How to begin running after birth

Taryn Gaudin Women’s Health Physio

Often, I get asked “How do I return to running after baby”. “What do I need to be able to do before I start running?” ” How will I know if it’s too soon?”

To be honest, these are HUGE questions and I won’t be able to answer them all in this single post, but I can give you some excellent starting points. In this post I will share with you:

What happens if you return to running too soon after birth
How to know when you are ready to start running after birth
What signs and symptoms to look out for when returning to running after birth
How to rebuild your core with running in mind
When you can start running after birth

The pelvic floor muscles are a group of muscles that form a sling that creates the floor to our pelvic ring and the base of our pelvic bowl. The muscles of the pelvic floor attach from the pubic bone at the front, to the coccyx (tail bone) at the back, and to the ischial tuberosity (sit bones) on the left and right of the pelvis. There are two layers of muscles that make up the pelvic floor muscles; the deep pelvic floor muscular layer that makes up the internal muscles of the pelvic floor and the superficial layer that make up the external layer of the pelvic floor. The deep pelvic floor muscles are responsible for providing ‘lift’ to the pelvic organs and supporting the connective tissue of the pelvis. The superficial muscles help to give added closure to the vagina and the anus.

Physically the pelvic floor has a significant role in:

Maintaining continence – stopping leakage from the bladder and bowel
Sexual pleasure – orgasm
Supporting the pelvic organs – bladder, bowel, uterus in place

Physiotherapists often talk about ‘running safely after birth’ and not running too soon after birth. But what is it that women are actually risking if they begin running too quickly after delivering a baby? Returning to high impact exercise too soon after birth can put increased pressure onto our pelvic floor, and can put our body at risk of developing Pelvic Organ Prolapse, worsening incontinence, and creating other secondary musculoskeletal issues like back pain and pelvic pain. In order to minimise risk, and to create an enjoyable postpartum running journey, a gradual progression towards running needs to take place. Building pelvic stability and deep core strength, and allowing the body time to heal naturally is part of this gradual progression.

Often, women are told at that their postpartum 6 week check if they are ‘ready to return to exercise’. However, your ‘6 week check’ tells you very little in regards to your ‘readiness’ to return to exercise. One of the biggest considerations for returning to running is the condition of your core and pelvic floor.

To understand the strength and condition of your pelvic floor, I recommend a detailed INTERNAL vaginal pelvic floor examination from a Pelvic Floor Physiotherapist. A pelvic floor physiotherapist can give you an indication of the strength, co-ordination, and endurance of the pelvic floor muscles; along with the pelvic organs are sitting, and the condition of the fascia and ligaments that support the pelvic floor organs.

Some women don’t have access to a Women’s Health Physiotherapist, and some women don’t want to have this assessment done. That’s OK! In the Run Mama program I will give you all the details of how you can tell if you are able to contract your pelvic floor muscles using multiple ‘self assessment techniques’.

I also recommend having a therapist who knows running! Having a Pelvic Floor therapist check the condition of your pelvic floor is a quite separate thing to having someone guide your return to running after birth. You want both a therapist who understands postnatal pelvic floor health, and running!

Evidence based clinical guidelines suggest that before beginning running women should be able to:

Walk at least 30 minutes comfortably
Contract the pelvic floor muscles fully for 6-8 seconds, for 8-12 contractions
Perform 10 single leg squats in a row on each leg, stand on one leg for 10 seconds comfortably (left & right), and do
Perform a sub-maximal (half way lift) pelvic floor contraction for at least 60 seconds
Run on the spot comfortably for 1 minute

Building strength and stability with running in mind

Often women are referred to ‘pilates’ to rebuild their core and pelvic floor after baby. This is a great starting point. But there is a big difference between mat based work, and RUNNING! There are a whole bunch of steps in between!

The effects of pregnancy and birth can be significant, and we need to address the ‘whole picture’ which means:

Reconnecting to the body after birth (shared in depth in my signature program Homegrown ON SALE NOW)
Rebuilding deep core and pelvic floor strength and endurance, and developing adequate core co-ordination
Improving our posture & alignment (if required)
Understanding breathing patterns and how to apply them for running
Addressing pelvic health from a lifestyle perspective, and
Having a graduated return to running using exercises that relates to running!

Some excellent postpartum running related exercises include:

Single leg squats
Single leg bridging
Single leg calf raises
Single leg sit to stand

All of which is in the ‘Run Mama’ online postnatal running program. This program helps you start with mat based work PLUS running based core exercises, which then progress to running workouts and running drills specifically with the postnatal runner in mind. Once you are running I show you how to build at a steady pace, how to choose your terrain, improve your running gait, and correct the common mistakes that I see postnatal runners making time and time again.

