I was really excited to see new guidelines released last month on returning to running after having a baby. “When can I start back running again?” has got to be the most common questions I get asked by post natal women in my clinic. I see the pressures of social media on women to “bounce back” (its even a hashtag on instagram)!! Why is there so much pressure on women to get back to their pre baby bodies and is this pressure potentially putting women out running too soon and causing harm? The typical advice of waiting for the 6 week check after your baby, and then go back to whatever you used to do pre-baby always seemed a bit unhelpful to me, so its now fantastic to have concrete guidance.
The new guidelines (https://mailchi.mp/38feb9423b2d/returning-to-running-postnatal-guideline) recognise running as a high impact sport with up to 2.5x the amount of pressure compared to walking on the body. Lower impact exercise is recommended up to 3 months after having a baby with a gradual return to running or other impact exercise at 3-6 months. This does not mean that you cannot exercise before 12 weeks but you do need to choose lower impact exercise such as walking, post natal yoga, post natal pilates or strengthening exercises.
I love to run – no mad distances or anything, but I love the freedom, ease and whole body workout of a run. Plus as a mum of two the logistics of going for a run compared to having to haul yourself to the gym and back is so much easier, but there is a time and place for everything (as my mum always says). We need to recognise that it takes time to recover from childbirth and a gradual return to exercise is best.
I went back running too soon after my first child. I thought I was fit and strong and did not do as much strengthening and muscle control work as I should have. Thankfully I didn’t have pelvic floor problems but looking back I was just dragging myself around the place and I had pain down my right leg. After my second child I worked on my muscle strength and control more and delayed my return to running and it felt much easier. It was around this time that I created The Bump Room Beyond Birth programmes to help guide women back to higher impact exercise gradually.
How Do I Know I’m Ready?
The guidelines recommend that all women have an assessment with a chartered physiotherapist who specialises in women’s health for a pelvic health assessment, to evaluate strength, function and co-ordination of the abdominal and pelvic floor muscles especially if you have:
- Heaviness or dragging in the pelvic area.
- Leaking urine or inability to control a bowel movement.
- Pendular abdomen or noticeable gap along the midline of abdominal wall (Diastasis Recti).
- Pelvic or lower back pain.
- Increased blood loss beyond 8 weeks post natal not linked to monthly cycle.
The following are load tests to assess whether your body is ready for the demands of running. You need to achieve the following without pain, heaviness, dragging or leaking:
- Walk x 30 minutes.
- Single leg stance x 10 seconds (each side).
- Single leg squat x 10 reps (each side).
- Jog on the spot x 1 minute.
- Forward bounds x 10 reps (each side).
- Single leg running man (each side).
Watch this video clip to see the tests in action.
The following are strength tests to assess if key muscle groups are ready for running. Each should be performed to fatigue, counting the number of repetitions on each side. Aim for 20 of each test on each side.
- Single leg calf raise.
- Single leg bridge.
- Single leg sit to stand.
- Side lying abduction.
Watch this video clip to see the tests being performed.
These are challenging tests. You may find that you need to work on strength and endurance of your muscles before getting back running if you are not able to manage 20 repetitions each side.
Return To Running
Once you have been assessed by a chartered physiotherapist who specialises in women’s health and you can complete the load and strength tests without issue then you are safe to start running again. A gradual return is sensible. The couch to 5km is a good programme begin with which combines running with walking. It is also recommended to build up on distance/time first before pushing the intensity of your running. Key signs to reduce/stop running are heaviness, dragging, incontinence or moderate to severe pain.
The best advice to follow is to listen to what your body is telling you. If you feel good during and after your run then you are doing something positive for your body, however if your body is shouting at you to stop then it is best to listen and work on your strength and muscle control before getting back to running.
I hope you found this helpful.