8 Key Considerations to Guide Your Postpartum Return to Running

After my daughter was born, before I even had my 6-week check-up, I had purchased a new Garmin multi-sport watch and new running shoes- ready to start training for my next 13.1. There was so much anticipation.

And then the day came. I went for the run- and I felt like a marionette puppet. I could pull the strings and make the arms and legs move, but they didn’t feel like they were really anchored in the middle. I marveled at how loose and disconnected my body felt. But, I thought this was par for the course. I thought this is just what it * should * feel like to start running again after pregnancy.⁠

I was fortunate to find a personal trainer who was well-educated in postpartum rehab. And she encouraged me to back off on the running and invest the time in core rehab and strength training. And of course, I didn’t want to listen. Do you know what finally convinced me? Not logic. Money. She was like “Hey, you can do what you want, but you paid me a lot of money for this advice.” That finally got to me. Or at least, made me feel some sense of financial guilt or obligation. And after resisting for a few weeks, I backed off. I grudgingly put in the weeks and months of consistent strength training, and then I got back out there. And in hindsight, I’m so grateful that I stashed my ego and put in the work.⁠

Just saying, I’ve been where you are. ⁠

Returning to your sports or activities postpartum doesn’t always happen as fast as you want it to, I can’t sugar coat that. But if you put in the time and effort to reconnect to and rehab your pelvic floor and core it will pay off in spades later on.⁠ ⁠ Ultimately, I returned to running. And it didn’t take years. My average running times were faster by the time I became pregnant with Max than they were when I became pregnant with Talia. I had never invested in true core strengthening before and it made a night and day difference in my athletic performance.⁠

In the past four years, since I gave birth to my first baby, there has been a REVOLUTION in the information available to postpartum athletes in general, and runners in particular. At the end of this post, I will link to 3 resources that I think are particularly outstanding.

But now, let’s talk about you, friend. You’re probably here for some nitty gritty. You are probably looking for some guidance surrounding good way to progress back to running after having a baby. So, here are my top pieces of advice:

1. Rest, recover, reconnect with and retrain your innermost core and pelvic floor.

Your inner core is made up of your diaphragm, pelvic floor, innermost abs (transverse abdominals) and multifidus (see image below). Together, these muscles are a team that is essential to the maintenance of upright posture and stability through the torso during movement (like running!). The inner core is greatly impacted by pregnancy and any disruption to its optimal function can lead to symptoms like excessive abdominal separation or coning along your abdominal midline, leaking of urine during activity, sensations of pressure in your vagina or pain in your body as other joints and muscles try to compensate for lost stability.

Deep core muscles: Diaphragm, Pelvic Floor, Innermost Abs and Multifidus — *Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com*

Before you think about returning to run, learn to breathe with your diaphragm, connect with your pelvic floor and coordinate your core through your breathing. Learn how to breathe well during simple exercises so that your breathing strategy becomes automatic during dynamic activities like running. Work with someone in person or online who has training and experience helping athletes return to sport using a core- and pelvic floor-focused approach.

Learn more about strategies to retrain your breath in The No B.S. Guide To A Stronger Drier Pregnancy And Postpartum.

2. Get in shape to run (not the other way around!).

We tend to think of running as a “simple” activity, but it actually places a very high demand on your body (in general) and on your inner core (in particular). Strength training provides an opportunity to progressively build tolerance to the loads and impact your body will experience during running. It’s also a great way to correct muscle imbalances that develop during your childbearing year. Failure to correct this may result in you compensating via strategies that lead to injury or exacerbate those imbalances.

Plan to spend a minimum of 3-4 months of consistently strength training and engaging in other low-impact activity before you hit the trails or the pavement. Areas to focus your efforts include the posterior chain (in particular glutes, hamstring and calves), core strength and reflexive stability, and single leg stability and strength. You can use the suggested strength tests below to set a few goals.

Consider using these strength tests, recommended in guidelines recently published by a team of physical therapists, to benchmark your readiness to return to run:

The four tests consist of 20 reps each of:

single leg sit to stand
side lying abduction
single leg glute bridge
single leg calf raise

In addition to those tests, I like to have clients test their pelvic floor’s readiness by assessing whether or not they can do the following (more or less) symptom free:
- consistently walk for 30-45 minutes
- squat jump (10 reps)
- single leg hop (10 reps/side)
3. Check-in with a pelvic floor physical therapist if you haven’t already.

