Returning to Running Post-Partum

Returning to Running Post-Partum

Chelsea Hall, PT, DPT

Fit For Life Physical Therapy

You have had your 6-week check-up with your OB, and you were cleared for return to exercise.  To you that means “I can go run 5 miles, right?”  I get it—we all want to get back to running for our mental health, physical health, and just to have some “me” time.  But it may be beneficial for you to tap the breaks and take the time now to truly rehab your body.  Some people may feel great at 6 weeks postpartum, but many will not.  The latest research recommends waiting until 12 weeks postpartum to return to running.  Everyone’s recovery will look different, and the 12 weeks is a guide and not a cutoff.  It is normal for recovery to take longer, even up to 6-12 months.

The way the body adapts and grows a human life is astounding but it also places a lot of stress on your ligaments, tendons, and muscles.  The weight of the baby and placenta stretches your pelvic floor, hip muscles, and core, leaving them initially unable to contract at their normal force.  Additionally, giving birth vaginally stretches your pelvic floor 259%.  With a caesarean section, your abdominal muscles are literally cut and repaired.  On top of all this, the lack of sleep that comes with a newborn can inhibit your body from recovering.

There are several warning signs that your body is not ready to return to running yet:

• Leaking with coughing, sneezing, jumping
• Pain with intercourse
• Pressure/bulging in the pelvic region
• Low back or pelvic pain
• Coning or bulging with abdominal muscles when you sit up

If you are experiencing these symptoms, they are common but not normal and following up with a pelvic floor clinician for personalized guidance is recommended.

Instead of focusing on what you cannot do, changing your mindset to focus on what you CAN do will be beneficial in the end.  Although the latest research recommends not returning to running until 12 weeks post-partum, there are exercises you can begin the first week post-partum to prepare your body for that first run back!  However, always consult your OB before beginning any exercises post-baby.  Following is a general guide:

• In the first few weeks after labor, SLEEP should be your priority. While this can be a frustrating piece of advice as sleep is minimal with a newborn and especially if there is another little sibling running around too, choose sleep over doing the laundry, cleaning, or exercise.  It is essential in your healing and recovery.

• 360 breathing or diaphragmatic breathing: Focusing on breathing is a helpful way to strengthen your pelvic floor and can be practiced anywhere.  As you take a deep breath in, your pelvic floor relaxes and as you exhale, it contracts.  To perform this, place your hands around your ribcage.  Take a deep breath in and feel your stomach, rib cage, and back expanding into your hands.  Exhale and allow everything to return to neutral.  Perform 20 breaths several times a day.  Feeling stressed?  Take a few moments to focus on your breathing as it targets the part of our nervous system that provides calming effects.

• Pelvic floor contractions: Daily pelvic floor exercises can usually begin immediately but always consult with OB prior to initiating them.  Begin these by laying on your back and progress to seated and standing.  There are several types of contractions to perform: 1) quick contractions, 2) maximal contractions holding for 5-10 seconds, 3) 30-40% effort contractions holding for 30-60 seconds.  Always allow your pelvic floor to completely relax between repetitions.

• Walking: Walking can begin whenever you feel ready and is a fantastic way to get outside and enjoy the mental health benefits of moving your body. 

• Core strengthening: Begin with gentle abdominal bracing laying on your back and progress to marching while maintaining the brace.  Bridges and side-lying leg raises are another safe exercise to begin the first few weeks.

• General strengthening: At around 2-4 weeks, body weight strengthening exercises that are required for mom life can be introduced such as squats, lunges, and deadlifts.  The addition of weights to these movements can begin around 6-8 weeks.

So now you have learned these guidelines and are approaching the 12-week mark, wondering if you are ready to return to running physically.  Are you able to perform the following pain free and symptom free?

• Walk >30 minutes
• Run in place 1 minute
• 20 single leg hops
• 20 lateral hops
• 10 single leg squats
• 20 single leg heel raises

If so, you are ready to begin your return to running!  Here are a few tips as you progress your running:

• Focus on a gradual return to running beginning with a walk/jog progression. Build training volume (i.e., miles) before intensity (i.e., workouts). 

• Focus on a cadence between 170-180 steps per minute to decrease your risk of injury.

• If running with a jogging stroller, there will be an asymmetrical arm swing so switching which are you are pushing with every so often will aid your form. If you listen to music, switch arms every verse.

• Continue with strengthening exercises 2-3 days a week as able. Consistency is key with this. Fifteen to twenty minutes targeting core control, quadriceps/hamstrings, hips, gastrocs/soleus endurance, foot strength, and postural strengthening exercises will help decrease injury rate and can improve performance.  Also optimize mechanics required for repetitively lifting babies, toddlers, car seats, heavy strollers, etc.!  Involving your child in your strengthening circuit is also a terrific way to demonstrate the benefits of life long physical activity.  Also, your toddler makes a great 30 pound weight!

• And most importantly, listen to your body. Modify your plan if needed and seek out professional help to address post-baby issues!

Fit For Life Physical Therapy cares for people of all activity levels - to help prevent, recover from, or rehabilitate sports & orthopedic injuries.  We are proud to move people every day.

Please visit our website https://www.fitforlifephysicaltherapy.com/, email us at info@fitforlifephysicaltherapy.com, or call or text us at any of the phone numbers for our three convenient locations inside Fleet Feet + FrontRunner stores:

Polaris:  1270 East Powell Road Lewis Center, Ohio 43035 ~ 614-981-2065

Upper Arlington:  1344 West Lane Avenue, Columbus, Ohio 43221 ~ 614-981-1979

New Albany:  5792 North Hamilton Road, Columbus, Ohio 43230 ~ 614-581-7441