Having a baby can be an exciting and life-changing experience, but it can also greatly impact a mother’s body. For those who love to run, taking time off from running due to pregnancy and postpartum recovery can be challenging. Hitting the pavement and getting back into exercise after having a baby can be daunting and confusing without a good plan. You’ve done all your pelvic floor exercises but don’t know where to start; you’re tired; fearful you might make something worse and everything just feels different. There is a way to get back on track, with the proper care, support and preparation, it’s possible to return to running (and enjoy the experience) once again!
How Pregnancy Changes your Pelvic Floor Region
During pregnancy, the pelvic floor muscles adjust to hormonal and physical changes in the body. The pelvic floor muscles relax and there is an increase in joint laxity due to changes in hormone levels. There is also increased load and pressure onto the pelvic floor muscles from the weight of the growing baby, and the possibility of injury to the pelvic floor muscles during delivery.
After giving birth the current advised recovery time for tissues is between 4-6 months (Stær-Jensen et al. 2015), which extends well beyond the 6-week postnatal check by your doctor. Around the world, Pelvic Health Physiotherapists are driving instrumental research and working with postnatal women to improve their care and recovery support after pregnancy. By educating women to understand the changes that pregnancy has on their body, Pelvic Health Physiotherapists aim to empower women with the tools they need to prevent and manage common (but not normal) pelvic floor issues.
What do the Current Guidelines Recommend?
In March 2019 the first-ever guidelines were released to specifically offer evidence based recommendations for postnatal women returning to running. Goom, Donnelly & Brockwell (2019) in their article “Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population” recommend four important points for women planning on exercising after giving birth:
- All postnatal women, regardless of delivery mode, should be assessed by a pelvic floor physiotherapist prior to returning to running or any high impact sports. The prevention and management of many pelvic floor dysfunctions including pelvic organ prolapse; heaviness/dragging in the pelvic area; urinary or faecal incontinence; pain with intercourse or pelvic pain should be addressed by your pelvic floor physiotherapist.
- Postnatal women should wait until at least 12 weeks prior to commencing a return to running program. This timescale is advised as a guide rather than a prescriptive cut off and should be discussed with your pelvic floor physiotherapist.
- Assessment of pelvic health; load management and general strength testing to assess the whole body’s readiness to return to running postnatal should be performed.
- Consideration of other factors which may impact returning to running including: weight; breathing; fitness; psychological status; sleep deprivations; breastfeeding; abdominal separation; running with a pram and Relative Energy Deficiency Syndrome (RED-S). RED-S results when the body isn’t getting enough energy intake to meet the physical demands placed on it.
Tips for a Safe and Enjoyable Running Experience
- Start slow: After giving birth, the body needs time to recover and adjust. It’s important to start slowly and gradually increase intensity over time.
- Stay hydrated: Hydration is important for overall health and to prevent injury. Make sure to drink plenty of water before, during, and after running.
- Listen to your body: It’s important to listen to your body and be aware of any signs of discomfort or pain. If something doesn’t feel right, stop and rest. Returning to running is different for every mum and by understanding your symptoms, your recovery can be individualised for your running goals. This is where working with a pelvic floor physiotherapist is beneficial.
- Get support: Joining a running group or finding a running partner can provide motivation, encouragement, and a sense of community.
- Wear good supportive gear: Choose appropriate clothing including a well fitted sports bra.
- Running with a pram: Paediatricians recommend not using a pram until after 6 months, or when your baby has good head control. A good 3-wheeled running buggy can make a big difference to your running enjoyment.
- Remember everyone’s journey is different so work towards your goals at your own pace.
Returning to running after having a baby can be a wonderful way to regain strength, boost your mood, and get back to doing what you love. By following these guidelines and tips, you can ensure a safe and enjoyable experience. Remember to be patient, listen to your body, understand the why behind your symptoms, train for impact and enjoy the journey back to running.
At Medicine in Motion our pelvic floor physiotherapist can perform a thorough pelvic floor assessment and also take you through a return to run readiness screen. From here an individualised program can be developed to give you simple and supportive directions on where to begin. It takes a holistic approach to a safe, graded return to running and impact that works towards your goals the way that suits your body.
Book an appointment with our Women’s Health Physiotherapist, Rosie HERE
References:
Goom, T., Donnelly, G. and Brockwell, E. (2019) Returning to running postnatal – guideline for medical, health and fitness professionals managing this population. [https://mailchi.mp/38feb9423b2d/returning-to-running-postnatal-guideline]
Stær-Jensen J, Siafarikas F, Hilde G, Benth JŠ, Bø K, Engh ME. Postpartum recovery of levator hiatus and bladder neck mobility in relation to pregnancy. Obstet Gynecol. 2015 Mar;125(3):531-539.