These professionals are the only ones who are qualified to evaluate the function of your pelvic floor and core and advise you on your readiness to return to sport. They can help you rehab any core and pelvic floor considerations that may have developed during your pregnancy or childbirth. There are resources available on my website to help you locate one, or you can contact me directly.

4. Evaluate your sleep, nutrition and general stress.

If any of these areas still need significant improvement, consider giving yourself more time. One of my mentors, Jessie Mundell, likes to say, “When life stress is high, exercise stress is low”. When it comes to stress, your body doesn’t know the difference between the good kind or the bad kind. Until you are sleeping 7-9 hours a night, you are able to eat in a manner that feels good to you and your stress level is manageable, you may want to hold off on introducing running back into your routine. On the flip side, if running is essential to managing your stress level, take that into consideration!

5. Are you breastfeeding?

The hormones your body produces while you are breastfeeding may contribute to joint laxity and put you at an increased risk of injury. On the other hand, if you’ve build a good base of strength, that might help counteract some of that hormone-induced instability. I don’t believe breastfeeding is a reason not to run, it’s just good to be aware of what the potential considerations and plan your return to sport accordingly.

6. Walk before your run. Literally.

The principle of progressive overload is a concept drawn from strength training that dictates one should increase stress on the body gradually. It applies to running just as it applies to strength training. Begin by walking increasingly long distances and progress to running short intervals (preferably on hills!) with long rest intervals (for example, 30 seconds run, 2 minutes walk). Progress from intervals to steady state running over a minimum of 12 weeks, paying close attention to your body. Many people take longer, upwards of 16 to 20 weeks or longer to return to steady state running. Don’t compare your progress to anyone else’s.

7. Learn the signs that your pelvic floor is overtaxed so if you experience any of them, you can course correct.

Here are the things to look out for:
- Pain (anywhere)
- Pressure through your pelvic floor, perineum or vagina
- Peeing or any other unwanted leaking
- Peaking or doming of the abdominal midline
If you ARE experiencing any of these symptoms, consider that your body is trying to tell you something. Have you laid your foundations of good breathing and full body strength? If no, don’t skip those steps! How far can you run before you experience symptoms? That’s your threshold, gradually push it. Are you giving your self enough rest (either in the form of rest intervals during your run or between runs)? Perhaps you can give yourself more rest. If your problems aren’t easy to troubleshoot, reach out to myself, another trainer qualified to work with postpartum runners, or a pelvic health physical therapist for personalized advice.

8. Buy a new pair of shoes.

During pregnancy, your feet may have changed size slightly and your gait has likely changed. Get your foot size and gait evaluated at a store with experienced, knowledgable sales staff. They’ll help you find an appropriate shoe to support you as you begin running again.

My best piece of advice is this: Keep your long-term goals at heart. Don’t sacrifice your long-term performance by rushing your return to sport and risking injury. I wish you the best of luck during your postpartum recovery and return to run (or your high impact sport of choice!). Having a baby is not, in most cases, a reason why you can’t continue to do the activities you once loved, but it does take intention and smart training to get back to those activities safely. You can do this!

Resources:

Returning to Running Postnatal- guidelines for medical, health and fitness professionals managing this population;Tom Goon, Grainne Donnelly and Emma Brockwell

Go Ahead Stop and Pee; Kate Mihevc Edwards and Blair Green

POP UP (Run), an add-on to the fabulous POP UP- An Uplifting Guide; This is a return to run program specifically designed to support postpartum people managing pelvic organ prolapse

Disclaimer: Please note that some of the links in this post are affiliate links, and at no additional cost to you, I will earn a commission if you decide to follow the link and make a purchase. Please understand that I recommend these books or programs because they are helpful and useful, not because of the small commissions I make if you decide to purchase one. The commission is just a perk of sharing good information with people who appreciate that information. Please do not spend any money on these books unless you feel that they will enrich your perinatal experience.

Take a deep dive into HOW to dial in your breathing strategy to manage your pelvic health and feel stronger in your workouts. Download a copy of The No B.S. Guide to a Stronger, Drier Pregnancy and Postpartum.