As a new mother you are probably overjoyed! But also over-tired, overwhelmed and OVER feeling like a stranger in your own body. You’re itching to get back out there. I know the feeling. You dutifully waited to exercise until your 6 week check-up (or maybe not quite that long… no? Just me?), and were given the all clear – so you can run now, right? I had the same burning question, and found good evidence that says NO.
A group of physical therapists out of the UK published a suggested protocol in 2019 for guidance on postpartum running, or return to running after having a baby. And they say don’t run before 12 weeks postpartum, at the earliest1. A quick subsequent search reveals several other therapists and doctors that agree. That was stunning to me. I also felt inexplicably personally offended by it. I just got steadily slower and slower for 40 weeks, and now I’m supposed to wait 12 more? So, I get it. But hear me out. There is good evidence that we should wait a while for our postpartum running plan, and plenty to do to prepare in the meantime.
Most of the concern here is regarding the trauma that birth causes to the pelvic floor and abdominal musculature. High impact exercise like postpartum running depends on controlled intra-abdominal pressure via these muscles to support your organs and maintain continence. Your pelvic floor muscles do have the ability to recover after birth, but it can take 4-6 months2. Allowing a full recovery can help prevent real and scary issues like urinary and fecal incontinence, pelvic organ prolapse (when your organs actually start to fall out – yikes), and sexual dysfunction. It’s also important to appreciate the need for appropriate strength in your legs and core that may have also been affected by different and often decreased training as your pregnancy progressed.
How can I get ready?
So if that list of complications doesn’t sound good, and you’re on board with waiting a few months in order to avoid them, there is still a lot you can do in the meantime! Here’s how you can get started with your postpartum running plan:
- Start with walking – as soon as you feel ready! Begin to increase hills/incline after you’re comfortable with flat ground.
- Total body strengthening – squats (progressing to single leg), lunges, bridging, side leg lifts, and single leg balancing are all great ways to prepare for both life with a baby (think getting up and down off the floor several times a day), but also for your return to postpartum running.
- Basic core strengthening – exercises like pelvic tilts and bent knee fall-outs are great for prepping you for postpartum running, and you can begin right away!
- Breathing – diaphragmatic breathing can help with pelvic floor and abdominal recovery. Breathe in through your nose, deep into your belly. Hold for 1-2 seconds, then exhale through pursed lips until all the air is out. Repeat 30 times.
- SLEEP – as much and as often as you can. This is easier said than done with a newborn, but it is so important for your mental health as well as your body’s ability to heal physically. The goal is 7-9 hours (haha, I know).
Please keep in mind, any therapist worth their salt will tell you that timelines are just suggestions. There is no magic transformation that takes place at 12 weeks. Objective targets are what can really gauge your preparedness. Here are a few commonly agreed upon criteria that you should meet before you consider postpartum running, regardless of the timeline:
- See a pelvic health specialist/women’s health physical therapist so they can assess your pelvic floor recovery. A quick home screen is:
- 10x fast repetition kegels in standing position
- 10 repetitions of 6-8 seconds maximal contraction (as strong as you can) standing
- 60 seconds hold at about 50% of your maximal contraction standing
- Check that there is no overt separation between your abdominal muscles (called diastasis recti) – if you’re not sure, ask your therapist!
- Ensure you have appropriate single leg, hip and core strength – another area in which a physical therapist can help you with an assessment and individualized plan if necessary
- You have no pelvic or low back pain with exercise
- You have no increase in vaginal bleeding with exercise (or otherwise that is not associated with your monthly cycle)
Tips for how to ramp up your postpartum running plan
- Start with walking, and slowly increase your distance. A very commonly accepted guideline is to increase no more than 10% mileage per week, but use your good judgement.
- Begin with short 1-2 minute jogs peppered into your walks. This will help you assess how you feel in real time and help you gauge your readiness for postpartum running a lot better.
- Gradually increase the length of your jogs, and shorten your walking recoveries. If you need more guidance here, “Couch to 5k”-type programs are plentiful online, and great for this!
- Progress your distance/time running before you increase your speed/intensity. (Read: no sprints right off the bat).
Want a little full disclosure? I didn’t wait for 12 weeks. I just checked, and the first time I went postpartum running after giving birth to my son was 9.5 weeks. I went 3 miles, and it felt… okay. Looking back, I did have some pelvic pain during and after that run, but it was easy to tell myself, “Hey, you just had a baby, so everything is a little weird right now and what is “feeling normal” anyway?” But I know now that I should have waited. Focused on my pelvic floor recovery. Done a few more readiness exercises. Stuck with walking (you can get a great workout pushing a stroller, trust me). It’s easy to believe that a gradual approach to returning to run is best, while still feeling a lot of pressure to “get your body back”(hate that phrase) and squeeze back in your pre-pregnancy jeans. It’s hard to be patient. But I have been there, and I would tell myself (and you!) to worry about all that less, and to prioritize a progressive, safe return (and brand new baby snuggles) more.
If you have any further questions, think you’re in need of postpartum physical therapy, or want any further evaluation for postpartum running, our therapists at Health Loft are here to help you via video-conferencing, telehealth, or in person in Chicago, IL. Remember to also check out our Facebook, Instagram, and Twitter pages for more fun facts and articles on nutrition, physical therapy, and exercise!
- Goom, T. (2019). Return to Running Post-Pregnancy, free guide for clinicians. Retrieved from https://www.running-physio.com/postnatal-guide/
- Starr-Jensen, J., Siafarikas, F., Hilde, G., Benth, JS., Bo, K., Engh, ME.(2015) Postpartum recovery of levator hiatus and bladder neck mobility in relation to pregnancy. Obstetrics and Gynecology; 125(3):531-9.