One of the most frequently asked questions I am asked is “When can I return to running after having a baby’?

The answer is not a simple one because it really depends on what type of birth and recovery you have had and there are many things to consider before heading out for a run.

Using my specialist knowledge in postnatal health, fitness and wellbeing and women’s pelvic health, alongside other expert opinion and research I am going to bring together what you need to know about returning to running post birth.

In this blog we will discuss:

  • Facts about your postnatal body and running
  • The risks associated with returning to running in the postnatal period
  • What the experts say
  • Signs that you should stop running
  • Other considerations when returning to running
  • How do you know if you are ready to run
  • Top tips if you are ready to return to running 
  • What you need to do if you’re still not sure you are ready to run

Lets’ take a look at a few facts first

  • After having a baby the pelvic floor has gone through some degree of trauma so it’s important that you give yourself adequate time to heal and regain strength in your pelvic floor and core before commencing running. 
  • If you had a C-section you will require more time to recover
  • If you had stitches (following tear or episiotomy) then you will need further recovery prior to returning to exercise. 
  • Running is a high impact sport which places a lot of demand on the body. 
  • Running is associated with a sudden rise in intra abdominal pressure which is a huge problem if the pelvic floor and core is weak.
  • Running dramatically increases the amount of force through the core, pelvic floor and legs.
  • When running with Diastasis Recti then it is likely that your body will compensate ( because the core is weak and can’t do it’s job) which can lead to knee pain, IT band pain, plantar fasciitis, low back pain and hip flexor issues, just to name a few. Not to mention increased strain through your pelvic floor. 

Are there any risks in returning to running?

Yes is the short answer. There are a number of risk factors which may affect your return to running including:

  • Being less than 3 months postnatal
  • Any pre existing hypermobility conditions 
  • Breastfeeding
  • Any pre existing Pelvic floor dysfunction – you can read more about the signs of this HERE
  • Lower back pain or sacroiliac joint pain
  • Obesity
  • C section or perennial scarring (from natural tear or episiotomy)

What do the experts say?

There are some evidence based recommendations with regards to returning to running so here’s what the experts say: 

  • It is NOT advisable to return to running prior to 3 months postnatal.
  • It is NOT advisable to return to running beyond 3 months postnatal if any symptoms of pelvic floor and / or core dysfunction are identified PRIOR TO or AFTER ATTEMPTING A RUN. 

    Symptoms of pelvic floor & core dysfunction include:
    • Urinary and / or faecal incontinence
    • Urinary and / or faecal urgency 
    • Heaviness/pressure/bulge/dragging in the pelvic area
    • Pain with intercourse
    • Struggling to empty your bowels fully
    • Seperated abdominal muscles (you can read more about Diastasis Recti signs and symptoms HERE)
    • Pain in the lower back / pelvis

  • Pelvic health should be assessed to see if your pelvic floor is strong enough to take the load of running.
  • Consideration should also be given to:
    • weight, breathing, diastasis recti  breast support, feeding, psychological issues and running with a buggy. These are all covered in more detail below.

Signs that you should STOP running

If you experience any of the symptoms below prior to or during the commencement of running then you need to STOP:

  • Urinary and/or faecal incontinence 
  • Pressure/bulging/dragging in the vagina 
  • Ongoing onset of vaginal bleeding, not related to menstrual cycle,
  • Pelvic pain 

If you have any of the above symptoms then please reach out and ask for help. 

Other considerations

Weight – Being overweight increases the load on the pelvic floor. If you have a BMI >30 then there is a higher risk of pelvic floor related symptoms.

Fitness – it’s all about doing the right type of exercise at the right time and only progressing to more challenging and high impact activities (such as running) when your body is ready.

Breathing – The diaphragm, (your breathing muscle) works in synergy with the pelvic floor. It is essential that you learn how to connect to the core and pelvic floor with the breath. Once you have learned to do this you need to maintain this connection when running. Therefore, your return to running should be a slow pace so that you are able to control your breathing.

Mental Wellbeing – I understand the importance of running for many women as their way of ‘letting off steam’, ‘de-stressing’, getting some headspace’. It’s quick, convenient and easy to do. It’s a great tool for improving our mental wellbeing.

However, we need to be cautious because there can be a tendency to go too hard too soon to get that ‘buzz’. This can mean starting running when you are not ready or already have pre existing pelvic floor or core dysfunction.

It’s important to learn alternative coping strategies such as relaxation and meditation if running is not available to you at the moment.

Diastasis Recti – if you have a diastasis recti then proceed with caution. In fact I would recommend not running with a diastasis because having a diastasis can impact upon the function of the abdominal wall.

If you start to run before regaining full function of the abdominal wall (which enables you to manage intra abdominal pressure and load transfer) then this results in overloading in the pelvic floor.

Scar Mobilisation – Both c-section scars and perineal scars (from natural tear or episiotomy) can result in pain and restriction throughout the body. This is because scar tissue affects the surrounding areas which has a knock on effect on how the rest of the body functions. It is possible to get a specialist scar massage that will work on the affected area.

Breastfeeding – Breastfeeding prolongs the natural changes of hormones that occur during pregnancy into the postnatal period.  These changes in hormones can affect joint laxity. 

Although it is not fully understood why, it is recognised that for a period of up to 3 months following weaning, these changes in hormones influence joint laxity. 

This needs to be considered as returning to running whilst breastfeeding, or 3 months after weaning may increase the risk of developing injury or dysfunction including pelvic floor dysfunction or pelvic organ prolapse.

How do you know if you are ready?

You will only know if you truly ready to run by being assessed by a womens health physio or a specialist coach like me who will:

1) Screen you for Pelvic Floor Dysfunction.

2) Carry out a hands on assessment for Diastasis Recti.

3) Carry out some load and strength tests.

4) Guide you through a pelvic floor & core rehabilitation 

If you are confident that you are ready to return to running then here’s a few more tips for you:

Supportive Clothing
A personally fitted sports bra is recommended but choose one that offers support rather than compression.

Supportive footwear is also important as shoe size can alter permanently with pregnancy so you should not assume that your pre pregnancy footwear still fits!

Consider the times of feeds around running to ensure breasts are not overly full or likely to become uncomfortably full during the run.

Consider hydration and the intensity of your run in order of reduce potential impact upon supply of milk.

For your information, moderate to vigorous exercise during lactation does not affect the quality or composition of breast milk or impact infant growth.

Running with a buggy
If you are running with a buggy then it should have been designed for this function and include:

  • Five point harness for baby
  • Fixed front wheel
  • Hand operated brake
  • Read wheel suspension
  • Pneumatic tyres
  • 3 wheels
  • Wrist strap

Running with a buggy should only commence between 6-9 months of age to protect baby’s neck & spine.

If running with a buggy it is also recommended that you should include a strength and stretch programme for spine, pelvis and hips.

If you are still not sure if you are ready to return to running..

Then please contact me. I can help you either by:

  • Answering your concerns and offering my advice
  • Carrying out a full Postnatal Assessment which will include screening for pelvic floor dysfunction and an assessment for Diastasis Recti.
  • Guiding you through a Diastasis Healing or Pelvic Floor Rehabilitation programme if needed.
  • Referring you to a specialist women’s health physio if I think you would benefit from doing this.

The information in this blog is a mix of my own specialist knowledge in postnatal health, fitness and wellbeing and women’s pelvic health but also some expert opinion.

Thanks to:
Tom Goon, Grianne Donnelly and Emma Brockwell authors of the ‘The Return to Running Guidelines’  March 2019

Burrel Education for the fabulous training in postnatal health fitness and wellbeing and womens pelvic health.

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