Returning to Running Postnatally.
So your baby is three weeks old, you’re feeling well and your runners are starting to talk to you… “c’mon lets get out for a little run- nothing too bonkers just around the block to get out the house!”
Every time to walk past they get louder… “THE SUN’S SHINING, THE RUNNING BUGGY HAS BEEN PUT TOGETHER LET’S GOOOO!”
Does the sound familiar!? For many new mamas it won’t (for me it didn’t the only thing I like running is a bath,) but for so many women running is a real joy and a very easy exercise to access from home. No fancy memberships or special contraptions needed. Just get into your PE kit, trainers on and head out the door (find someone to look after the baby too.) But how and when should we return to running?
Before we get to it let’s just recap on what we might be experiencing as a new mother;
Sleep deprivation
Muscle changes to the abdominal wall and pelvic floor
You might be breastfeeding
Changes in your body mass
Fluctuating hormones
Lack of childcare options
Fluctuating breast size
A lot is happening at this time and every single woman’s experience is different to the next. A few things that are important to consider before starting exercise. Do you have clothing that you feel comfortable in and that will support you. Breastfeeding or not we want to really make sure your breast tissue is well supported when we are exercising. Shock absorber do a really useful tutorial on how a sports bra should fit. This isn’t sponsored and I have no affiliation with them. I wore there bras through pregnancy and postpartum, I had some pretty sizeable boobs so I can highly recommend!
Now we’re well supported when is it a good time to start to return to running. Well, shall we reframe this, we are starting the journey to return to running from day one postnatally. Eg- get up out of bed and walk down stairs, taking deep breaths, stretching, doing your pelvic floor exercises, walking up the stairs. Everything you do from day one postnatal is preparing you for loading the pelvic floor, testing the abdominal wall increasing your aerobic capacity. Anybody who wants to argue this point just needs to spend a day with a mother wrestling children into and out of a car, trying to get them dressed and running up and down stairs to collect various forgotten items. Not to mention lugging upwards of 15-20 kg’s worth of kit in and out of the car- car seats, buggies changing bags babies come with a lot of heavy things!
So let’s look at a little timeframe for what we can introduce and when…
Source - Goom T, Donnelly G & Brockwell E. Returning to running postnatal - Guidelines for medical, health and fitness professionals managing this population. March 2019.
I love this little guide and discuss it with nearly all my lades in clinic. Returning safely to exercises is a huge part of what I do. A lot of the time people are surprised by the 12 weeks. I think this is mostly to do with the expectation of the 6 week check being the all clear for returning to running. It’s a massive misconception and having had a baby myself I can definitely say I did not feel ready to return to running at 6 weeks!
Everybody is different, this is why a thorough subjective assessment to gain undertaking to symptoms, pregnancies and births, toileting habits, worries, athletic ability prior to pregnancy, patient goals… (I could go on forever here a good subjective assessment is paramount.) That’s before we’ve even started to look objectively.
As discussed above A LOT is going on in the postnatal body. When I see ladies in clinic I have a few hard no’s with regards symptoms and running. These include;
Leaking urine or faeces
Pelvic Pain
A dragging or heaviness in the vagina or back passage
By hard no I mean that I would ask the patient to stop before these symptoms occur. This is the body’s way of telling us there’s something going on and we have a look at what that might be. The biggie here is taking that symptom (and treating it of course) but finding what the individual CAN DO symptom free. This is really important. The pelvic health research Queen Gráinne Donnelly makes such sense on the topic of postnatal return to exercise, she points out that-
“postpartum recovery should be considered similar to injury rehabilitation, which adopts a graded approach to activity and training with progressive loading.”
The paragraph I started this post with is almost a carbon copy of the wonderful messages I get from ladies who want to get back to doing what they love. I hear you and I totally understand why at 2/3/4 weeks you want to get back to doing what you enjoy. So often I think it’s misunderstood as a fitness obsession or a fixation on losing weight. But here’s the thing, missing doing what makes you feel good is totally normal. Having a postnatal body that you don’t love is okay. I’ve been there. Feeling a bit weird in clothes and uncomfortable because of the changes your body has gone through is familiar to many many postnatal women. I feel it’s important, instead of criticising someone for wanting to be active and maybe wanting to feel like themselves again, we should just listen! Instead of- “Christ alive Susan you’re only 8 weeks postnatal chill out!” Perhaps that’s Susan’s way of chilling out. We just need to find a way of making sure Susan is working towards her goal of getting out of the house and exercising. Guidelines are guidelines, Susan may actually be a high level athlete and able to do considerably more than I was able to and this is why a pelvic health physiotherapist is your best friend! This is what we do, we find a way of getting you back to what you love. It doesn’t matter how many years ago you had your baby, if you stop doing what you love because of symptoms this is your sign to get booked in and for us to have a chat!
References
Goom T, Donnelly G & Brockwell E. 2019., Returning to running postnatal - Guidelines for medical, health and fitness professionals managing this population. British Medical Journal. May 20th 2019.
Grainne Donnelly. 2022., The 6 R’s Framework: return to sport postpartum. Journal of Pelvic, Obstetric and Gynaecological Physiotherapy, Autumn 2022, 131, 57–59
National Health Service (NHS) (2019) The NHS Long Term Plan. [WWW document.] URL https://www. longtermplan.nhs.uk/wp-content/uploads/2019/08/ nhs-long-term-plan-version-1.2.pdf