This is one of the questions that I get asked the most as a postnatal exercise specialist and I really wish there was a more straightforward answer!
It’s frustrating because there IS no definitive answer to this question. The truth is the time since you gave birth is almost irrelevant as it is much more about how well you can control intra-abdominal pressure, support the load on your abdominals and how ready your body is for running in terms of glut and leg strength. However, there are some key points to consider that are definite red flags and some ‘goals’ you can make sure you are able to do before going for a run.
The first thing to understand is that you shouldn’t be running postpartum until you have fully rehabilitated your core. As the first 4-6 weeks should be mostly about rest and gentle restorative movement, the rehab doesn’t really begin until around 6 weeks (and more like 8-12 weeks if you had a caesarean birth). No matter how strong you were pre-pregnancy, you need at least 6 weeks of building up strength before you should consider adding running into the equation so the ABSOLUTE EARLIEST would be 3 months. However, realistically for most women around 6 months is when you may have had the time to put in to your rehabilitation and be able to consider running again.
Running is a high impact form of exercise – every time your heel strikes against the floor it causes a huge impact throughout your whole body. The pounding motion of high impact exercise like running has a high impact on the pelvic floor and can have a negative impact on vulnerable tissues that have already been weakened by pregnancy and childbirth. When the stride is repeated again and again, the impact forces the pelvic floor downwards and the abdominal wall is pushed outwards which can exacerbate issues like abdominal separation (Diastasis Recti) and Pelvic Organ Prolapse.
Did you know that 1 in 3 new mums experiences postpartum urinary incontinence and over half of women over 50 suffer from some form of pelvic organ prolapse (where 1 or more of the organs in the pelvis slip down from their normal position and bulge into the vagina)?
The key thing with returning to exercise postnatally is that there is no ‘one size fits all’ rule to follow. Every birth is different, every body is different, every baby is different and all of these things will affect how your recovery goes and as a result how and when you can return to exercise.
However, I would generally advise to wait until around 3 – 6 months postnatal to give your body a decent recovery time and minimise the risk of causing long term issues. If you wait 6 months it gives you time to build yourself up with low impact exercise and, crucially, learn how to control intra-abdominal pressure (IAP), which is created in high impact exercise like running. Your level of control of IAP is actually more important than how many weeks (or months or years!) postnatal you are – plenty of people who haven’t been through a rehab programme after their babies have poor control over their abdominals or pelvic floor and therefore are likely to have almost as many problems with running as a new mum.
Often women are cleared to return to exercise at their 6 week check at the GP but many have little understanding about what a safe return to exercise means. The postnatal healing process is only really just beginning at 6 weeks when the organs have returned to their usual positions and you may be feeling like you want to start doing more. But, particularly if you are breastfeeding, there are still hormonal changes, healing taking place and lots of things going on in your body that mean intense and high impact exercise is not what you need. When you add to that the fact that most new mums are sleep deprived and nutritionally depleted following their pregnancy, it makes sense to nourish your body rather than punishing it.
The ideal first step in working out whether you are able to start running again is to visit a Women’s Health Physio so they can assess you internally and check your pelvic floor function and abdominals as well as an overview of your physical well being such as glut and hamstring function. They should perform a few assessments to give you an idea of whether running is a good option for you.
Immediate red flags are:
* Leaking urine or faeces – and actually that’s not only when running – if you don’t have ‘accidents’ when you run but are unable to withstand the IAP created by a sneeze or a star jump that is still an indication that you shouldn’t be putting your pelvic floor under undue pressure – go and see a Women’s Health Physio and work out what is going wrong. Leaking may be normalised within our society but that doesn’t mean you should just put up with it, there is lots that can be done!
* Heaviness/dragging feeling in your pelvis – this is a common indicator of POP and should be investigated. Go to your GP and insist on a referral or find a Pelvic Health Physio privately.
* Pain during intercourse can indicate tightness in the pelvic floor which is a sign that things are functioning as they should be so again this is worth investigating.
* Diastasis Recti – severe abdominal separation often goes hand in hand with pelvic floor dysfunction and both of these are a sign that you are not controlling your intra-abdominal pressure. This means you need to work on this and make sure you abdominals can take a level of loading before you are ready to add high impact exercise into the equation.
* Lower back pain – while this can be a normal part of the physicality of caring for a baby, it can also indicate pelvic floor dysfunction so it is worth getting this investigated before you add running into the equation
Our advice is to err on the side of caution when it comes to pelvic floor health. While there is no need to be afraid, so many people do too much too soon and regret it later on. If you can afford to, go and see a Pelvic Health Physio before you start running even if you don’t have any symptoms – they can assess whether running is appropriate for you at this time and give advice about what you need to do to bring yourself up to appropriate strength.
The Return to Running Guidelines was written by 2 Pelvic Health Physios and is a fantastic resource for anyone who wants to ensure they are running safely.
These guidelines include a list of exercises you should be able to do without any sign of pain, dragging, heaviness or incontinence before you start to run.
Our Centred Mums in Motion online programme builds you up to this in a safe and thorough way. We take you from the very basics in pelvic floor health all the way through to full classes including many of the exercises above.
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