Many women contact me wanting to know when they can get back to running; and for many years, we had no standard answer or much research addressing the question at all. Luckily for us, in 2019 three prominent UK physiotherapists (one of whom was a wonderful clinical educator of mine when I was a student – very niche claim to fame) published the very first endorsed guidelines based on best available evidence and specialist clinical opinion.
I must be clear from the outset: when and how you get back to running, depends entirely on YOU and will be different for everyone. There are so many variables that can affect when you can safely return to running. This list gives you an idea of the complexity of what we consider in helping you return to running, and is by no means exhaustive:
- Your pre-pregnancy and pre-birth levels of activity, strength and conditioning, or pre-existing injuries
- Your mode of delivery and any birth injuries
- Length of active labour
- Medical and obstetric history
- Breastfeeding history
- Current symptoms of pelvic floor dysfunction
- Current symptoms of musculoskeletal pain
- Assessment findings such as; single leg stability and control, glut strength, diastasis recti, core strength, pelvic floor strength, co-ordination and speed
It is impossible to set a “standard” for safe return to running for an individual without an in-depth assessment by a specialist covering these factors and much more. Your GP will not have the time nor the expertise to perform such an assessment – so you will need to seek out an experienced pelvic health physiotherapist.
As your pelvic floor will undoubtedly be weak or injured after having a baby, there is risk surrounding return to high-impact and repetitive activities such as running. Your pelvic floor muscles fulfil many vital functions for you, including:
- External and internal support for your pelvic organs (bladder, vagina, bowel and uterus)
- Urinary and bowel continence
- Modulation of pressure within abdominal cavity
- Key role in dynamic stability of lumbo-pelvic region
- Major role in sexual pleasure
Running is associated with a sudden rise in intra-abdominal pressure, and necessitates absorption of ground reaction forces through your pelvis and lower limbs; both of which your pelvic floor and core muscles must be able to cope with. Weak and less co-ordinated muscles are likely to find this sudden increase in pressure more difficult to cope with and, even in the absence of symptoms such as leaking while running, the biggest risk regarding returning to running too soon is increasing the risk of pelvic organ prolapse or dysfunction down the line.
Running is rarely safe to do prior to 3 months postpartum. When considering a return to running, it is always recommended to do so in a graded way – the NHS Couch to 5K program is a fantastic free resource that will help with this. Running should also always be symptom-free; so look out for any symptoms such as and STOP if you feel them:
- A “dragging” or “heavy” sensation in your pelvis/vagina
- Any pain
- Leaking of urine or faeces
With an effective, individualised rehab program you will be able to return to what you love doing; whether that’s a leisurely 5km or a return to marathon training. Specialist physiotherapy assessment is vital to ensure you have the solid foundations necessary to return to running safely. The best place to start with this is to book a Mummy MOT, where we can assess everything we need to in order to give you a structured plan to get you back running again, with peace of mind that you are doing things the right way for your future.
If you are a runner, or would just like to have the option eventually; get in touch to book your Mummy MOT today!