Most moms get the OK to return to exercise at their 6 weeks follow-up appointment, but this clearance is generalized and not based on any physical assessment. Research recommends waiting at least 3 months for returning to running postpartum and stress the need to build a solid foundation of strength and stability first.
Running is a high impact sport that requires higher levels of strength, stability, agility and power. Running significantly increases intra-abdominal pressure which can exacerbate urinary incontinence, prolapse or diastasis recti symptoms. It also leads to a 2x increase of your body weight in ground reaction force, which is then absorbed through your legs, hips, pelvis and core. If these are weak points in your body due to a lack of adequate strength, running can lead to injury. Even if you’re an experienced runner, it’s imperative to set a solid foundation of breath work, core and pelvic stability and lower body strengthening.
Returning to running requires patience and the timeline isn’t linear. Your birth experience, postpartum recovery and hormones are just a couple factors that play a major role. If you’re nursing, you’ll continue to have hormones that make your joints more flexible. This is why it’s important to listen to your body and gradually test your abilities along the way.
Where do I start?
It’s essential to regain core, pelvic floor and hip strength. Without first creating a strong foundation of strength, research shows that you'll be more likely to experience pain and injury, stress incontinence, and diastasis recti (DR) with running.
Running is off the table for the first 12 weeks, but other types of exercise are ok. Walking is one of the best forms of exercise and is a great precursor to running. Focused training on posture, breathwork and strengthening of the core, pelvic floor and hips is also a must. Chelsea Method’s 6-week Foundation Challenge lays down this foundation in an accessible way that takes out the thinking.
Postpartum Running Prep Self-Test
To be confident that your body is ready to meet the high demands of running, you need to pass the running preparedness self-test. If you are at least 12 weeks postpartum and would like to return to running, make sure you can complete these 7 movement tests first:
- Thirty-min walk without any symptoms
- One-minute jog in place without any symptoms
- Standing on one leg for 10 seconds on each side. During this activity, your pelvis and trunk should stay level and your standing leg shouldn’t be wobbly.
- Ten single leg squats on each leg. During this activity, our pelvis should stay level and your knee shouldn’t rotate in.
- Ten single leg hops in-place on each leg. During this activity, our pelvis should stay level and your knee shouldn’t rotate in.
- Ten Forward Bounds
- Ten Running Mans on each leg
For all seven movement tests, you must be able to do the exercise without leaking, feeling a sensation of pelvic heaviness or something falling out of the vagina, vaginal bleeding (besides normal menses), seeing a noticeable gap bulging out at midline of the stomach or experiencing any pelvic, hip or lower back pain.
Build Back Slowly
Pushing too fast or too far can be hard on your body, even if you feel ready. Gradually progressing your runs is the safest way to build up your mileage, endurance and speed. This process can take time and that’s completely normal (and smart!). During this time, continue to prioritize breathwork and core, pelvic floor and hip strengthening. Proper diaphragmatic breath will make you a more efficient runner, and adequate strength will help prevent injuries.
Here’s a great 6-week guideline for returning to a 20-minute run:
Signs You Need to Pull Back
If you’ve just started running again, mild soreness and musculoskeletal aches and pains that resolve within a couple days is to be expected. If you’re experiencing more than that, it may be a sign to pull back. Here are some symptoms to watch out for:
- Bladder Incontinence (leaking urine)
- Sharp joint and muscle pain that doesn’t resolve
- Pelvic heaviness
- Heavy or dragging legs
- Prolapse symptoms (pressure in vagina or rectum like something is going to fall out)
- Vaginal bleeding
- Shortness of breath
- Visual changes
- Pressure in the chest or upper abdomen
- Swelling in legs
Vaginal bleeding, shortness of breath, visual changes, pressure in the chest or upper abdomen, or swelling in legs are red flags! If you are experiencing any of these signs, stop running and immediately reach out to your doctor.