If You Work Out, You're Actually at HIGHER Risk for Pelvic Floor Dysfunction Postpartum 👉🏼 Here's Why

By Dr. Kelsy | The Strong Moms Club

Athletes have a 54% risk of pelvic floor dysfunction postpartum. Non-athletes? 7%. 👀

Read that again.

The moms who are the most dedicated to fitness: the gym rats, the runners, the CrossFitters…the ones who were in the best shape of their lives before baby are statistically the ones most likely to struggle with pelvic floor dysfunction after having a child.

Why?

Not because exercise is bad, or because they did anything wrong. But because nobody taught them how to come back properly, and they did what felt natural. They got their 6-week clearance, laced up their sneakers, and went straight back to what they knew.

And their bodies paid for it. 💔

This post is about why that happens, what the research actually says, and what proper return to sport ACTUALLY looks like so you don't have to learn this the hard way.

🚨 The Stats That Will Shock You

Unfortunately, this problem isn’t rare..it’s widespread, under-discussed and frankly a huge failure to moms that are actually trying their hardest to continue to take care of their bodies after baby.

Research published in the International Journal of Sports Physical Therapy states that athletes have a 54% risk of pelvic floor dysfunction compared to just 7% in the general population. 👀

And it gets more specific: female athletes have three times the risk of activity related leaking compared to non-exercisers. And for high-impact sports specifically? The prevalence of tinkling yourself is nearly 5 times higher than in low-impact activities.

But here's what really gets me 😬

Despite all of this:

• 71% of athletes return to training within 6 weeks postpartum

• 40% of postpartum recreational runners return to running at just 4 weeks

So we have a population that is already at significantly higher risk... and they're also the ones rushing back the fastest. The math ain’t mathin’ sis.

Working out doesn't protect you from pelvic floor dysfunction postpartum. Returning to sport without proper rehab first is what puts you at risk.

😤 Why the 6-Week Clearance Is Failing Active Moms

The 6-week postpartum checkup is important. I'm not dismissing it. But "cleared by your OB" does not mean "cleared to run, jump, lift heavy, or return to high-impact training." 

It means:

✅Your incision healed. 

✅Your uterus has returned to its normal size. 

✅You’re not at risk for life threatening bleeding if you were to be active.

❌It does not mean your pelvic floor is ready for anything you want to throw at it.

Reality check: the research shows that changes to pelvic floor muscle function and pelvic organ support are still present at 6 weeks AND at 12 months postpartum. The tissues are still healing. The muscles are still rebuilding. Your system is still in recovery lonnnnggggg after your doctor told you you're good to go.

One study put it bluntly: vaginal birth has the highest rate of musculoskeletal injury per hour of exposure of any natural human activity. Yet postpartum athletes are not routinely assessed or given rehabilitation for these injuries. We'd never send an athlete back to sport after an ACL tear without proper rehab. We need to stop treating birth injuries any differently.

If you're dealing with back pain, headaches, jaw pain, leakage pain with intercourse or other pelvic floor symptoms, I wrote a whole post on why that sneaky 10,000 step goal might actually be making things worse: Why 10,000 Steps a Day Might Be Making Your Back Pain Worse 👈🏼

🫁 What's Actually Happening to Your Pelvic Floor

Let’s break down what’s going on here. Knowledge is power, and your OB probably didn’t teach you this…

Labor and delivery are a massive musculoskeletal event. Your pelvic floor has been under load for 9+ months of pregnancy, and then it absorbs the full impact of delivery. Postpartum, the pelvic floor muscles are typically dysfunctional in three key areas: strength, motor control, and endurance.

Think of your core as a pressure canister: your diaphragm on top, your pelvic floor on the bottom, your transverse abdominis wrapping around like a corset, and your spinal stabilizers supporting from behind. When everything works together, pressure is managed beautifully. When the pelvic floor is weak and uncoordinated postpartum, that whole pressure system gets disrupted. 👇🏼

And here's what happens when you jump back into running, HIIT, or heavy lifting before that system is restored: every step, every jump, every heavy rep sends a pressure wave downward through a pelvic floor that isn't ready to manage it. The result is leaking, doming, heaviness, pain and for a lot of women, symptoms that get worse over time, not better.

