You want to return to running now that you have had your baby! But how do you return to running safely?
There aren’t yet any established national or international guidelines that help Mom’s return to running. This makes it difficult to help all the Running Mom’s out there to return to doing what they were doing before having their baby. It’s especially tricky if you feel great, say at 4 weeks and you want to start running again!
Because of that, there have been some guidelines created by Tom Goom, Grainne Donnelly and Emma Brockwell that are based on the best available evidence coupled with their experienced clinical opinions. Read further as I’ve summed up all their pertinent points!
Are You Ready To Return To Running?
You need to hold off for a bit longer if you:
- have vaginal bleeding
- experience pain
- have feelings of pelvic heaviness/pressure
- have tried running and feel more pressure or pain and/or started to bleed
- have feelings of instability around your belly/back
- experience urinary/fecal incontinence
If you experience any of the above symptoms, check in with your family Doctor and your pelvic health physiotherapist. Your Doctor will ensure there isn’t anything serious going on which is always comforting information. Your pelvic health physiotherapist will assess your pelvic floor and guide you back to attaining your goals; which in this blog, is all about returning to running safely!
Once you have the go ahead, read on to find out the 0-3 months exercises!
What Sort of Timeline Should You Be Aiming For?
For the first 3 months, follow a low impact exercise regime. This means that you can begin doing your pelvic floor muscle and transverse abdominis exercises as soon as you feel ready. These are the same exercises you would/could have been doing all throughout your pregnancy. Check out the videos below to get an idea of what those exercises look like.
You can continue doing these types of exercises while you add in some overall body strengthening exercises. Examples like:
- Squats
- Lunges; begin with stationary lunges but progress to dynamic lunges
- Deadlifts
- Calf Raises
- Hamstring curls using the ball
- Bridges
- Head Lifts using proper core engagement
- Bicep curls, tricep kickbacks, lateral shoulder raises
Including all parts of your body when strengthening is super important! Add in walks throughout the week. Begin on flat terrain and when this feels easy, add in some hills. Cycling, swimming and light hikes are also great to do during this period.
Check out more videos here:
Browse my youtube channel https://www.youtube.com/channel/UCJqDcZOOLoNKdBwxmY_wawA for even more exercise videos!
Between 3-6 months, begin a return to running exercise regime. This might look like a Couch to 5km at first. Begin with walking for the first 10-15 minutes to warm up. Run for 30 seconds and walk for 4.5 minutes and do this 4 times to add up to 20 minutes. Trying out a sequence like this for the first week is good to ‘test the waters’. If everything feels great, continue to progress according to the 5km guidelines.
You really want to make sure you aren’t feeling any of the symptoms that were mentioned above. Even if you were a seasoned runner, please take the time to progress slowly.
Why Do You Need To Be Careful?
Well, I think we can all agree that high impact exercise can be more challenging on our bodies. Running is fun, it gets our endorphins going and is fantastic exercise for our heart and lungs. But, our bodies do need to be able to absorb the forces that come with running.
In a nutshell, your tissues continue to heal far past the “It’s 6 weeks, you feel fine and can get back to doing whatever you want” time period! So slow and steady is the best route back to fitness!
For the anatomy nerds: ((all of these studies are directly from the running guidelines which you can check out here) https://www.absolute.physio/wp-content/uploads/2019/09/returning-to-running-postnatal-guidelines.pdf
A Few Interesting Summed Up Facts
- high impact exercise may increase the risk of pelvic floor dysfunction 4.5 times greater than low impact exercise (De Mattos Lorenco et al 2018)
- The levator hiatus area will widen during pregnancy and will be significantly wider after delivering vaginally. This area doesn’t become smaller until 12 months postnatal (Staer-Jensen et al. 2015)
- The levator ani muscles, the connective tissue and associated nerves may take 4 months to recover (Shek et al. 2010, Staer-Jensen et al. 2015)
- The bladder neck becomes much more mobile after delivering and though it does becomes stiffer, it may retain an increased level of mobility even when checked 3 years later (Toozs-Hobson et al 2008, Staer-Jensen et al. 2015)
- With c-sections; the uterine scar, when checked at 6 weeks postnatal, continues to show that it is still in the process of remodelling (Hamer et al. 2007)
- With c-sections, the abdominal fascia has regained just 51%-59% of its strength at 6 weeks and 73%-93% at 6-7 months (Ceydeli et al. 2005)
The importance of these facts is not to freak you out. It is just showing that there is healing that is going on, even while we continue to feel great. So, taking it a little easier is not such a bad thing!
How Do I Return To Running?
Try some of these tests for your pelvic floor muscles first:
- Can you do 10 fast contract/release reps with your pelvic floor?
- Can you do 8-12 reps, holding for 6-8 seconds with a maximum amount of effort?
- Can you hold your pelvic floor muscles on for 60 seconds, using a 30-50% amount of effort?
If you are confident you can do those, that’s great! Your pelvic floor is showing you that it is ready for an increased level of fitness.
If you are struggling with one or more of the above exercises, that’s ok. Work on them so your pelvic floor will help support you when you return to running.
f you would like a great at home exercise program that is super affordable and will check all the pelvic floor and core strengthening boxes, check out this link: https://lp.activepelvicfloor.com/pelvic-floor-rebuild-program/
Try some of these active tests to ensure the rest of your body is ready:
- Walk for 30 minutes
- Stand on one leg and balance for 10 seconds, repeat the other side
- Single leg squat, 10 reps each side
- Jog on the spot for 1 minute
- Forward bounds, 10 reps
- Single leg hop in place, 10 reps, repeat the other side
- Single leg running
If you can perform all of the above without feeling any negative symptoms, then you are safe to return to running.
Try some of these strength tests:
- 20 reps of a single leg calf raise, repeat each side
- 20 reps of a single leg bridge, repeat each side
- 20 reps of a single leg sit to stand, repeat each side
- 20 reps of a side lying leg raise, repeat each side
If you find yourself a little weak in the above strength tests, it doesn’t mean that you can’t return to running. It means you have found some weaknesses that need to be strengthened.
If you need some extra help with this, contact me at cathy@cathywatsonphysio.ca and we can book an in person or a zoom call!
Stay safe and happy running!