In this blog, I am going to talk through a recent publication which is rare its in context; providing guidelines for women wanting to return to or begin running after giving birth. It aims to serve as a guide for all new mums that love exercise or want to start after having a new-born.
Let’s dive in!
There is little guidance provided to healthcare professionals on how to transition runners back to activity postpartum; so, it’s easily understandable why new mums themselves may run into trouble (pun intended; apologies). There are three stages within the postpartum phase; lasting up to 6 months, but there are still intrinsic factors such as hormone level changes that are still adjusting even longer than this – so we need to be considerate for a significant period of time when returning to exercise.
Barriers that may affect women when returning to running postpartum may include;
- inadequate quality and quantity of sleep
- learning to care for a new-born
- a changing schedule
- physical changes
During pregnancy and postpartum the pelvic floor muscles (PFM) undergo significant change, including stretch from the increased weight gain and postural changes, increased muscular demand because of these changes, possible tearing during childbirth and then ultimately recovery through the pregnancy and postpartum period.
These changes may lead to decreased core stability, pelvic floor weakness, urinary incontinence, stress urinary incontinence (SUI) while running, lower back and hip pain and other musculoskeletal injuries.
See more info on PFM and the affects of pelvic floor weakness in our previous blog here.
There is an association with the intrinsic changes above and altered running gait post-partum. Therefore, it may be important to modify frequency and intensity of running with the guidance of a healthcare professional.
So, when is it safe to return to running?
There is currently no guidance available for women who want to return to running or begin to run postpartum.
There are some recommendations for exercise in general. Return to exercise gradually when it is medically safe, when physical stress is tolerable.
The recommendations outlined in the aforementioned study are as follows;
- Clearance to exercise by physician
- Evaluation by healthcare professional specialising in pelvic health
- Comprehensive assessment of physical function and biomechanics
- Initiation of running and strength programme
Walking is a great way to begin safely exercising immediately postpartum. It provides many of the psychological benefits of exercise while preparing the body for running. Despite the overwhelming changes that occur postpartum, many women progress or start with running much sooner than their bodies are ready to.
If you do suffer from incontinence, diastasis recti abdominis (DRA) or any other associated post-partum issues; it doesn’t mean you cannot return to running, it may just mean modifying activity and completing specific exercises to address any issues. Many women are under the misconception that leakage while running is normal and it is not.
Many women return to running between 6-8 weeks post-partum, without guidelines or instruction from a healthcare professional, with biomechanical and physiological changes that occur during pregnancy and remain postpartum potentially increasing risk of injury.
Currently, there is no gold standard for the management and care of women returning to running postpartum. The reviewed article highlights changes that occur during pregnancy that may alter the way women walk, run, lift and move postpartum.
Following the 4 stages of returning to running above should reduce the risk of complications and increased injury risk, whilst being under the guidance and care of a healthcare professional.
At Emma James Physio we pride ourselves in offering specialist women’s health, biomechanical and strength and conditioning services. So, come and see us and we will get you back to where you want to be, or for you new mums; help you take those first steps after your new-born!