How soon after birth can I begin running?

The effects of pregnancy and birth are many and varied. A huge range of factors will affect how soon you can begin to run after birth including:

The type of birth you had,
How active you were during your pregnancy,
The condition of your deep core and pelvic floor,
What level of running you have experienced previously,
Factors that contribute to pelvic floor changes during pregnancy and birth like genetics, your age, how much weight you gain during pregnancy etc

Clinical guidelines also suggest that women should hold off running and other high impact exercise until at least 3 months postpartum. In addition to these guidelines women need to know what warning signs to look out for when running postpartum.

There is not ‘one way’ to know exactly when you are ready to run. This is why in the Run Mama (ON SALE NOW) program I give you a series of progressive exercises along with a ‘checklist’ which helps you know exactly when you are ready to run – and how to progress.

First and foremost, if you experience any of the above mentioned ‘warning signs’ when you start running – you know you’re not ready – OR you need to CHANGE HOW you run.

Amongst other things, before you start running, you want to:

Know & understand the ‘warning signs’ to look out for
Have mastered a single leg squat – and have good ‘pelvic stability’ and trunk control when you do your squat.
Be sure that you can generate ‘adequate tension’ across your abdomen.
Be able to perform a series of running drills, and feel comfortable doing them…

All of which I teach you to do in the ‘Run Mama’ Program. Remembering though, that it’s not just about the condition of the core and pelvic floor, it’s also about HOW YOU RUN . Which is a HUGE FOCUS in the Run Mama Program.

Warning signs to look out for

It’s easy for health professionals to tell you ‘take it steady’ and ‘return to running slowly’, but what are you really looking out for?

One of the major things we are trying to avoid when we are returning to exercise is pelvic organ prolapse – or a ‘falling’ of the pelvic organs into the vagina. The major ‘warning signs’ to look out for when returning to running are:

A heaviness or dragging sensation within the pelvis or vagina
Low back pain
Incontinence or leakage from the bladder or bowel
A bulging sensation in the vagina
A sensation that ‘everything is going to fall out’

These may happen immediately, or you may feel pelvic heaviness after your run. If you do feel any of these ‘warning signs’ – you need to either take a step back in your running, modify HOW you are running, or continue to strengthen and rebuild your core. Often, the core can be ‘strong’ but the problem lies in HOW we run.

am i doing my pelvic floor exercises right?

IMPROVE YOUR TOILET POSTURE:

Sit with the knees higher than the hips, preferably by using some kind of stool/foot support. The neural pathways that help us to press up onto our toes are the same as those that help to maintain continence. Think about young children who dance on their tip-toes when they need to use the bathroom – this is one of our body’s natural ways to stop us from leaking. This is why a stool is preferred so that we don’t have to work against this natural neural pathway.
Have the knees slightly wider than the hips to allow for a gentle lean forward from the hip joint and an open outlet.
Keep the back relatively straight to avoid compression on the abdomen.
Allow the belly to soften and bulge.
Don’t push, simply allow the bowel motion to fall away naturally.

MAINTAIN ADEQUATE HYDRATION

Enure you are well hydrated so that your bowel motions are soft and easy to pass
You can tell by the colour of your urine if you are well hydrated – a pale straw coloured urine indicates good levels of hydration. Anything darker, you can drink more fluids. Anything lighter is not a problem, but you can drink less if you like.

LISTEN TO YOUR BODY DURING EXERCISE

If you are feeling prolapse symptoms either during exercise, or after exercise, it is recommended that you stop and modify that exercise in some way. In some instances you may need to take a break from a particular exercise and slowly build up to it again. Some of the most challenging exercises that women find aggravate prolapse symptoms include:

High impact exercises like running
CrossFit
Weighted exercises like gym classes or free weights, and
Strong deep core exercises like sit-ups, V-sits and some pilates style exercises

Run Mama is a self paced, online postpartum running program that helps you to understand how to run safely after birth.

Rebuild your core and pelvic floor using the best core workouts specifically designed for runners.
Know how to return to running safely after baby!
Access affordable, expert guidance from a Physiotherapist who understands running
Feel empowered to make your own decisions, without having to fear movement & exercise
Build more power, & use less energy when you run
Stop leaking when you run! (no, kegals are not the answer!)
Know how to assess & treat abdominal separation
Understand the most common mistakes of ‘mums that run’ & how to fix them.
Enjoy core workouts from the privacy of your own home, that are specifically designed to get you back to running safely
Have access to ongoing expert advice, without having to keep paying for it!
Be guided by a therapist that ‘get’s you’

Guided by Women’s Pelvic Floor Physiotherapist, mother, and age group world champion triathlete Taryn Gaudin. You can access the program today for just $66 AUD! Check out the program here.

