It’s not surprising that running is such a popular way to exercise among postnatal women … it’s free, you can throw on your trainers and get a great workout in a short period of time, and it’s easy to fit in when you have childcare.
In fact, one of the most frequent questions we are asked by new mums coming into our clinic for a postnatal check-up is: when is it safe to start running again?
As a Women’s Health Physiotherapist, I want to encourage as many postnatal women as possible to run because it offers such amazing physical and mental health benefits. However, adequate time for healing and the development of strength – in preparation for running – are important components of a ‘pelvic-health friendly’ running plan.
When is it safe to start running after you have had a baby?
There is no set protocol or timeline for this, as postnatal readiness for running varies widely between individuals, but you wouldn’t expect to start running within a few weeks of having hip surgery, and you’d probably think it was a good idea to do some exercises to rehabilitate your knee first. In the same way, your post-partum body also needs time to heal, strengthen and rehabilitate in preparation for running after pregnancy and birth.
This is why I recommend waiting a minimum of 12 weeks before doing any form of high-impact exercise, including running. This is based on nationally recognised and well-researched guidelines. It’s the same advice whether you have delivered vaginally or via Caesarean section because this is the minimum time required for tissue healing after surgery, and it ensures that your pelvic floor and the surrounding structures have adequate recovery time after pregnancy and birth before exposure to the impact forces of running. I always stress to my patients how important it is not to rush back into running too quickly and that there are plenty of low-impact exercises which can be started straight away to build a strong foundation for running.
How can you tell if you are ready to return to running post-partum?
If you have any of the following symptoms, then you are not ready to run yet, even if 12 weeks have passed:
- Leaking urine
- Bowel incontinence
- Urinary or faecal urgency
- Feeling heaviness in your vagina
- Pain in your lower back or pelvis
- Bulging or doming around the middle of your abdomen
Instead, I would recommend seeing your GP to discuss a referral to a pelvic health physiotherapist to address these issues before starting any high-impact activity.
If 12 weeks have passed and you are symptom-free and can walk outside on uneven ground for over 30 minutes without experiencing any symptoms, then you might be ready to start a walk-to-run programme like the Couch to 5K.
Here are a few simple tests that I use with my postnatal patients at our clinic in Cambridge to see if they are run ready … are you able to:
- Complete your pelvic floor exercises while standing (holding for 10 seconds, 10 times and 10 fast repetitions).
- Stand on one leg with good control and balance for 30 seconds on each side.
- Squat or sit to stand on one leg 20 times, with good control of your knee, pelvis and trunk position?
- Hop on one leg for 30 seconds without losing control or balance.
- Complete 20 single-leg calf raises on each side.
- Complete 20 single-leg bridges on each side, maintaining good control of your pelvis.
Safe postpartum strength training for runners – 6 steps to guide your training
To avoid injury and keep it pelvic-health friendly, you need to build up to running gradually. Here is my six-step framework to guide your training:
- Initial rest period
During the first 2 weeks, rest really needs to be prioritised. Gentle walking is fine, but squeeze in some extra sleep whenever you can. - Breathing, reconnection & engaging core muscles
When you feel ready, start to practice diaphragmatic breathing. This might feel quite gentle initially, but it’s a great way to reconnect with your pelvic floor. - Core & Body weight exercises
Building up strength in your core muscles, as well as your hip and leg muscles is important preparation for running and body weight exercises are great. Start with mat-based core exercises after 2 weeks postpartum and move onto body weight lower body exercises by 4 weeks. Whole body circuit training is also a great way of doing this and also works on your cardiovascular fitness, which will make running easier when you start. - Gradually add weight to increase challenge
As you are able, gradually add some weights into your workouts. Your body will quickly adapt, so body weight exercises will become too easy. - Impact training (not advised before 12 weeks after having you baby)
Exercise involving jumping and hopping are really important to prepare our joints, muscles, tendons and pelvic floor for the deceleration and acceleration forces involved in running. This is commonly missed but is especially important. - Gradual build-up from walking to running
Introduce running and progress gradually. A program like couch to 5km, or a walk run program on the treadmill are ideal. Gradual progression is the best way to minimise the risk of injury. Running with a buggy is much harder work, so I wouldn’t recommend this until you have completed the Couch to 5km (around 6-9 months). This also fits in with guidance not to commence buggy running until your baby is 6-9 months old and can protect their neck and spine.
We offer specialist postnatal appointments with our Women’s Health team online and face-to-face at our clinic in Cambridge. If you have any questions at all or would like some more advice, please don’t hesitate to get in touch.
We are passionate about helping women navigate their journey back to running!
Blog written by: Anna Birch, Physiotherapist specialising in Women’s Health.
