The journey of motherhood is a transformative experience, marked by a whirlwind of emotions, adjustments, and joys. Amidst the chaos of caring for a newborn, it's common for personal pursuits to take a backseat. For many mothers, one such pursuit is running— a familiar movement that can feel like a distant memory in the early days of parenthood.
Fortunately, peak athletic performance has been shown to coincide with the predicted peak fertility years. With a little work, returning to running and activities you love after giving birth are very attainable. Unfortunately, it may take more time than you’re expecting. If I’m being honest, running after childbirth can take 3-6 months.
We’ve all heard that the first six weeks of postpartum is the “gold standard” for healing. “You can return to all activities after six weeks” – when in reality your body has not fully recovered from childbirth at that time. Think of any other injury – a shoulder labrum repair, hip replacement, tearing of your achilles, a muscle strain. When these injuries happen, most are quoted somewhere between 3-12 months of recovery to return to baseline.
So why aren’t new mother’s being sent to physical therapy to rehab after child-birth? In the United States, pelvic rehabilitation is currently not recommended for women as standard of care, requiring many to advocate for treatment. For whatever reason this is happening in the United States - I say our healthcare system is ignorant, has lack of education on the topic, and has limited understanding on women’s health. You have just gone through major body changes; perhaps you had a C-section, perhaps you had a perineal tear, perhaps you labored for 15+ hours. During labor muscles become strained, tear, or are even cut into. These are injuries to your body that should be rehabbed and monitored prior to returning to “all” activities.
WHEN SHOULD I RETURN TO RUNNING AFTER GIVING BIRTH?
Unfortunately, there isn’t a clear-cut rule. The answer is - it depends. This is a phrase physical therapists use a lot, and I know how frustrating it can be. Let me explain:
Every child-birth story is different and each body has gone through a different level of trauma/change. Fortunately, there are guidelines available to assist in optimizing your recovery and safely introducing running (or any other high-impact cardio) into your routine.
LOOK BACK FIRST
Before you think about running again, it is important to look at your birth story. Did you have a smooth delivery, or did you experience complications? Did you deliver vaginally or via a c-section? If you experienced some trauma, you may need a little longer to return to all activities than the traditionally recommended timeframe - and that is completely fine! Honor your body by giving it the time it needs to heel.
During pregnancy, did you maintain a strength and conditioning schedule? Did you run throughout your pregnancy? Did you go to a physical therapist to help you with changes in your body and to maintain activity without incontinence or pain? Typically, women who were able to maintain a workout routine and safely continue exercise during pregnancy without complications or pain, are likely able to return to running sooner than those who didn’t - but of course it all still depends!
CONSIDER WHAT YOUR BODY IS DOING NOW
If you have any of the following symptoms or diagnosis, it is not advisable to return to running prior to seeing a professional for guidance:
- Urinary or fecal incontinence
- Organ prolapse (feeling of heaviness or bulge)
- Ongoing vaginal bleeding during or after attempting low or high impact exercise
- General pain in your pelvis, hips, back, legs, etc.
If you can relate to any of the above, don’t be discouraged. With some help and guidance all of this can be managed and even rehabbed to baseline. None of these will keep you from an active lifestyle, but you may just need to adjust for the time-being.
ERR ON THE SIDE OF CAUTION
A wide variety of physiological changes occur during pregnancy, such as weight gain, ligament laxity, postural changes, strength changes, alignment changes, and endurance limitations. For example, the hormone “relaxin,” does exactly what the name says - it relaxes your ligaments, muscles, and joints in your body to help it stretch during pregnancy. It remains in your system until you are no longer breastfeeding. In fact, during labor and delivery, the pelvic floor musculature is stretched 250% of its resting length. Recovery of these muscles don’t happen until about 4-6 months postpartum. This is just one of the many changes that occur in your body. Take this into consideration as you prepare to run.
If you take one thing away from this blog, it is - don’t go from zero to one-hundred. Generally, you may begin running at 3 months postpartum, as long as you have been training in other ways!
WORK WITH A PELVIC FLOOR PHYSICAL THERAPIST
This is so important, even if you can only fit in one or two appointments.
A pelvic floor PT will evaluate your muscle strength and coordination, as well assess whether you have organ prolapse, muscle restriction, asymmetry, functional endurance, and more. This will give you a much clearer picture of your healing progress and even identify potential diagnosis or risk factors for you to consider.
NEGATIVE CONSEQUENCES OF RUNNING TOO SOON
If you return to high impact cardio before your body is ready, it can have lasting consequences. I’ve worked with women 2-5 years postpartum, still dealing with:
- Incontinence
- Prolapse
- Pelvic floor tightness
- Inability to coordinate pelvic floor and abdominal activation
High impact exercise has been found to increase risk of pelvic floor dysfunction nearly five-fold as compared to low impact exercises.
MORAL OF THE STORY
Don’t be afraid to get some help! Book an appointment with a pelvic floor physical therapist, even if it is just for one or two sessions. Your body will thank you later!
In the Boise area and ready to book an appointment?
REFERENCES
de Mattos Lourenco TR, Matsuoka PK, Baracat EC, Haddad JM. Urinary incontinence in female athletes: a systematic review. Int Urogynecol J. 2018;29(12):1757-1763. doi:10.1007/s00192-018-3629-z
Svabík K, Shek K, Dietz H. How much does the levator hiatus have to stretch during childbirth? BJOG. 2009;116(12):1657-1662. doi:10.1111/j.1471-0528.2009.02321.x)