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What studies say about returning to running as postpartum exercise

Most of the therapists in our office are moms, and we intimately understand wanting to get back to exercise after delivery. Caution should be taken when returning to running postpartum - we see this clinically and research also shows postpartum movement strategy changes that can increase your risk of injury.

A recent pilot study by Provenzano et al., 2019 compared the biomechanical changes of runners pre-pregnancy (or <14 weeks gestation and postpartum). They found at six weeks postpartum subjects had decreased trunk and pelvic rotation, decreased running speed, with increased step width and stance time compared to pre pregnancy measurements. They also found decreased motion in the hips with increased motion at the knee as a compensation.

These findings are similar to several studies that have assessed walking in pregnancy. It is believed that these changes may help with stability and prevent falls. These changes may also be compensations to avoid pain in the back and/or hips.

Exercises that improve range of motion

What’s important about this article is that most women are cleared to return to running at six weeks postpartum when pregnancy related changes in the trunk and pelvis are still present. Further studies need to be done to determine how long these changes remain.

Pelvic stabilization may be an appropriate strategy to prevent these biomechanical changes during pregnancy. In another biomechanical study by Mens et al., sacroiliac joint mobility was measured in pregnant patients with a belt. They found decreased sacroiliac joint laxity and improved stability with movement through the pelvis while wearing a belt.

In a systematic review of twenty-three articles, pelvic stabilization exercises were beneficial at decreasing low back and pelvic girdle pain in pregnancy (Bogaert et al., 2018). A combination of using a pelvic belt and internal stabilization through exercises could possibly help decrease muscle overuse and allow for better range of motion through the pelvis, trunk and hips. A pelvic brace or belt is not always necessary but can help with pain management. Seeing a qualified physical therapist or pelvic floor therapist can help you determine if this is something you may need.

Contact us for a telehealth session in California (or virtual consultation worldwide) so you can improve your form and function with your postpartum return to running program.

 

Resources:

Bogaert, J., Stack, M., Partington, S., Marceca, J., & Tremback-Ball, A. (2018). The effects of stabilization exercise on low back pain and pelvic girdle pain in pregnant women. Annals of Physical and Rehabilitation Medicine, 61. doi:10.1016/j.rehab.2018.05.356

Mens, J. M., Damen, L., Snijders, C. J., & Stam, H. J. (2006). The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain. Clinical Biomechanics, 21(2), 122-127. doi:10.1016/j.clinbiomech.2005.08.016

Provenzano, S. G., Hafer, J. F., Peacock, J., Kempner, S., Zendler, J. D., & Agresta, C. E. (2019). Restriction in Pelvis and Trunk Motion in Postpartum Runners Compared With Pre-pregnancy. Journal of Womenʼs Health Physical Therapy, 43(3), 119-126. doi:10.1097/jwh

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A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

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I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

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I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

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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.

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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.

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Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

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