How to Safely Return to Running Postpartum
If you are someone who enjoyed running prior to having a baby, or are new to running now that you are postpartum, then you may be wondering how to know when it’s safe to start running postpartum without causing injury or having to deal with pelvic floor (or other) dysfunctions. This blog post is going to cover the reason why running can be so exacerbating to the pelvic floor, a few things to avoid when returning to running, and my fool-proof method for returning to running safely. I’ll also be going over the foundational work needed to prepare yourself for returning to running, several exercise examples that can be helpful to build strength prior to running, and some tests and assessments I recommend doing prior to returning to actually running. If you are a runner or are looking to start running once postpartum, you’ll want to make sure to save this one!
What is the big deal with returning to running postpartum?
What is it about running that has got everyone so concerned about returning to it? Why is running once you are postpartum such a big deal?
Well, to break it down simply, it’s because running is actually a very high impact and complex activity!
Because of the level of impact running has on our bodies, if I can advise you on ONE thing with returning to running postpartum, it would be to NOT just “jump back into it” or go out and try to do a 3 mile run on your first attempt postpartum. Running postpartum should be a slow integration alongside pelvic floor/core rehab so you don’t have issues later on down the road.
I know what you’re thinking…”But I ran when I was pregnant so that I could get back into it quicker once postpartum!”. Unfortunately, my word of advise goes for even those who did run during their pregnancy! So let’s get to it! What is it about running that warrants such caution and attention in order to return to it after having a baby?
Let’s talk about the research…
According to Selman et al., high impact activities (like running) put a significantly increased demand on the pelvic floor muscles. The reason for this being the sudden rise in intra-abdominal pressure as well as the force that occurs through the body when each foot touches the ground (which is 1.6-2.5x the force of your bodyweight). Because of the high demand running places on the pelvic floor, our pelvic floor would actually have to quickly contract followed by then quickly relaxing over and over again throughout the entire act of running. And this would need to happen on a reactive or sub-conscious level…meaning you aren’t actively contracting and relaxing your floor, but instead your body is just automatically doing this in response to the high demand and force placed on it.
And as we know, having a baby can be very traumatic to the pelvic floor and core muscles, with either a vaginal OR a C-Section birth. Because of that trauma, oftentimes the “natural” or “automatic” response that you may have had prior to having a baby, just isn’t quite there anymore after having a baby. Also, if you are unable to contract and relax your pelvic floor consciously, then we can also pretty safely assume that your body would likely be unable to do this sub-consciously or without actively thinking about it as well.
So, knowing all of this, it makes a lot of sense that if you try to jump back into running without any prep work following having a baby that you may experience things like incontinence, pelvic heaviness or even prolapse. And this is not to say that running postpartum just isn’t in the cards anymore, but what it does mean is that if you have a goal of returning to running postpartum, then you will need to be doing some sort of a pelvic floor and core rehabilitation program to work on getting that automatic pelvic floor contraction/relaxation response back prior to going out for a long-distance run! If that is not done, then you do run the risk of having pelvic floor issues/dysfunction or potentially even injury.
Which then begs the question of HOW do we go about doing that??
How to Create a Solid Foundation
If returning to running postpartum is the goal, then the first thing you will need to focus on is creating a solid foundation. What do I mean by that? A solid foundation means to relearn or reteach your pelvic floor how to contract and then relax on demand. At first, you will need to consciously and actively be connecting your mind back to your body and your pelvic floor in order to take your pelvic floor through a full range contraction followed by a full range relaxation.
You will not be able to contract/relax your pelvic floor automatically and sub-consciously if you can’t first do it actively and consciously. So this means we should just go out and do a bunch of kegels then, right??
Not quite…setting the foundation is more than simply activating and relaxing your pelvic floor over and over again while keeping the rest of your body still. Your pelvic floor has to do these things while you are taking your body through various planes of movement! Your pelvic floor and core rehab should reflect that. This means that your foundational work needs to include movements that not only connect to the core and pelvic floor, but also integrate different planes of motion like moving forward, to the side and rotationally, because running truly does require strength and endurance in all of these different planes!
