Pelvic Floor Dysfunction in Runners

Running is a sport that spans a whole gamut of activity levels. Some runners run a mile or two casually every evening, some sprint competitively, and some runners train towards running marathons.

Female runners of all ages report urinary incontinence while running. The incontinence that is reported while running is not restricted to occurring while running at high speeds or long distances. There are runners who complain of leakage as soon as they start running, while there are others who leak mid-way into the run. Part of treating pelvic floor dysfunction in runners involves the ability to be able to tease out where the breakdown that is causing the dysfunction is occurring. Clinicians who treat pelvic dysfunction in runners have to be able to perform a running analysis to find the biomechanical faults that can contribute to the dysfunction that the runner is experiencing.

One common fault found during a running analysis is a pelvic hip drop on the stance leg, possibly indicating a weakness in the hip abductor muscles, specifically the gluteus medius.Hip abductor muscle weakness has been found to be a contributing factor in many running-related injuries, including iliotibial band syndrome, patellofemoral pain syndrome, stress fractures, and Achilles tendinopathy.(1) But, one can also link weakness in the hip abductors to increased pelvic floor dysfunction in runners

There are myofascial connections found through magnetic resonance imaging between the gluteal muscles and the levator ani and fossa ischioanalis. Multiple studies have found a significant correlation between weakness in the hip abductors, external rotators, stress urinary incontinence, and increased urinary urgency and frequency.(2,3)

Understanding the relationship between hip strength, biomechanics, and pelvic floor function is essential in supporting runners who experience urinary incontinence. By identifying and addressing underlying factors such as hip abductor weakness and faulty running mechanics, clinicians can help reduce leakage, improve overall running efficiency, and decrease risk of injury. With targeted assessment and treatment strategies, runners can return to the sport they love with greater confidence, strength, and pelvic health.

In the Running and Pelvic Health course taught by Aparna Rajagopal and Leeann Taptich, there will be instruction on how to perform a running analysis, how to assess for hip abductor weakness, and how to treat those findings to decrease pelvic floor dysfunction in runners. Please join us on November 1, 2025, for our next course.

Resources

1. Mucha MD, Caldwell W, Schlueter EL, Walters C, Hassen A. Hip abductor strength and lower extremity running-related injury in distance runners: A systematic review. Journal of Science and Medicine in Sport. 2017; 20: 349-355.
2. Marques SAA, da Silverira SRB, Passaro AC, Haddad JM, Baracat EC, Ferreira EAG. Effect of pelvic floor and hip muscle strengthening in the treatment of stress urinary incontinence: A randomized clinical trial. J Manipulative Physiol Ther. 2020; 43(3): 247-256.
3. Foster SN, Spitznagle TM, Tuttle LJ, Sutcliffe S, Steger-May K, Lowder JL, Meister MR, Ghetti C, Wang J, Mueller MJ, Harris-Hayes M. Hip, and pelvic floor muscle strength in women with and without urgency and frequency predominant lower urinary tract symptoms. J Womens Health Phys Therap. 2021; 45(3): 126-134.

AUTHOR BIO
Leeann Taptich DPT, SCS, MTC, CSCS

Leeann Taptich, DPT, SCS, MTC, CSCS (she/her) has been a physical therapist since 2006. She graduated with a BS in Kinesiology from Michigan State University and a Doctorate of Physical Therapy from the University of St Augustine. In 2009, she earned her Manual Therapy from the University is St Augustine and her board certification as a Sports Certified Specialist in 2018.

Leeann leads the Sports Physical Therapy team at Henry Ford Macomb Hospital in Michigan, where she mentors a team of therapists. She also works very closely with the pelvic team at the hospital, which gives her a very unique perspective of the athlete. With her combination of credentials and her exposure to pelvic health, she is able to use a very eclectic but complete approach in her treatment of orthopedic and sports patients. With the hospital system, she is involved with the community promoting health and wellness at local running competitions and events.

Leeann is passionate about educating and teaching and has assisted in teaching multiple courses at the local State university PT department. She is co-chair of the continuing education committee at her hospital, where she writes and develops courses. She is co-author of the Breathing and Diaphragm class at Herman & Wallace.

Leeann lives in the metro Detroit area with her husband and two children. She enjoys hiking, traveling, and watching football.