Abstract: Many women struggle in silence with pelvic floor issues that hold them back from running with freedom and confidence. AND leaking during runs isn’t just inconvenient or embarrassing. It’s also a sign that your body isn’t managing forces efficiently, which means lost power and performance. A responsive pelvic floor isn’t about endless Kegels; it’s about breathing, rib mobility, hip and glute coordination, and even foot mechanics working together so your pelvic floor supports you naturally. In this email, I break down how these systems connect, why addressing pelvic floor function improves both confidence and running economy, and how you can start training smarter to feel strong, efficient, and leak-free.

Hey Reader,

Today want to revisit a topic I’ve talked about many times before: the pelvic floor. While I sometimes feel like everyone is talking about it and I’ve covered it enough, conversations outside my regular circle remind me I mostly exist online in an echo chamber of women and coaches who think like me. Women outside this circle still desperately need this information, hope, and tools around this issue.

For example, recently, while at a “mommy and me” camp with my son, I had a conversation with another mom who confessed that she hadn’t been able to return to running after kids because of “certain issues.” She was hesitant even to say the words out loud (so much unnecessary taboo still exists around this issue).

Meanwhile, I’ve been open for years about my own experiences. I talk about peeing my pants on social media for thousands to see. For me, it feels like old news, but for many women, this is still something hidden in silence. They don’t know they can talk about it, and they certainly don’t realize that there’s hope for running without pelvic floor concerns.

When I told this mom that not only had I struggled too, but I now specialize in helping women return to running without worrying about their pelvic floors, she was shocked and hopeful again. The look on her face made me realize all over again why I need to keep bringing this conversation forward.

As my good friend and mentor says, “once is never.”

This specific content here was also inspired by a recent consult with my colleague, Tina Tang. Tina helps women return to jumping (plyometrics) in a way that feels safe, empowering, and athletic. Unsurprisingly, one of the biggest barriers she hears is, “I can’t. I pee when I jump.”

Tina recently went through my Pelvic Floor Fundamentals course, where I teach women the same strategies I’ve used with athletes for over half a decade to build a responsive pelvic floor. She wanted a little extra help to distill and adapt those strategies for jumping. Our conversation revealed some simplified but powerful ways to explain how the pelvic floor works; and I want to share those insights with you here.`

What Is a Responsive Pelvic Floor?

A responsive pelvic floor means freedom:

• No more rounding to the finish line about eek out that hard fought PR worrying whether or not that final kick is going to make you wet your pants!
• No more pulling back the reins on all the downhills because you are worried about peeing your pants!
• No more planning your runs around bathroom stops!
• No more only wearing black bottoms so no one can tell if you peed or not!

Instead, a responsive pelvic floor simply does its job in the background AND without you having to think about it.

But the benefits don’t stop there. Peeing your pants is a symptom of mismanaging forces as you run. It likely means you aren’t able to produce as much force in your stride.

Said a different way…It likely means you aren’t getting as much as you can out of the effort you are putting in!

Reducing incontinence and other pelvic floor symptoms with running in many ways means improving your efficiency of loading into midstance, putting force in the ground, and managing the forces the ground puts into you.

The Core Canister: Managing Pressure Inside Your Body

To understand the pelvic floor, start by picturing the space between your diaphragm (your main breathing muscle, just below your lungs) and your pelvic floor as a bag of water. Your organs (guts) are mostly water, and as you run, they “slosh” inside this system.

Part of your body’s job? To handle that pressure and sloshing, catching your guts and flinging them back up with every stride. Peeing your pants while running is simply a symptom of forces being mismanaged.

If your pelvic floor can’t keep up with those forces, it also means you’re not producing as much force in your stride as you could. In other words, symptoms often go hand in hand with inefficiency. By addressing pelvic floor function, you’re not just solving a “problem,” you’re also unlocking better performance.

The Top-Down Approach: Breathing and Rib Mobility

Imagine that core canister above. The diaphragm and rib cage are the top, the pelvic floor is the bottom, and your sloshing guts are creating pressure in the middle.

