Updated April 24, 2023
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 must be 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. She encouraged me to back off on the running and invest the time in core and pelvic floor rehab and strength training.
And of course, I didn’t want to listen.
After resisting for a few weeks, I finally took her advice. I grudgingly put in the weeks and months of consistent strength training, and then I got back out there. In hindsight, I’m so grateful that I stashed my ego and put in the work.
Just saying, I’ve been where you are.
What It Takes To Return To Running Postpartum
Returning to your sports or activities after giving birth doesn’t always happen as fast as you want it to, I can’t sugar coat that.
Patience will be your number one asset on your return-to-run journey.
But if you put in the time and effort to rehab properly, taking a core and pelvic floor-informed approach, it will pay off in spades.
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 in my strength foundations 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 postpartum runners in particular.
At the end of this post, I will link to 3 resources that I think are particularly outstanding.
But first?- Let’s explore 8 key considerations to guide your postpartum return to running:
1. Start with your core and pelvic floor
Your innermost core is your muscular system most impacted by pregnancy.
It’s also your powerhouse. The stable platform off which your arms and legs leverage to perform their powerful movements.
Why Your Core And Pelvic Floor Matter
It’s made up of your diaphragm, pelvic floor, deepest abdominal muscles (transverse abdominals) and multifidus (see image below). Together, these muscles are a team who’s function is dependent on precise coordination between it’s members.
During pregnancy, as these muscles are stretched and strained, coordination between the deep core muscles is disrupted. Their ability to reflexively stabilize the torso is compromised.
Disruption to the deep core can lead to symptoms like chronic abdominal separation, coning along your abdominal midline, urinary incontinence (peeing while you run), sensations of pressure in your vagina. It can also contribute to pain at other locations in your body as various joints and muscles try to compensate for lost stability.
And this: If your powerhouse isn’t so powerful, you won’t feel strong when you run.
How To Retrain Your Core And Pelvic Floor
Before you think about starting to run postpartum, retrain your deep core:
1. Learn to breathe with your diaphragm.
Try the 360 breathing exercise. This exercise teaches you to breathe into your diaphragm by bringing your attention to the movement of your rib cage.
2. Learn to contract and relax your pelvic floor muscles (aka –> kegel).
Try the pelvic floor elevator exercise. This exercise will spotlight a pelvic floor contraction AND relaxation. Learning to relax the pelvic floor is just as important as being able to contract.
3. Learn to coordinate your diaphragmatic breath with your pelvic floor contractions.
Put it together with the Connction Breath. The Connection Breath is an exercise that restores the coordinated activity of the diaphragm with the pelvic floor.
Learn how to breathe well during “simple” exercises so that your breathing strategy becomes automatic during dynamic activities like running.
The Connection Breath is my preferred breathing exercise to retrain your breath coordination. You can grab a complete tutorial 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 and movement compensations that develop during your childbearing year.
I recommend 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. If you experienced higher degree perineal tearing, a Cesarean delivery or any other significant birth injury, your timeframe might be a little bit longer.
Strength training focus
Focus your strength training efforts around your the posterior chain (in particular glutes, hamstring and calves), core strength, internal rotation at your hips and single leg stability and strength.
Progress your return to impact by learning to absorb force, generate force and manage intra-abdominal pressure during dynamic exercises.
Strength Tests And Pelvic Floor Screen
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 running postpartum:
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, assess your pelvic floor’s readiness by:
- consistently walk for 30-45 minutes
- squat jump (10 reps)
- single leg hop (10 reps/side)
You should be able to perform these (more or less) symptom free before beginning a graded return to run program.
3. Check-in with a pelvic floor physical therapist
Pelvic floor physical therapists are the professionals best qualified to evaluate the function of your pelvic floor and core muscles, the position of your pelvic organs and advise you on your readiness to return to sport.
They can help diagnose and manage any core and pelvic floor dysfunction that may have developed during your pregnancy or childbirth. Using tools ranging from manual therapy to specialized pelvic floor exercises, there are many tools at their disposal.
If you’re serious about returning to sport, and in particular if you are trying to push the timeline at all, make sure you schedule a pelvic floor PT appointment.
4. Prioritize your sleep, nutrition and stress management
Recovery is a non-negotiable part of any exercise program, and it’s especially important if you’re also recovering from pregnancy and childbirth.
Before your return to running postpartum, you should be sleeping at least 7 hours a night, eating in a way that feels healthful and managing your day-to-day stressors.
One of my colleagues, 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.
If you’re not sleeping well, eating well or coping with the stressors of postpartum, you may want to hold off on introducing running back into your routine. Of course, if running is essential to managing your stress level, take that into consideration!
5. Are you breastfeeding?
It’s absolutely fine to exercise while breastfeeding. Here are just a few things to be aware of:
While you are breastfeeding, your body produces hormones that may contribute to joint laxity and put you at an increased risk of injury.
If you’ve build a good base of strength, that will help counteract some of that hormone-induced instability.
You’ll also want to acquire a really solid sports bra to manage the extra bounce of larger-than-you-remember breasts. If you look around, you can find some pretty good nursing sports bras that will allow you to easily manage nursing around your workouts.
Consider timing your runs around your baby’s feeding schedule, or pump right before you run to prevent discomfort.
Breastfeeding is not a reason not to run, it’s just good to be aware of the potential considerations and plan your postpartum return to running 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.
Progress to short running 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. Watch out for the 5 P’s of pelvic floor dysfunction
Your body will send up early warning flares when your pelvic floor is overtaxed. If you experience any of them, you can course correct.
Here are the things to look out for:
Pelvic pain or discomfort
Pressure through your pelvic floor, perineum or vagina
Peeing or any other unwanted leaking
Peaking or doming of the abdominal midline
Pulling around Cesarean or perineal scar
If you ARE experiencing any of these pelvic health symptoms, ask yourself the following questions:
➡️ 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)? Try giving yourself more rest.
If your problems aren’t easy to troubleshoot, please reach out to a personal trainer qualified to work with postpartum runners (contact me here!) or a pelvic health physical therapist.
8. Buy a new pair of shoes
During pregnancy, your feet may have changed size and your gait has likely changed.
Before you return to running postpartum, 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 running journey.
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
👀 Next on your reading list:
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.
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Laura Jawad holds a PhD and a personal training certification (NASM). She’s a Certified Prenatal & Postnatal Coach, Pregnancy & Postpartum Athleticism Coach, and Pregnancy and Postpartum Corrective Exercise Specialist. You can check out the rest of her alphabet soup here.
