Thinking about returning to running after having a baby? Read on…..
After having had your baby, a quick and easy way to get some exercise, which works for you, your baby and your partner, is to lace those trainers up, and head out the door for a quick cardio boost and get the endorphins flowing. I absolutely get it, I have been there too.
But…. do you know what the recommended time scale is post-partum for you to return to running is?
It is not recommended to run any earlier than 12 weeks after you have welcomed the arrival of your baby. I have seen women before in clinic who have started sooner than this and have subsequently ended up with hip and pelvis issues, and some who have developed prolapses too.
The evidence tells us that most of us will get de-conditioned through pregnancy, no matter how active we are. In addition to that for the first couple of months after baby has arrived, it usually takes most of us all of our time to get showered, dressed and keep the baby fed without thinking about any formal exercise!
The research also demonstrates that the time scales for tissue recovery are much longer than lots of resources or advice would have us believe. For example- parts of the pelvic floor dont return to their pre-delivery status until 12 months post vaginal delivery, other parts of the pelvic floor and connective tissue the time scale is around 4-6months. The abdominal fascia post Caesarian section will be around 50% recovered at 6 weeks, taking 6-7 months to be back to 70-90% of its original tensile strength. Being ‘cleared at your 6-week check’ sadly isn’t really often the full picture, as components of mums wellbeing/strength aren’t currently addressed during this appointment which is most commonly with the G.P.
When we run- the forces through our lower limbs (legs!) and our abdomen- specifically the pressure in our abdomen which therefore has an effect on our pelvic floor - significantly increase which is why we can run (pardon the pun!) into difficulty,
If we look at the Table below- we can see that we may easily have a couple of the factors which have been identified may make us more prone to certain issues if we return to running too soon. One which isnt specifically mentionned here but we know also has a huge effect - is sleep. And we all know how that goes when a little person enters into our life! I read something the other day which said the statistic was we need more than 6.5 hours sleep a night to decrease the risk. I certainly had nowhere near that probably for many years post-natally.
Table 2: Risk factors for potential issues returning to running
• Less than 3 months postnatal
• Pre-existing hypermobility conditions (e.g. Ehlers-Danlos)
• Breastfeeding
• Pre-existing pelvic floor dysfunction or lumbopelvic dysfunction
• Psychological issues which may predispose a postnatal mother to inappropriate
intensity and/or duration of running as a coping strategy
• Obesity
• Caesarian Section or perineal scarring
• Relative Energy Deficiency in Sport (Red-S)
As a physiotherapist- a major part of my practice has always been to try my utmost not to advise people solely what they CAN’T do, but try and facilitate ideas and support around other possibilities with an end goal in sight. So the link below which will take you to an infographic on ideas on progression of ideas up to the 12 week period is a great summary.
Low impact exercise building up from early core exercises such as pelvic tilts,side lying hip lifts as well as your pelvic floor contract/relax exercise and short walks from weeks 0-2 building to bridges, lunges and. squats in week 2-4. Adding in static cyling if feeling comfortable in the perineal area from 4-6 weeks, and progressing low impact exercise, walking, and starting some resistance exercise from week 6 as you feel able are all ideas for your rehabilitation.
https://absolute.physio/wp-content/uploads/2019/09/excercise-in-the-postnatal-runner_comp.pdf
There are a serious of exercises you will be looking to complete to give yourself a good idea of your leg strength before you decide to dig your trainers out.
It is recommended you can do 20 repetitions of the below :
Single leg calf raise, Single leg bridge, Single leg sit to stand, Side lying abduction
As well as the below without pain, heaviness, dragging or incontinence:
⁃ Walking 30 minutes
⁃ Single leg balance 10 seconds
⁃ Single leg squat 10 repetitions each side
⁃ Jog on the spot 1 minute
⁃ Forward bounds 10 repetitions
⁃ Hop in place 10 repetitions each leg
⁃ Single leg ‘running man’: opposite arm and hip flexion/extension (bent knee) 10
repetitions each side
It is worth thinking about your sports bra too- good support for your breast tissue is really important, and it is highly unlikely that the sports bra you had before is going to be a good fit for you at this stage.
For some of us, even thinking about running at 12 weeks would be too soon. There is no rush, take the time on your rehab and it will be well worth it.
If you would like better direction with your rehab- perhaps you do have some incontinence either bladder or bowel, or feel that you may have a prolapse, or you arent sure about any diastasis (gap in your abdominals) - there are some great local Womens Health physios that I can direct you to, or you can seek a referral to the NHS Obs & Gynae team. Please pop me an email, or find me on social media and I will offer you some direction as able.
Please share this info with other mums you may meet, at the very least- encourage them to wait until 12 weeks plus!
I would love to hear from you either on your thoughts on this or your own experience if you are happy to, message me in the same ways I have mentionned.
Thanks for reading,
Kerry
