Elevation Physiotherapy | Returning to Running After Baby
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Returning to Running After Baby

Returning to Running After Baby

Let’s face it—giving birth is trauma to the body, and it takes time to heal before returning to anything even remotely athletic.  Several authors established the guidelines below based on the classifications from the Royal College of Obstetricians and Gynecologists (Goom, Tom & Donnely, Grainne & Brockwell, Emma. (2019). Returning to running postnatal – Guidelines for medical, health and fitness professionals managing this population.)

Woman running with baby in stroller

I can summarize it all by saying 3-6 months, depending on several factors, and it is best to start with low impact exercise and progress to running.

0-2 Weeks:

• Pelvic Floor muscle exercises (Kegels)

• Basic core exercises (e.g. pelvic tilt, bent knee drop off, side lying abduction)

• Walking

2-4 Weeks:

• Progress walking/pelvic floor muscle/core rehab

• Consider introduction of squats, lunges, bridges

4 -6 Weeks:

•can introduce biking, cross trainer or other low impact exercise, if new mother is comfortable

6-8 Weeks:

• Scar mobilization (for either C-Section or perineal scar)

• Power Walking

• Increased duration/intensity of low impact exercises

• Deadlift techniques beginning with light weights, no more than the weight of the baby in a car seat (15kg) with gradual load progression (e.g. barbell with no weight). This aims to strengthen and restore strategies for carrying out the normal everyday tasks required when caring for a newborn and/or older sibling

8-12 Weeks:

• Introduce swimming (if lochia has stopped and there are no issues with wound healing)

• Spinning (if comfortable sitting on spinning saddle)

Assessment of Pelvic Health

• Return to running is NOT advised if the following is present:

• Urinary and/or fecal incontinence

• Pressure/bulge/dragging in the vagina before or during the start of running

• Ongoing or onset of vaginal bleeding, not related to menstrual cycle, during or after attempted low impact or high impact exercise

• Reduced pelvic floor muscle endurance. Recommended baseline in standing:  10 x fast reps, 10x 6-8 second holds, and 60 seconds submaximal (30-50% contraction) hold

• strength testing of the pelvic floor muscles by a Physiotherapist should be > Grade 3/5

Objective Assessment

Before returning to running, it is recommended that the new mother needs to be able to complete the following without pain, heaviness 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 per leg

Aim for 20 repetitions of each test:

• Single leg calf raise

• Single leg bridge

• Single leg sit to stand

• Side lying abduction

And Other Considerations:

  • Weight: increased weight puts greater load on the pelvic floor
  • Fitness: it is better to start with lower impact activities, and where you have to start will depend on your birth experience and symptoms
  • Breathing matters!
  • Diastasis Recti: expert consensus is that a mother can return to running if the DR is functional (there are strategies to control intro-abdominal pressure) and not before
  • Scar Mobilization: Both C-Section and perineal scars can result in pain and restriction. It is recommended to assess and implement advice and guidance regarding scar mobilization.
  • Sleep: Sleep deprivation (<7-9 hours/night) is associated with increased risk of injury, increased stress, and may reduce muscle protein synthesis. Education regarding optimizing sleep, day-time naps and good sleep hygiene may be warranted.

So… clearly it is more involved than just “3-6 months”.  If you are not leaking, feel psychologically ready, and can perform the above pelvic floor and strength testing, it would still be smart to return to running using a walk:run program, such as 1 min run and 1 minute walk (with the run speed being able to hold a conversation, not faster), with gradual increase to 10:1

The Physiotherapists at Elevation Physiotherapy & Wellness excel at the proper and safe return to running after baby. Contact us anytime to make sure your pelvic floor health is adequate, and we can devise an individual program for you to improve strength to reach all of your fitness goals!