• If you arch your back and flare your ribs upward, pressure gets directed downward into your belly and pelvic floor.
• If you slump forward with rounded shoulders and or grip your upper abs, you’re again pressing extra force into the pelvic floor.
• If your ribs don’t move well at all up top, all the pressure will be forced down.

Either way, posture affects where the pressure goes. The solution? Working to find your “stack” (ribs over pelvis) so pressure is managed effectively.

Breathing plays a huge role here. Specifically, you need rib cage mobility to expand into the back ribs and fully exhale without crunching down from the top. Breathing drills are often the very first step in pelvic floor training because they retrain your rib movement and restore better pressure control. My cues for these breathing drills are almost always about what’s happening at the ribs, not cuing a specific pelvic floor contraction which you might more traditionally find

The Middle Approach: Training Length For Responsiveness

From hip/glute perspective, the key to a responsive pelvic floor is finding length:

• The pelvic floor must relax so it has space to contract from.
• Even when it lifts/contracts in your stride, it happens through length in the back of the pelvic floor.

This isn’t about constant squeezing or Kegels. While Kegels can help you build awareness of this area, over-reliance on them creates tension and prevents the pelvic floor from functioning naturally. Running requires dynamic, responsive movement, not static squeezing.

A 2013 study in the International Urogynecological Journal measured pelvic floor muscle activity during running. Here are a few key ideas from that study.

• Activity peaks at mid stance, when forces are highest.
• Activity is elevated the entire stride compared to standing baseline (Just like any other muscle it can get tired. Progressive overload is a thing here too.)
• The pelvic floor shows pre-activation before the foot strikes the ground.

​This pre-activation, in my view, comes from rotation. As one foot leaves the ground, your pelvis begins rotating toward the opposite side. By the time your foot lands again, the pelvis has moved into internal rotation, which naturally lifts the front of the pelvic floor through lengthening at the back.

This means pelvic floor function in running isn’t about conscious squeezing, it’s about coordinated movement and rotation.

One of the most effective approaches is integrating pelvic floor length into strength training movement patterns:

• Squats
• Lunges
• Hip hinges

In these movements, focus on finding “length in the back pocket” a sense of expansion and tension in the glutes. This helps develop the length and responsiveness in the pelvic floor that carries over into running.

If you struggle to feel your glutes in these exercises and also experience pelvic floor symptoms, the two are likely connected. Using breath can help here. On an inhale, the diaphragm contracts downward, gently sending pressure into the pelvic floor (see the core canister with your “guts” in the middle image above). I often cue my athletes to “breathe into your butthole” during this inhale, as it helps create that sense of length in the posterior pelvic floor.

This emphasis on length and internal rotation is the opposite of what you might get from exercises like clamshells or band walks. Instead, hinge patterns, hip-shifting drills, and mid-range squat work are far more effective for building a responsive pelvic floor.

The Bottom-Up Approach: Why Pronation Matters

From the ground up, the feet play a major role. Pronation is internal rotation AND we need it. True pronation at the foot allows efficient internal rotation of the pelvis during running, which naturally activates the pelvic floor.

Forget the myth that pronation is bad. Overpronation isn’t the same thing as true pronation. In fact, limited pronation can restrict pelvic internal rotation and reduce pelvic floor responsiveness. Training foot mechanics, including tibial internal rotation and pronation, is therefore essential

Taking It Further

For a deeper dive into understanding this interconnectedness throughout YOUR specific body and how it can inform your training, consider the Women’s Running Academy Intensive. It's a 12-week group mentorship that integrates these pelvic floor concepts and more into full-body strength and performance training. This program is designed to help women break free from the cycle of injury and burnout by understanding their bodies on a deeper level and taking full ownership of their training. This Intensive only runs once a year (we’ll start Round 7 on September 29th).

If you’re ready to perform with confidence and feel good for the long haul, check out the details now rather than waiting until next year. And if you found this discussion helpful, please share it. You never know who needs to hear that there’s hope and a path forward.

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Your Coach,
Alison

Alison Marie Helms, PhD Certified Personal Trainer and Running Coach Unlock your full running potential through physics and physiology. ​Work with me.​