In fact, more than one in three postpartum runners experience pain and urinary leakage when they return to running, and symptoms often don't show up immediately. They can appear weeks or months later, which is why so many moms don't connect the dots between their return to running and their pelvic floor problems.

Want to understand this system better before you do anything else? Grab my free Core Restore Guide here! It walks you through exactly how the core canister works and the foundational drills I start every client with. 🙌🏼

🏃🏼‍♀️ The Return to Sport Gap Nobody Is Talking About

Here's what's so frustrating about this whole picture: most physical activity guidelines don't even account for what it's actually like to be a postpartum woman… the sleep deprivation, the breastfeeding, the pelvic floor dysfunction, the emotional load. Let alone how those things specifically impact athletic performance and recovery.

Referral to physical therapy before AND after birth is not standard of care. Despite the mountain of evidence that it would significantly reduce symptoms and help women come back stronger, most moms are never sent. They Google, they guess, they try their darndest to go back to what they were doing pre-baby and they white-knuckle through symptoms that are telling them to slow down and restore first.

The result is a generation of fit, motivated, dedicated moms who are working so hard and feeling like their body is failing them…and that freaking sucks. BUT.. your body isn’t failing you… YOU were failed by a system that never gave you the right information. 💕

If you want to see how this played out for me personally as I rebuilt after bringing home my son, I share it all here: 4 Upgrades I've Made to My Health and Fitness After Becoming a Family of Four 👈🏼

✅ What Proper Return to Sport Actually Looks Like

This is the part I really want you to hear: this is not about waiting longer before you work out. Time does not heal these wounds.. RESTORING + REHABING does. It's about restoring first, then building on top of a solid foundation.

I use the ABC Method with every single client... and the order matters:

A: Activate 🔌

Before anything else, you reconnect with the muscles that pregnancy and delivery disrupted. This means learning to breathe properly (360 breathing), re-engaging your pelvic floor, and waking up your deep transverse abdominis before you layer any load on top. Most programs skip this step entirely. It is the most important step.

B: Build 🏗️

Once the foundation is in place, you progressively layer in controlled, functional movements that retrain your whole core system in the right sequence. This isn't about staying gentle forever, it's about building real load-bearing strength before you ask your body to handle impact.

C: Carry Over 🏆

This is the payoff. Running, jumping, lifting heavy, playing with your kids without pain or leaking… THAT'S what healing looks like. This is where your fitness life fully returns. And it returns stronger and more durable than if you'd just white-knuckled your way back at 6 weeks.

Most moms, especially fit moms,  jump straight to C. They skip A and B entirely because those steps feel too slow, too easy, too basic. And that's exactly why so many are still struggling years postpartum.

Want to start with A right now? Download my free Core Restore Guide.  It covers 360 breathing, how to properly engage your core + pelvic floor, and the exact activation drills I use as the foundation for every client's return to fitness. It's free and it's the best place to start. 💪🏼

🧠 The Mindset Shift Active Moms Need

Dear fitmoms every where:

Your fitness background is an asset. Your dedication is an asset. Your discipline is an asset. But none of those things are a substitute for doing this in the right order.

The moms who come back the strongest (and I mean genuinely strong, not just pushing through symptoms) are the ones who were willing to slow down and restore before they rebuilt. They treated their postpartum recovery the same way they'd treat rehab after any other injury: with patience, with structure, and with expert guidance.

You wouldn't run on a stress fracture. Don't run on a pelvic floor that isn't ready. 🙏🏼

For more on building real, sustainable fitness after baby, check out this post too: How to Rebuild Strength After Baby — No Time, No Gym, No Problem 👈🏼

💕 The Bottom Line

Being a fit, active mom does not protect you from pelvic floor dysfunction postpartum. In fact, the research is clear: if you're athletic and you return to sport without proper rehab, you are at significantly higher risk than the mom who never worked out at all.

This is not a reason to stop exercising. It's a reason to do it in the right order.

Restore first. Build on top of that. Then carry it over into the training and the life you love. 💪🏼

👇🏼 Ready to Actually Do This?

Done reading, ready to act? Here's where to go:

If you want expert guidance, an individualized plan, and someone in your corner every step of the way  apply for 1:1 coaching here → Spots are limited and I personally review every application. 💪🏼

Not ready for that yet? Start with the free Core Restore Guide → It's the foundation and a great place to get the ball rolling!!