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For many new moms, the desire to return to your pre-pregnancy fitness levels, including running, can be strong. However, resuming a running routine postpartum requires careful consideration of various factors to ensure safety and decrease risk for injury.
Historically, there haven't been very many guidelines to help new moms navigate returning to running/exercise postpartum. It wasn’t until March 2019 that 3 physiotherapists in the UK published the first evidence based practice guidelines for getting back to running postpartum (view PDF). This was a huge step in the right direction for women’s health! These guidelines connect pelvic health and pelvic dysfunction to both the musculoskeletal and mechanical components of running. I will summarize this article below, although I think it’s important to understand a few things before starting this journey.
First things first, you need to understand the profound physical changes that occur to your body during and after pregnancy. You need to give yourself grace during this period of your life as you are beginning to find your new normal postpartum. After having a baby, your abdominal wall and pelvic floor muscles are stretched, weak, and may still be recovering from giving birth. High impact activities dramatically increase the pressures in your abdomen and down into your pelvic floor. Returning to high impact exercise too quickly can lead to pelvic organ prolapse, urinary incontinence, sexual dysfunction, and pain. This journey will look different for everyone. You must take into consideration your pre-pregnancy level of fitness, whether you had a vaginal birth or c-section, and even whether you had a planned c-section versus an emergency c-section. These are just a few of the many factors that will effect your journey to get back to high impact activity.
Start by allowing time for your tissues to heal with a period of relative rest. You will likely receive the “all clear” at your 6-week checkup from your OBGYN. This simply means that there is nothing requiring immediate medical attention. This DOES NOT mean that your tissues have finished healing or are prepared for high impact activities. Read that sentence again. This DOES NOT mean that your tissues have finished healing or are prepared for high impact activities.
In the first 0-3 months after giving birth, it is important to rest, practice breath work, and to reconnect with your body. It’s also important to optimize your posture during all of these new activities you're participating in with baby, such as breastfeeding, sitting/laying on the couch with baby, holding baby in their car seat, pushing baby in a stroller, the list goes on. This first month postpartum is the perfect time to check out pelvic floor physical therapy for more individualized care.
Key Research Takeaways for How to Return to Running Postpartum: A Summary
Reading dense scientific articles is not how most new moms want to spend their time, so I have taken the key details from the latest research and summarized it below.
When to Reintroduce Running:
- Train and strengthen your pelvic floor and core muscles in the first 12 weeks after birth.
- Wait at least 12 weeks before you return to running or add high impact workouts back to your routine.
- You can start incorporating running ~slowly~ back into your routine starting 3-6 months postpartum. This is only if you don’t have any symptoms of pelvic floor dysfunction. I have listed what these symptoms may look like below.
Red Flags for Pelvic Floor Dysfunction:
- Urinary or fecal incontinence
- Pressure, heaviness, bulging, or discomfort in your lower abdomen or pelvic floor
- Diastasis recti (noticeable gap or bulging along the midline of your abdomen)
- Low back pain
- Hip pain
- Tailbone pain
- Pelvic pain
- Difficulty pooping/constipation
- Painful sex
- Increased bleeding or pain
Strength Testing:
You should be able to perform the following exercises/activities without ANY symptoms mentioned above.
(*) indicates performing exercise/test on both legs
- 30 minutes of walking continuously
- 30 seconds balancing on 1 leg (*)
- 20x single leg squats (*)
- 20x single leg bridges (*)
- 20x single leg calf raises (*)
- 1 minutes of jogging in place
- 10x forward bounds
- 10x single leg hops in place (*)
- 10x single leg “running man” - raise opposite arm and hip flexion, jump, and switch (*)
- 30 seconds of mountain climbers
- 1 minute plank hold
Additional Factors That Should Be Considered Before Return to Running:
- Overall fitness level pre-pregnancy and during pregnancy
- Abdominal wall recovery (c-section scar healing, diastasis recti)
- Pelvic floor/vaginal recovery (episiotomy, 2nd/3rd/4th degree tears)
- Sleep, nutrition, and hydration status
- Anxiety/depression status
- Breastfeeding status. Breastfeeding can alter hormone status, which can affect prolapse and pelvic stability. You may also have increased hydration and nutritional needs if you’re still breastfeeding.
Returning to running or high impact exercise postpartum involves more than just getting back into your old routine. It requires a thoughtful approach to ensure that you are supporting your body’s recovery. By obtaining medical clearance, understanding your pelvic health, starting with low-impact exercises, and progressing gradually, you can safely reintroduce running into your life.
I think it’s helpful to remember a few things when starting this journey: 1) every postpartum journey is unique, 2) postpartum journey’s take time, and most importantly 3) it takes a village. Lean in to your family and friends during this time period, seek professional guidance from your local pelvic floor physical therapists, doulas, and midwives, or join a support group! With patience, professional guidance, and self-care, you can enjoy a healthy and successful return to running postpartum journey.
Need help? If you live in the Atlanta area, contact me at Activcore Druid Hills to schedule an appointment.
REFERENCES:
Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. March 2019 (see article)
Postpartum Running: Safety Tips and Strengthening Freebie. Expecting and Empowered. February 2018 (see article)
Disclaimer: The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.
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