Returning to running for new mothers

Authors: Jess Kehoe, dpt & Josie Stokken, dpt

Being pregnant and giving birth changes the female body in many ways.  These changes can affect one’s ability to return to sport, especially high impact activities such as running.  However, the body is resilient and with training and guidance this can be done safely. Exercise is an important component of a healthy lifestyle both physically and mentally after having a baby.  Generally it is advisable to return to or begin a regular exercise program as part of recovery from pregnancy and birth. As physical therapists we are in a position to really help women who are interested in this goal.   Here are some basic guidelines to consider, but really the best thing is to gain individualized guidance by a PT.
It is important to first gain clearance from your OB, based on individual symptoms, before beginning with exercise.   However, it is important to note that many structures in the pelvic floor take 4-12 months to return to their normal position, and some things never return to pre-natal positions.  This means that you may be cleared to exercise before your body has recovered from pregnancy and birth. This is a reminder to start easy and build up to successfully reach your goals.
Begin core, pelvic floor and lower extremity exercises to regain strength needed for running and supporting the internal organs.  This is a HUGE step and progresses differently for every new mom. Pelvic floor exercises can be difficult, and even more so shortly after pregnancy.  We recommend guidance from your PT to learn appropriate Kegel exercises and deep core exercises, especially if you feel they are difficult or challenging, or you have no experience with them.

1. Kegel exercises: 30 reps of a 10 second hold, every day
   
2. Other exercises specific for running: increasing walking time, squats, lunges, plank, single leg balance, calf raises, bridges, side lying leg lifts, 2-3 times per week.
   

Due to the risk of pelvic floor dysfunction following pregnancy, a general guideline is to return to low impact exercise after about 3 months postpartum and return to running between 3-6 months postpartum.  Return to running with any signs of pelvic floor dysfunction, whether before or during exercise (pelvic pain, urinary or fecal incontinence, pain with intercourse, pressure or bulging in the vagina) is not recommended.
Begin with a walk/run progression, taking time to work up to 15 minutes of continuous running. It is important to set realistic goals and progress slowly.   It is better to increase the time of exercise before increasing intensity of effort. This slow progress can help reduce the chance for overuse injury, which happens when we increase exercise load more quickly than our tissues can recover.  This could take time, so be patient with yourself. Every mom recovers differently. Involve your newborn! Exercise at home or outside with your infant. Use a stroller and stop at the swing as the infant reaches the age that these activities are safe.   
Don’t forget that recovery from exercise requires rest and adequate nutrition.  These things can be challenging for new moms, but to be successful with return to running, at any level, they are important not to overlook.