From 0 to 30km: How to progress your run without sacrificing pelvic health

If you’ve ever crossed the finish line of a race and thought, “I wonder how much further I could go…”, you’re not alone. Whether you’re building from 5km to 10km, half marathon to 30km, or just chasing your next challenge, distance running can be one of the most empowering things you’ll ever do.

But as women, our bodies have unique considerations — especially after pregnancy, childbirth, or hormonal changes through perimenopause. The pelvic floor, hips, and core take on more load as distance and fatigue increase. Learning how to protect these areas helps you run further, faster, and without symptoms.

As a women’s health physio (and runner who’s learned this first-hand), here’s how to safely build your mileage while keeping your pelvic floor — and the rest of your body — strong and supported.

1. Understand what changes as you go longer

When you increase distance, every stride adds load — not just to your legs, but through your pelvis and core. If you’ve ever felt heaviness, leaking, or pelvic tension mid-run, your body is telling you it needs more support. Pregnancy history, posture, and breathing all influence how well your pelvic floor manages impact.

Building endurance isn’t just about miles — it’s about how well your core system (diaphragm, abdominals, and pelvic floor) works together.

2. Watch for early warning signs

These can signal your pelvic floor is struggling with impact or fatigue:

• Leaking or urinary urgency during or after a run

• Pelvic heaviness or dragging sensation

• Ongoing hip, glute, or low-back tightness

• Bulging through your abdominal wall

• Feeling unstable or “loose” through your core

These aren’t reasons to give up running — but they’re signs to adjust your training or see a women’s health physio before symptoms worsen.

3. Train smarter, not just harder

Think of your pelvic floor as part of your core endurance team.

• Strength train twice a week — focus on glutes, hamstrings, and deep core work.

• Progress gradually — increase mileage by no more than 10% per week.

• Recover properly — your pelvic floor needs rest too.

• Practise breathing control — exhale gently on effort to support your core.

• Prioritise nutrition — protein, collagen, and hydration help tissue repair and recovery.

4. Long-run day tips

• Warm up hips, glutes, and core before you start.

• Stay tall and relaxed — keep ribs over pelvis.

• Maintain a slightly higher cadence (around 170–180 steps/minute).

• If you feel heaviness or leaking, slow down or walk briefly.

• After your run: cool down, do a gentle pelvic floor release, and refuel.

5. When to seek professional help

If you regularly experience pelvic floor symptoms, leaking, or discomfort during longer runs, a women’s health physio can assess how your body responds under load. We can identify weak links, improve coordination, and help you train without symptoms.

Final thoughts

You can build distance and protect your pelvic floor. With smart training, proper recovery, and the right support, your body can adapt and thrive as a distance runner.

If you’d like personalised advice before increasing your mileage, book an assessment here. Let’s keep you running stronger, longer, and symptom-free.

Happy running 🏃‍♀️💪 

Ali x