Speaking of strength and endurance, running really is more complex than most people give it credit for. It requires BOTH strength and endurance while at the same time tolerating the impact with each step. And in order to perform a high-intensity activity like running, our pelvic floor has to be able to support us in all three areas: tolerating the impact, tolerating the level of endurance and stamina required for the run, and having the strength to contract/relax repetitively.
But, before we get too far ahead of ourselves, let’s take it back a step or two and think about the very first thing we should do when we start working on the foundational level of rehabilitating our core and pelvic floor to prep for returning to running, which is….BREATHING.
Yep, again, something that should be so automatic and without much thought, we really need to leverage and utilize to help us create that solid foundation between our breathing and our pelvic floor/core. So let’s go over each phase necessary to safely return to running postpartum.
Phase 1: Reconnecting with Our Breath
If it starts with the breathing, how might we go about using our breath to reconnect to our core and pelvic floor?
I would recommend starting with learning how to perform diaphragmatic breathing. Not sure how to do this? Make sure to watch the video below for a step-by-step guide!
And just like with everything else, diaphragmatic breathing starts out very simply and one-dimensionally and can then be progressed and performed very multi-dimensionally as you learn how to breathe and connect with your core and pelvic floor.
Phase 2: Progress Into Functional Movements
Once we have our breath work down and we have learned how to connect our breath to our core and pelvic floor in various positions, now we need to add it into functional movements.
Adding in functional movements can again be a very progressive activity, starting off with a low-load, low intensity movement and then progressing in load and intensity over the course of several weeks.
Some of my favorite exercises specific to returning to running include:
1. SL Banded Superman
2. lateral lunges to bounds
3. pallof press variations
4. side plank variations
5. supine march variations
6. forward jump lunges or bounds
These are just a few examples of exercises that are great for returning to running and can also be progressed as they start to feel easy for you. Progressing these exercises could look like increasing repetitions, resistance and/or the intensity at which you perform them.
Phase 3: Assessments & Tests
We’ve reconnected our breath to our core and pelvic floor, we’ve developed our strength and progressed in multi-dimensional movements, now it’s time to perform some assessments and tests to see if we are truly ready to hit the pavement!
3 assessments to do prior to returning to running:
Pelvic floor assessment
Strength assessment
Impact test
These are essentially a set of exercises that test the bodies strength and endurance to withstand the impacts of running with decreased risk of injury, incontinence or prolapse. Obviously having a test or assessment performed is a really great way to know for sure if you are ready to return to running!
Phase 4: A Gradual Return to Running
If you have completed and “passed” all three phases, now it’s time for the fun part…RUNNING! But still, I do not recommend going out for a 3 mile run on your first attempt. Instead we want to slowly and gradually progress in the same way we slowly and gradually progress through all the other phases. We can do this by following the 1:2 ratio, meaning 1:2 ratio of walking to running and then building up as the weeks go on.
Phase 5: Evaluating Your Post-Run Symptoms
Once the run is over, the one thing you don’t want to forget to do is assess how you are feeling and if you have any symptoms. You want to make sure you evaluate and assess yourself immediately after the run as well as 24-48 hours later to ensure you aren’t experiencing any delayed symptoms.
Symptoms like:
Pelvic heaviness
Increased incontinence (urinary or fecal)
Hip pain
Back pain
Pelvic pain
Having any of these symptoms during or after your run would likely mean that whatever type of run you did was a little too much for where you are currently at and would require you take more time to build up to that intensity of a run.
Reach Your Goals Postpartum
If returning to running is a postpartum goal for you, then Mind Body Core Postpartum program is here for you! Mind Body Core will walk you through step-by-step each movement, exercise and progression to make a full return from baby to running.
If you’re looking for guidance and support, Mind Body Core is the fully comprehensive program to do that for you whether it be returning to running or any other goal you have for yourself in your full recovery following birth.