and conversely the hamstrings to lengthen. Also, if your core isn’t doing its thing (see above point), your hip flexors will try to stabilize you.  We are quick to assume our hip flexors are tight, when reality they are often also weak. We stretch the heck out of hamstrings hoping it will help with the tightness, but often, the remedy is a little hip flexor strengthening.

Here are two drills to improve hip flexor and low ab strength.

And try this drill that targets hip extension, plus unilateral glute strength.

While all of the above tips and exercises helps the pelvic floor function more optimally and feel supported, let’s talk a little more specifically.  Leaking urine running is a common occurrence for many runners (approximately 30% of women), especially postpartum women. And while it is common it is NOT normal, and you do not have to live with it!  Leaking can be caused from muscles being weak, or too tight. Working with a pelvic floor physical therapist to determine your exact cause is important. Find one here.

You can do a check at home by sticking two fingers into your vaginal opening and then squeezing the muscles you use to hold in gap or pee (yeah, like a kegel). You should feel a sensation like a circle closing around your fingers and lifting inward and up. Now relax. You should feel a release. If nothing changes when you “release” you may have an overactive pelvic floor.  While you might be thinking a tight pelvic floor is a good thing, it is very important for your muscles to know how to relax. Think of it this way…if you held your arm out to your side all day and then your friend placed a weight in your arm, your shoulder muscle would give out.  It couldn’t handle the load. The same goes for your pelvic floor. If you are holding that muscle and doing loads of kegels all day, and then you run (or sneeze or jump), that muscle is going to give.

So yeah, working on more optimal alignment, glute and core strength is going to help your pelvic floor, working with a professional on a case-by-case basis can make all the difference.