Returning to Running After Having a Baby
After having a baby, many women are desperate to get back to their pre-pregnancy fitness and resume the hobbies they love. There is also often a lot of pressure on new mums from across society to rapidly lose weight and ‘bounce back’ to their pre-baby body.
Unfortunately, this pressure can sometimes lead to women rushing into certain types of exercise that may not be suitable and could potentially lead to problems with their pelvic health. Until recently, there has been a lack of consensus and evidence-based guidelines outlining when it is safe for women to return to running and the risk factors they should consider.
Earlier this year in March 2019, a group of physios from the UK published a set of guidelines that summarise the most current evidence on this topic, giving women a starting point when it comes to running.
Earlier this year in March 2019, a group of physios from the UK published a set of guidelines that summarise the most current evidence on this topic, giving women a starting point when it comes to running. The guidelines are titled ‘Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population’ by Tom Groom, Grainne Donnelly and Emma Brockwell. Published March 2019. Their purpose was to inform GPs, midwives, physiotherapists and trainers who work with postnatal women.
Conditions such as incontinence, pelvic organ prolapse, pelvic pain and abdominal muscle separation can be common in runners, so to ensure none of these develop or are exacerbated it’s important that returning to running is at the right time for each woman. In this blog, I will summarise some of the key pieces of information from the guidelines on returning to running after having a baby.
After birth, the pelvic floor muscles are weak and often injured, furthermore running is a high impact activity that places a lot of demand on the body.
After birth, the pelvic floor muscles are weak and often injured, furthermore running is a high impact activity that places a lot of demand on the body. Postnatal women need adequate time to heal and regain strength, especially in the pelvic floor and abdominal muscles. Ignoring these factors could have detrimental, long term effects to a woman’s health. Many women will need help to correctly activate their pelvic floor muscles and rebuild strength in this area, especially if they were not training the pelvic floor muscles before having a baby.
The guidelines recommend a low impact exercise programme is followed for the first 3 months after birth, with a return to running at 3-6 months at the very earliest so long as the mother is showing no signs of pelvic floor dysfunction or abdominal separation before or after attempting to run. An assessment by a pelvic health physiotherapist is recommended for all women who have given birth no matter what their mode of delivery, to evaluate pelvic floor muscle function as well as any signs of abdominal separation. This will screen for any pelvic floor problems as well as a woman’s individual risk factors and enable professionally guided, individualised rehabilitation.
An assessment by a pelvic health physiotherapist is recommended for all women who have given birth no matter what their mode of delivery.
The importance of seeing a pelvic health physiotherapist is further highlighted if you experience any of the following signs or symptoms before or after attempting to return to running; vaginal heaviness or dragging, leaking urine or an inability to control bowel movements, doming of your abdomen or a noticeable gap in your tummy muscles, pelvic or low back pain. These could be signs and symptoms of pelvic floor dysfunction or abdominal muscle separation.
Other factors to consider are the body’s ability to deal with load and impact as well as how strong key muscle groups are that are necessary for running. It’s useful to practice some higher-level activities before running such as hopping, jogging on the spot and forward bounds in order to see how the body and pelvic floor can accommodate the increase in load. These should be performed without any symptoms of pelvic floor dysfunction and more details are available in the guidelines themselves or from your physiotherapist.
Once a woman is more than 3 months postnatal and it not experiencing any of the above symptoms, she has adequate lower limb and core strength, a graded return to running programme can be started. It’s a good idea to start small with for example 1 to 2 minutes of running at a steady pace. Including walk breaks initially can be helpful to reduce tiredness. A ‘Couch to 5k’ programme works well for some women as it builds up gradually to a 5k distance. It is key that during this return, women monitor how they are feeling and if they experience any symptoms to seek help and advice. Running with a buggy is not recommended until the baby is 6-9 months old (as per the manufacturers guidelines to protect the baby’s neck and spine) and it is thought to place greater demand on the body when compared to independent running.
So, the bottom line? Prior to 3 months postnatal low impact, gentle exercise and only from 3 - 6 months postpartum at the earliest, should running be considered if there are no signs of pelvic floor or abdominal muscle dysfunction. It is beneficial for all women, regardless of how they gave birth to see a pelvic health physiotherapist to evaluate their pelvic floor and abdominal muscle function as well as identify any problems or risk factors for their future health.
Prior to 3 months postnatal low impact, gentle exercise and only from 3 - 6 months postpartum at the earliest, should running be considered if there are no signs of pelvic floor or abdominal muscle dysfunction.
Get in touch if you have any questions about how pelvic health physiotherapy can support your journey to return to exercise and running after having a baby. Bethany offers ‘New Mum Check-Up’ appointments and pelvic health physiotherapy for any stage of your life at InForm Physiotherapy in Silverstream, Upper Hutt, Wellington. Contact 04 527 4155 for bookings.
References:
Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. Tom Groom, Grainne Donnelly and Emma Brockwell. Published March 2019.