12 Sep When can you start running after having a baby?
“When can I start running after having a baby?”. It’s a question asked by many postnatal women, and the answer isn’t always a simple one. If you’re keen to get back to pounding the pavement, we’re here to help. We asked Accredited Exercise Physiologist and women’s health expert, Esme Soan, to break it down for us.
So, when can I start running?
The first research evidence guidelines were published in 2019 to help support graduated return to high intensity exercise postpartum (i.e. running). There are certain considerations when returning to higher intensity exercise – both for short term & long term health outcomes.
I advise waiting for at least 4 months before returning to higher intensity exercise. This is because the levator hiatus (the gap in your pelvic floor muscle through which your vaginal travels) widens during pregnancy. And it significantly widens after vaginal delivery (uhh – duh!). It’s returns to similar size 12 months post a vaginal delivery without interventions, but it never returns to prenatal size. Women who have experienced C-section deliveries return to a similar size much sooner.
The recovery of your levator ani muscle (part of the complex of muscles that makes up your pelvic floor) and all the connective tissue & nerves that have been stretched via delivery is maximised (that is – healed to the best it can) at 4 – 6 months postpartum. If you start jumping, running & placing impacting loads through this pelvic floor as it is still recovering, you may delay your recovery or take a step backwards.
It’s just like any other injury…
Consider this… If you have a surgery on your knee or badly roll your ankle – where ligaments were stretched, or surgically cut and stitched – you have an enforced rest period. This is followed by rehabilitation and a slow progression back to running post injury.
Why would we not provide the same rehabilitation and progression after child birth? A C-section is major abdominal surgery, and vaginal delivery involves your pelvic ligaments being stretched and your abdominal or vaginal wall may have been cut, torn or sutured. Rest is important!
How to safely start running
There are some important steps to take before you hit the streets. During this initial phase of rehabilitation, I strongly recommend working with an Accredited Exercise Physiologist who specialises in women’s health. They understand the complexities of returning to exercise post-pregnancy, and will prescribe movements that are safe and specific to your individual needs. Here’s how I progress new mum’s to running after having a baby…
1. Retrain the brain
Firstly, we know that motor control (that is how your brain talks to your muscles) is altered between your deep abdominal wall & pelvic floor after pregnancy. We need to retrain the brain to speak with these muscles! This helps with your core stability and controlling your intra-abdominal pressure. During this first stage of rehab, we also want to see resolution of any abdominal separation (diastasis recti) and rehabilitate any pains or injuries.
2. Restore strength and stability
Secondly, we need to restore strength & stability to your pelvis. Running is a single leg exercise, so it’s important to make sure you’re strong enough to stabilise on a single leg. It’s also important that your pelvic floor is strong enough to withstand impact! Do you know how many muscles are active during a running cycle? There’s at least 10 just in your lower limbs. Plus your core stability also helps with increased demand on breath. That’s a lot going on!
Your exercise physiologist will work with women’s health physiotherapists at this stage. Information from internal exams help your health professionals to understand what your pelvic floor is doing. Without this knowledge, you may feel like you’re running great – but your pelvic floor muscles, ligaments and pelvic organs might not be doing so well.
If you do have a prolapse, an exercise physiologist can help you to improve strength surrounding the pelvis and to your control of your breath through exercises. They can also provide alternatives and modify exercises to keep you moving without fear and supporting your pelvic floor!
3. It’s time to run
Thirdly, it’s time to expose you to running. As an exercise physiologist, I want to make you as efficient as possible! Efficiency means being able to run at a given speed with the least amount of effort. Work smarter, not harder! Exercise Physiologists are experts at this… We work with patients completing rehabilitation after chemotherapy all the way up to athletes trying to better their performance.
How long do you have to wait?
Postnatal “clearance to exercises” appointments are appropriate from:
- 6 weeks postnatal for vaginal delivery and;
- 8 – 10 weeks postnatal for C-section or interventions deliveries (forceps, vacuum, episiotomy)
At this appointment, your exercise physiologist will screen your abdominal wall. They’ll check for diastasis recti (abdominal separation), pelvic floor co-ordination and any pelvic girdle dysfunction. From there, they’ll help to graduate you from low intensity exercise back to the activities you love!
Why to see an exercise physiologist?
Exercise physiologists have further education and in-depth understanding of the physiological changes in your body brought on by pregnancy, birth, surgery and rehabilitation for the pelvis & pelvic floor.
Working with our exercise physiologists can help transition you back to exercise safely after birth, with rehabilitation for your abdomen & pelvic floor, and graduated return to exercise, sport & running!
Exercise Physiologists can also help with rehabilitation for:
- Back, hip or pelvic pain
- Incontinence (leaking of urine)
- Prolapse managament
- Abdominal separation (DRAM or diastasis recti)
To find your local Accredited Exercise Physiologist, ask your GP for a referral or use this search function to find one near you.
Written by Esme Soan & Annika Coyne. Both Annika and Esme are Accredited Exercise Physiologists and women’s health experts at Pear Exercise Physiology. They are passionate about helping women stay strong and healthy both during and after pregnancy.