Rachel Fawcett – Soft Tissue Specialist, Personal trainer and Marathon runner

When it comes to running health, most people spend their timing worrying about injuries, chafing and trainer fit; urinary tract health is not usually the top of anyone’s discussion list. But it should be.

Ultimately, as people progress with their running, they want to run further, the further we run, the more we need to consider our kidney and urinary tract health. So what do we need to consider?


Urinary Tract Infections are far more common in women than in men but not exclusive to women. These infections can be exacerbated by exercise if you are not very careful. Pressure on the bladder caused by the jolting up and down can cause more pain. This really is a time to listen to your body and exercise within the limits which it is giving you. Ensure that you change out of sweaty kit as soon as you can and stay hydrated throughout.


UTI’s often lead to antibiotic prescriptions. There is one group, fluoroquinolones which have been linked to weakening tendons due to the affects they have on a tendons’ ability to regenerate normally. These side effects have led to the FDA in America to add warnings to these antibiotics on the effects on tendons, joints, muscles and nerves. These warnings highlight that side effects can occur from a few hours after taking them right up to a few weeks after finishing the course. Maintaining a running program throughout a course of antibiotics is not worth a ruptured Achilles so, consider your training load carefully if placed onto these drugs.

Blood in the urine

Some runners notice that a long run will lead to obvious blood in the urine (haematuria). This is not something which should be taken lightly. It can be the sign of something as simple as old shoes with reduced shock absorbency or an increase of eccentric loading (downhill running), both of these will lead to increased cell breakdown showing up as a red tinge to the urine (foot strike haemolysis). However, urinary blood can also be the sign of extreme dehydration. Running causes minor muscular injury and the release of myoblobin which needs to be flushed out by the kidneys.

If you do not hydrate properly then this flushing system stops working and the myoglobin can clog up the filtration system of the kidneys which can lead to long term kidney damage.

If you see a reddish tinge to your urine, your body is telling you something, take the hint and take a long hard look at how you are hydrating before and after a run. Excess blood in the urine can also be caused by abrasions of the bladder wall and there are suggestions that this can be reduced by not going for a wee just before a run; a suggestion which clearly hasn’t come from any woman who has gone through pregnancy or childbirth! In summary, if blood in the urine after a run becomes common or it doesn’t clear up within 72 hours, you really need to see a doctor.

Use of Anti-inflammatories

I see lots of people chatting about using anti-inflammatory to get through long races. If can offer any advice at all is don’t take anti-inflammatories when undertaking exercise. Not only will they hide potential injuries, but they can cause intestinal leakage leading to gastrointestinal damage. In addition they inhibit the hormones (prostaglandins) which help regulate blood flow to the kidneys thereby reducing renal blood flow. This eventually reduces the filtration of the blood and can lead to kidney shut down. Just don’t do it, whatever distance you are running.

As about half of women are affected by urinary tract infections, women runners are at a higher risk than men. Women who have suffered from UTI’s in the past and need additional protection, may try a proactive approach taking a herbal supplement like Uralix before and after the run as additional protection.

Renal and urinary tract health needs to be considered far more than it currently is whether you are running 5km or ultras.

Keep an eye on how your body is functioning and don’t be scared to speak to the doctor if you see anything unusual.