Ready to run postpartum? Start here!
Chiropractor Dr. Brittany Moran is a new Mom and talented runner. She’s sharing a few key concepts that have helped her gear up to run after welcoming her first baby.
With a historical trend of very few guidelines and all the highs and lows that come with life with a new baby, it’s no wonder that returning to running postpartum can be daunting and, quite frankly, scary.
Many well-intentioned healthcare professionals default to clearing postpartum runners to lace up again after six weeks. It’s not unusual for this clearance to come without a proper assessment or recognition that current evidence suggests we can do so much better.
The good news is that in recent years, abundant research, publications, and well-informed guidelines have been popping up to support a healthy return to running.
The even better news is that they’re sparking more research and conversation on the topic.
The first thing to remember is that just because you are medically discharged at six weeks does not necessarily mean you are ready to lace ’em up the very next day.
This article will present an overview of current guidelines and a few thoughts on how to tailor them to your unique needs, goals and experience. We’ll cover:
Factors contributing to your postpartum running experience.
Timelines for a return to run.
The role of a pelvic health assessment.
Tests to confirm readiness to run.
Other considerations to help you prepare for your triumphant return.
It’s your journey!
A lesson seemingly forced on us the moment we learn that we are expecting is that each pregnancy, birth, child and postpartum experience is unique.
Just as one person seemingly breezes through pregnancy with little more than a bit of fatigue while others seem to tally side effects by the minute, some runners will have a relatively quick, smooth return to running. In contrast, others will find themselves existing in a body that doesn’t feel like their own for far longer than they ever imagined.
Amy Poehler said it beautifully: “Good for her! Not for me. That is the motto women should constantly repeat over and over again. Good for her! Not for me.”
Regardless of which camp you fall into, know that you’re in good company and that the demands of running are no joke. It’s worth it to take your time to build up at a rate that feels best for you.
Running is a high-impact activity. It requires forces of 2.5-6x your body weight with every step, with an average of around 1,000 steps per kilometre run. That means that it takes extra training and intention as you look to build back.
A few factors that can play a role in when and how you build up to your running:
How far into pregnancy did you run, and when was your last run?
Pre-pregnancy activity level
Sleep (or lack of)
Energy availability (fuel!)
Breastfeeding/milk supply
Current stress levels and mental health status
Training goals
Current chronic abnormal postures
Birth experience and healing
Support with childcare
A few basic timelines:
Historically, women have been cleared to fully participate in activity at six weeks postpartum. Often, this guideline has been shared with women without a proper exam to assess function. Remember, the forces your body needs to tolerate when running are significantly greater than those of daily life.
Being symptom-free in daily life doesn’t mean you’re safe to give the green light to running!
Recent research has sought to clarify more appropriate guidelines.
One study suggested that the minimum recovery time should be 12 weeks and include an assessment by a pelvic health professional and a gradual increase in demand.
Another study suggested a minimum of 3 weeks of no load, with an individualized plan to progress from there. Note that this does not necessarily mean running at three weeks but progressing towards running with movements and loads designed to mimic the loads of running.
While it’s clear that there is no “perfect” time to begin returning to running, it’s also clear that an individualized approach designed to target the unique needs and goals of each runner is of great benefit.
Typically, that means an assessment with a pelvic health physiotherapist to assess for:
Pelvic floor function (strength, coordination, endurance)
Pelvic organ prolapse
Incontinence (urinary and anal)
Lumbopelvic strength
Inter-recti distance and function (Diastasis recti)
Balance/proprioception
Gait analysis
General strength, coordination and stability.
It’s important to note that outcomes improve regardless of how a runner gives birth.
Ready to run?
While working with a pelvic health therapist, it’s not uncommon for both runners and clinicians to overlook the need to gradually build towards the high loads of running. Many clinicians unfamiliar with the sport don’t have a complete understanding of the loads that we need to be able to tolerate.
So, while we recommend using a running lens from the beginning of the rehab process, it’s never too late to incorporate a running focus.
Before you lace up, you should be able to perform the following activities free of pain or other symptoms:
Walking for 30 minutes
Single leg balance for 10s each leg
Single leg squat x10/leg
Jogging on the spot 1min
Forward bound x10
Hopping on the spot x10/leg
Single-leg running man x10/leg
Single-leg calf raises x20
Single leg bridge x20/leg
Single leg sit-to-stand x20/leg
Here are a few favourite strategies to help you get there:
Mobility: hips, spine, ribs
Pelvic floor control (contract & relax)
Lumbopelvic strength
Single leg/balance work
Brisk walking, stairs, and uphill walking
Cross training, such as bike, elliptical, or pool running
Along with the cardio that so many runners crave, it is vital to incorporate strength training, specifically pelvic floor strengthening, into your routine.
Strength should focus on first re-engaging the pelvic floor and core with the breath. Starting with exercises on the mat and progressing to standing and single leg, ideally incorporating load (i.e. weights! Explosive movements!). The strength work should be targeted at getting you to a place where you can easily pass the above tests.
Next up: Time to run!
Now that you’re ready to get after it with a little more confidence that you’re set for a healthy, happy return to running, stay tuned for our next blog on how to get back at it!
In the meantime, check out 5 Tips for Postpartum Running.