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Steps to return to running in postpartum | image courtesy of sam chaffin via unsplash
Steps to return to running in postpartum | image courtesy of sam chaffin via unsplash

During pregnancy, the body goes through tremendous changes that can significantly impact strength, endurance, and ability to absorb ground reaction forces that are required to safely return to running. Your growing belly changes your posture, your hormones are making your joints more flexible, and some amount of deconditioning is expected and normal as pregnancy progresses. 

For most postpartum runners, their return to running following birth can be intimidating and overwhelming. 

A woman's OBGYN will commonly clear her for exercise at six weeks postpartum if she is not bleeding. According to guidelines published by Tom Goom and others, most women aren't ready to return to running or impact for twelve weeks postpartum due to significant healing needs. As with most things, healing takes time, and some women may need to wait even longer to return to running. Breastfeeding mothers, women experiencing fatigue, sleep deprivation, or inadequate nutrition may need additional before getting back to running. Nevertheless, this does not mean you should be sedentary for your baby's first 3 months! To prepare your body for impact, you can focus on low impact exercises and activities in the meantime: 

Walk before you run -

Start with increasing your steps gradually. Start with a 10 minute walk daily, increasing by 5 minutes each week to add some light cardiovascular activity into your routine, with the goal of being able to walk for 30 minutes without fatigue, pain or pelvic floor related symptoms.

Focus on your breath -

During postpartum, breath work can help you breathe more efficiently and help you recover faster.  Focus on diaphragmatic breathing. Allow your belly to fill on the inhale, and relax and soften on the exhale.

Prioritize core and pelvic floor bracing -

After you’ve mastered your breathwork, start to add gentle core bracing and pelvic floor contractions. If you are not sure how to activate your core or pelvic floor, it’s best to speak to a pelvic floor physical therapist to ensure that you are performing this properly. 

Check out this previous blog post we wrote for some exercise inspiration.

Are you at least 3 months postpartum and unsure if your body is ready to return to running? Try this simple self test!

First, assess the health and function of your pelvic floor muscles. Ask yourself the following questions: 

  • Do you experience urine, stool or gas leakage when you cough/sneeze/laugh/ exercise? 
  • Do you have a bulge or sense something falling out of the vaginal area?
  • Do you experience pain with bowel movements, tampon use, or intercourse? 
  • Can you walk 30 minutes or longer without onset of symptoms?

If your answer is ‘yes’ to any of these above questions, then it is recommended to have your pelvic floor evaluated by a pelvic health physical therapist. You can make an appointment to see one of us here.

However, if your answer is ‘no’, then you may be ready to be screened for your readiness to run. (yes, we do that, too!) Everyone needs good baseline strength and coordination of the lower extremities in order to run.

Try the following return to running assessment: 

  • Single leg calf raise, 20 repetitions
  • Single leg sit to stand, 20 repetitions
  • Single leg bridge, 20 repetitions
  • Side-lying hip abduction, 20 repetitions
  • Single leg running man, 20 repetitions
  • 30 second single leg stance
  • Jogging on the spot for 1 minute
  • Single leg hopping in place

If these drills feel good, then you may be ready to trial some running! Experts on postpartum rehabilitation recommend following a run/walk protocol, slowly increasing the time that you are running each week. Here is a simple example:

If you do experience any vaginal heaviness, urinary leakage or pain with the above exercises, then it is strongly advised to get your pelvic floor examined by a physical therapist prior to returning to running or other forms of high impact exercise.

Still have questions? At Fusion Wellness & Femina Physical Therapy, our team of expert physical therapists can assess your pelvic floor and whole body to determine your readiness to return to these activities and reduce your risk of injury. 

References: 

  1. Goom T, Donnelly E, Brockwell E. Returning to running postnatal—guidelines for medical, health and fitness professionals managing this population. https:// www.absolute.physio/wp-content/uploads/2019/09/returning-to-runningpostnatal-guidelines.pdf. Published 2019. Accessed May 28, 2021
  2. Christopher, Shefali & Gallagher, Sandra & Olson, Amanda & Cichowski, Sara & Deering, Rita. (2022). Rehabilitation of the Postpartum Runner: A 4-Phase Approach. Journal of Women's Health Physical Therapy. Publish Ahead of Print. 10.1097/JWH.0000000000000230. 

What Our Patients Have to Say

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Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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