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Return to Running Post-Baby


So, you think you're ready to return to running post-baby?! We are going to dive into some things to consider before you hit the pavement running after pregnancy.


First, picture this. You're an athlete who had an ACL injury and surgery. You were referred to physical therapy and spent 6-8 weeks retraining the muscles affected, retraining functional movement patterns, and building strength of your whole body. You progressed through a specific, individualized rehab plan and return to running program. Then, finally, after months of rehab you were cleared to 'return to sport.' Why don't moms receive the same level of care and guidance when it comes to postpartum return to exercise?! Your body grew and carried a baby or babies for 9+ months of pregnancy and delivered that baby! Then, we just expect to be 'healed' at our 6-week check-up and continue on exercising like none of that just happened and with little guidance.


I am here to provide you better guidance because YOU and YOUR body deserve it! You are amazing, Mama.


Let's start by talking a little bit about what happens to the pelvic region during and after pregnancy. This information is from the evidence based guidelines for postnatal women returning to running (Returning to running postnatal - guidelines for medical, health and fitness professionals managing this population - Goom, Donnelly, and Brockwell 2019). The levator hiatus widens during pregnancy and also increases significantly during a vaginal birth. The best evidence suggests that recovery time for these tissues and healing time is 4-6 months (Shek et al, 2010, Staer-Jensen et al, 2015). This challenges the thought of "full recovery" by that 6-week check-up. Now, what about a Cesarean delivery?! We know that the abdominal fascia following a C-section has only regained about 50% of its strength at 6-weeks postpartum (Ceydeli et al, 2005). We must allow our bodies time to heal and recover and know that your body is still healing and recovering beyond that 6-week mark. The latest research recommends waiting until at least 12 weeks postpartum to return to running.


The KEY takeaway from these return to running postnatal guidelines is that ALL postpartum women, regardless of delivery mode, should be assessed by a pelvic health therapist prior to returning to high impact exercise.


QUESTIONS TO ASK YOURSELF PRIOR TO RETURN TO RUNNING:

  • Am I at least 3 months postpartum?

    • The latest research recommends waiting until at least 12 weeks to begin a return to running program. Working with a physical therapist can help determine your readiness.

  • Have I spent time rehabbing my deep core and pelvic floor?

    • This is a crucial piece of postpartum recovery that is often missed. Many women don't know how to properly use their diaphragm or coordinate their diaphragm, pelvic floor, and deep abdominals. We must build a solid foundation first before progressing to more challenging exercise.

  • Am I still breastfeeding? Am I getting enough sleep?

    • Breastfeeding affects your hormones and sleep deprivation can really take a toll on our bodies and the ability to recover well. These are factors to consider when returning to running post-baby.

  • Am I experiencing any pelvic girdle pain (pubic symphysis, tailbone, hip, low back or SI joint pain)?

    • Pelvic girdle pain is common during pregnancy and postpartum. If you are experiencing any pain, please seek out help from a professional. You do not have to live with this just because you are pregnant or just because you had a baby! There is help :) I recommend not pushing through any type of pain when returning to exercise. Seek help first!

  • Am I experiencing any urinary or fecal incontinence?

    • If so, please don't begin a return to running program at this time. Seek out help from a pelvic health professional to create an individualized plan for you! This is common post-baby, but this is not normal!


WHAT DOES AN ASSESSMENT LOOK LIKE WHEN WORKING WITH YOU FOR RETURN TO RUNNING?


Here are some things that I might look at when assessing someone wishing to return to running post-baby or someone who already has return to running for weeks/months/years postpartum that is having pain or leaking:

  • Diaphragmatic breathing & rib cage angle/alignment

  • Pelvis alignment and position

  • Coordination and strength of the deep core (diaphragm, pelvic floor, transverse abdominis, and multifidi)

  • Ability to perform proper pelvic floor contractions (squeeze, lift, and relax)

  • Thoracic and lumbar spine range of motion and mobility

  • Hip mobility and strength

  • Squat and hip hinge mechanics

  • Single leg balance and stability

  • Muscle strength of certain muscles active during running (ex: calf raises, single leg bridges, single leg squats, side lying hip abduction)

  • Running mechanics & form


Based on the assessment, we would determine a specific, individualized plan to assess any symptoms, muscle imbalances, retrain movement patterns, and return to running!


Here is an example from the Return to Running Postnatal Guidelines by Goom, Donnelly, and Brockwell of what exercise progression should look like in the postnatal runner:




The ultimate goal is to get you back to running safely, pain-free, and leak-free and keep you running for the long-term!! I hope you found this information helpful. I love helping women return to the exercise they love postpartum without worrying about pain or leaking. If I can help you along your journey...please reach out to chat more or schedule a 1:1 in-person or virtual consultation (restore.physicaltherapy614@gmail.com).


Happy Running!


Kaitlin Hartley, PT, DPT, PPCES




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