Why shouldn’t I return to running straight after having a baby?
Running is considered a high impact sport as it places a lot of demand on the body compared to low impact exercises. After having a baby, postnatal women need time to heal and regain strength, especially in the pelvic floor and the abdominal muscles due to pregnancy and delivery.
In fact, after a vaginal delivery, some research studies suggest it can take 12 months before the pelvic floor reaches near its prenatal size!
Following a caesarean delivery, there needs to be consideration given to the healing time required for the uterine scar. It is also important to note the abdominal fascia (connective tissue) isn’t back to near 100% till 6-7 months postnatal.
I’d still like to exercise. What can I do?
Therefore because of these considerations, the general guideline is that postnatal women should do low impact exercise for the first 3 months and return to running between 3-6 months. This does not mean you can’t exercise beforehand, this blog is specific to running. The guide for Mums who want to return to their exercise of choice is to progress training gradually and modify it to their individual needs.
It is recommended that all women, regardless of how they deliver, seek out a pelvic health assessment with a specialist Women’s Health Physiotherapist to evaluate strength, function, and coordination of the pelvic floor and abdominal muscles which are often affected by pregnancy and delivery.
Why are there guidelines for returning to running?
In general, as Women’s Health Physiotherapists, we are trying to prevent clients from having pelvic floor and/or abdominal wall problems. Key signs of having problems include:
- Bladder and/or bowel leakage (Urinary and/or faecal incontinence)
- Urinary urgency (rushing to the toilet to void)
- Heaviness/bulge/dragging sensation in the vaginal area
- Pain during sex
- Difficulty emptying bowels
- Separated abdominals (Rectus Abdominal Diastasis)
- Back pain
Is there anything else I need to consider before returning to running?
- Weight (being overweight will put more pressure on your pelvic floor)
- Fitness (Are you fit enough to start running?)
- Breathing (Start with a slow pace, can you talk whilst running?)
- Psychological status (exercise can be a good coping strategy, but it is important to have other strategies as well such as relaxation, counselling, mindfulness, etc)
- Breastfeeding (running around the timing of feeds, when the breasts aren’t as full, consider hydration)
- Supportive clothing (get a personally fitted sports bra)
- Sportswear and clothing (Aim for support around the pelvic and abdominal area)
- Sleep (Are you too tired to start running?)
- Are you eating enough for your body to add the extra demand of running?
What do I need to achieve before being ready to run at 3 months postnatal?
- Walking for 30 minutes
- Single leg balance for 10 seconds
- Single leg squat for 10 repetitions on each side
- Jog on the spot for 1 minute
- Forward bounds for 10 repetitions
- Hop in place for 10 repetitions on each leg
- Single leg ‘running man’: opposite arm and hip flexion/extension (bent knee) for 10 repetitions on each side
A physiotherapist can assess these activities to make sure you are doing them correctly.
- Sufficient lower limb strength, including your pelvic floor, which can be assessed by a Women’s Health Physiotherapist
What will a Women’s Health Physio do?
- Assess the impact and strength exercises of each individual (as stated above)
- Assess and assist in improving abdominal and pelvic floor function. This may include an internal examination and/or real-time ultrasound.
- Develop a whole-body strength and fitness program, this may include:
- An individual clinical movement exercise class to get expert feedback from a physiotherapist.
- Home exercise program – including pelvic floor and abdominal exercises
- Facilitate safe return to your chosen sport or exercise
- Help improve your physical and mental well being
- Create manageable short- and long-term goals
In Summary, to return to running, you should be able to answer yes to all of the following:
- 3 Months Postnatal
- Can correctly do all of the impact exercises above
- Have sufficient strength in the lower limb (assessed by a physio)
- Good pelvic floor and abdominal strength (assessed by a physio)
- Have considered all of the above factors (weight, fitness, breathing, psychological status, supportive bra/clothing, sufficient sleep, eating enough)
If you tick these boxes then, Well Done! You can return to graded running!
If not, that is ok, you can still exercise and work towards your goal. it just may take a little more time.
If you are experiencing endometriosis or pelvic pain, don’t put up with it, call us to make an appointment with one of our experienced Women’s Health physiotherapists at either our Claremont or Nedlands physio clinics.
To make an appointment, call our Claremont physio clinic on (08) 9384 1555 or our Nedlands physio clinic on (08) 6389 2947.