Run, Baby, Run: When is It Safe to Return to Running Postpartum?
The pelvic floor is a key part of the chain when it comes to running yet it is also one of the most overlooked. Having a baby definitely comes with challenges to the pelvic floor. So how do you know when you’re ready to lace up the old running shoes? Oftentimes women will get cleared to return to exercise at their 6 week follow-up with instruction to start slow and gradually return to activity. It’s important to remember that your body just went through A TON of changes. If you sprained your ankle, you wouldn’t just jump right back into running and expect it to be strong enough. Just like any other body part, the pelvic floor and core need to be retrained and progressively strengthened to be able to safely run again.
Just like any other body part, the pelvic floor and core need to be retrained and progressively strengthened to return to running.
The pelvic floor and your core go through major changes with pregnancy and childbirth, regardless of type of birth:
Stretching of the abdominal muscles
Increased pressure through the pelvic floor muscles
Perineal tearing or other tissue injuries
Increased joint laxity resulting in pelvic, hip and low back pain
Weakening of abdominal muscle strength from c-section birth
Altered posture from center of mass shifting forward due to weight of baby
In 2019, specialists in women’s health published guidelines for return to running. Here are the main points I have found to be helpful in my own practice.
Walking for exercise and gentle core/pelvic floor exercise can be initiated in the first couple weeks with a gradual progression of LOW IMPACT exercise up to week 12
All women should have the opportunity for their pelvic floor and core to be assessed by a pelvic health physical therapist, regardless of how they deliver.
Return to running at 3-6 months, depending on any symptoms of pelvic floor dysfunction.
Pelvic floor physical rehabilitation has been shown to be effective to treat and avoid any problems such as urinary incontinence (leaking), pelvic organ prolapse, and pelvic/low back pain
Get this. Studies have shown that running impact can be anywhere from 2-4 times your body weight! The muscles of the core and pelvic floor need to be strong enough to adapt to that level of force.
Three things to look out for that indicate that the body is not strong enough to uphold the demands of running… The 3 P’s:
Pain: pelvic, low back, hip etc
Pressure: feeling of pressure in the vagina could be a sign that the muscles are not strong enough to support the pelvic organs during impact
Peeing: Urinary incontinence is a sign that the muscles are not sufficiently strong and coordinated for running.
It is absolutely possible for most individuals to get back to running, however, women’s bodies have unique needs when it comes to rehabilitating. It takes time and gradual progression to bring the body back into balance and allow the muscles to strengthen and adapt to the demands of running. As a PT that treats both women’s health and runners, I really enjoy helping moms get back to their sport! Dry needling, exercise prescription, manual therapy and video analysis are a few of the tools that I use to help you get back to being active!
*Information is for educational purposes only. Not to be a substitute for medical advice.
Works Cited
Goom, Tom & Donnelly, Grainne & Brockwell, Emma. (2019). Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. 10.13140/RG.2.2.35256.90880/2.
