Whether the goal is a casual five-kilometre jog, or to run a marathon, it is important to approach it safely and gradually. After giving birth, the abdominal wall and pelvic floor tissues are stretched and weak. High impact activities dramatically increase intra-abdominal pressure and muscular demand on the pelvic floor. Return to running can contribute to pelvic organ prolapse, leaking, pain and sexual dysfunction if not done appropriately.
I remember having the itch to return to running shortly after giving birth to my first child. I wanted to feel like my old self again and lose the baby weight. I wanted to have that time to myself. I wish I could tell you I was responsible and saw a pelvic health physio. That I strengthened my core and pelvic floor before starting to run again. But I didn’t because no one told me to. At 6 weeks postpartum, I went on a 7 kilometre run. It felt like a major achievement. I was reenergised – mentally. But I learnt that I had done too much too soon and physically I wasn’t ready. I ended up with leaking (pee) when I went to laugh, sneeze and exercise. I learnt my lesson. I should have been more patient.
Our bodies go through significant changes. It takes time to rebuild strength and endurance, regardless of prior physical condition or type of birth. So when is it safe to return to running?
A 2019 study by UK physiotherapist Tom Goom and colleagues strongly suggest women wait at least 12 weeks before returning to running. Many of us are mentally ready to run before our bodies are. Recovery time for tissues however is understood to be between four to six months.[1] This is why it is so important to make a gradual return.
The first step is to assess your pelvic floor health and if you are ready to start running. Even if you had a c-section, the pelvic floor can still be affected. Make sure you see a pelvic health physio if you had trauma, tearing, or can’t feel what your pelvic floor is doing. The main focus initially should be to work on deep breathing as well as core and pelvic floor function.
As long as signs and symptoms of pelvic floor dysfunction are not present and there has been rehabilitation of the core and pelvic floor, you can gradually return to running after 12 weeks. But before you do, there are a few things that should be considered. We need to be strong to be able to run, rather than running to get strong. You need a base level of strength to have a good foundation for running. Running is basically single leg, low level plyometrics (a single leg hop over and over) so if you don’t have the necessary strength or control, this can lead to overuse injuries throughout your body and can negatively affect your pelvic floor and diastasis. So let’s ask a few questions first about strength.
Can you stand on one leg without losing pelvic stability and keep your rib cage stacked over your hips?
Can you do a single leg squat while keeping your hips level, knee and foot pointed straight ahead, and your rib cage stacked over your hips? Can you feel it in your glutes and quads evenly? Can you do it for 30 total reps? Even a little bit of deviation will become an issue as you get fatigued muscularly and cardiovascularly.
Do you have the calf and arch strength for a good foundation to concentrically push off from (and feel your calves and arch working) and also eccentrically lower down for shock absorption and controlling the movement? Can you do it for 30 total reps?
Do you have good posture with your ribs stacked over your hips without upper ab gripping, glute clenching or feeling strain in your back?
If you find that you just have to run or are transitioning back into running, here are some tips and things to consider when you’re running to help you get the most out of it. Remember, if at any point you have a feeling of heaviness in your pelvic floor, a tampon feeling, or are leaking while running, STOP immediately and hold off on running until you get stronger. This is a sign that your pelvic floor is being negatively affected by running and it is doing you potential harm. You can also check your diastasis before and after a run to see if your running had any negative effects on your diastasis.
- Have a slight forward lean posture. This will help you push the ground away and keep your rib cage stacked over your pelvis.
- Don’t overstride. This will keep the shock evenly distributed throughout your pelvis to help work your pelvic floor as well as help you better access your glutes as your primary hip driver.
- Start with short walking and running intervals and gradually increase the intensity so that you work up to consistently running half an hour. Increase volume before intensity. In other words, distance and frequency before speed and terrain challenges.
- Try challenging yourself and running uphill which naturally makes you lean forward, limit over-striding, decrease impact forces, and improve hip extension mechanics.
A professional pre and postnatal coach like myself can work with you to develop a plan so that you can meet your running goals. Knowing how you are healing postpartum, and knowing what to do for your specific needs is powerful!
[1] Donnelly, G, Brockwell, E, Goom, T. Ready, steady, go! Ensuring postnatal women are run-ready! BJSM. 2019 May; Blog.
Comments