Some women are able to run through their pregnancy, other women are so unwell they can barely leave the house. Returning to running after having a baby looks different for everyone. The physiotherapy goals with returning to running after bub include;
- Protect your pelvic floor (pelvic floor dysfunction included pelvic organ prolapse and incontinence)
- Avoid injury (returning to running after your baby is like returning to running after any usual hiatus from running, and you need to take things gradually. Hormone changes from delivery and breastfeeding can put you at higher risk of tendinopathy and other injuries)
- Enjoy it! We want you to get back to what you love doing
Below is a list of some things you can do to help make your return to running as safe and as fun as possible.
- Consider what exercise you did before and during your pregnancy
How you recover after your pregnancy is not only dependent on what exercise you did during your pregnancy, but also what you did prior to falling pregnant. It will be easier for someone to return to running if they always ran prior to pregnancy and did some running during your pregnancy, compared to someone has never run before. If you always ran marathons, then getting back into Parkrun is going to be easier for you, compared to someone who never has exercised in their life and then is keen to run to lose some weight after bub.
- Make sure you do your pelvic floor exercises
Your pelvic floor is made up of muscles and ligaments that support your pelvic organs (bladder, uterus and bowel). You can have very strong pelvic floor muscles, but the ligaments will still become relaxed due to the hormones released during pregnancy. So it is important to give your body some time after pregnancy to allow the hormones to calm down and ligaments to return to pre-pregnancy tightness before you bounce up and down on them during running. A general rule for returning to running is to wait three months post birth before starting. If you always did your pelvic floor exercises and your obstetrician is happy with your pelvic floor contraction, you may want to return to running earlier. The gold standard way to know if with an internal examination to assess your pelvic floor strength. You want to be confident with performing 10 repetitions of 10 second holds in a standing position (against gravity).
- Strengthen your glutes to help support your hips, lower back and pelvis
During pregnancy, our joints are able to move more easily. Some women experience lower back pain, SIJ pain or pubic symphysis pain due to this reason. When returning to running, it is important to be able to stabilise through your pelvis and hips to prevent putting extra pressure on the joints. Hip stability exercises will help to support you during running and help to propel you forward and put less stress through your lower limbs which means more efficient running. Pilates can be a great way to build up some gluteal strength, or getting a home exercise program from your physiotherapist. Typically I will see people at 6 weeks post birth, I then get them to get started on their strengthening exercises, and then we do another check at the 12 week mark to clear them for running.
- Gradually build up your distance and speed
If you take a break from any sport, whether it is 9 weeks or 9 months, you wouldn’t go straight back into what you were doing before. Pregnancy is exactly the same. After you give birth, you are able to start walking straight away. Once you feel confident in your pelvic floor to return to running, starting with some intervals of running and walking is a great way to start building up your body’s tolerance to running and cardiovascular fitness. As your fitness increases you can increase the running time and decrease the walking time until you feel as though you can keep on running. Eg Run 30 sec, walk 2 mins x 10 and as that gets easier transition to run 60 sec then walk 60 sec.
- Get a running assessment
If you return to running and start to experience lower back pain or something doesn’t feel right, a physiotherapist will be able to video your running style and give you tips and tricks and exercises to help your running style be as efficient as possible
- Look out for signs of prolapse
Pregnancy and childbirth increase your risk of pelvic organ prolapse. As you increase your exercise and running, keep an eye out if you experience
- leaking (urine, faeces or wind) either during exercise or with a cough/sneeze/increased pressure
- a heavy dragging sensation down through your vagina.
This is a sign you have done too much and need to take it down a notch. This is when you need to focus on your pelvic floor exercises and decrease the pressure on your pelvic floor. If symptoms of leaking or heavy sensation continue, make sure you see a women’s health physiotherapist to make sure you are doing your exercises properly and so they can help give you an individualised exercise program.
Luginbuehl, H., Baeyens, J. P., Taeymans, J., Maeder, I. M., Kuhn, A., & Radlinger, L. (2015). Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence: a systematic review. Neurourology and urodynamics, 34(6), 498-506.
Brumitt, J. (2009). A return to running program for the postpartum client: a case report. Physiotherapy theory and practice, 25(4), 310-325.