Now that you have been cleared by your OB at your 6 week postpartum check, it's time to lace up those running shoes and hit the pavement. Or is it?
Are you dying to get back out and start running? Are you ready to shed the baby weight? Do you need to get out of the house for your sanity? Is this the longest you've gone without running? Are you ready to start making healthier choices and running seems like a good way to get started? Before you lace up your shoes, let's take a look at how you should prepare to run after having a baby.
At 6 weeks postpartum, many women are cleared by their OB for all activity. Although this is great news, your body may not be ready for "ALL" activity quite yet. Generally this 6 week clearance means your uterus has healed and any wounds are closed. This does not mean your muscles and joints are ready to take on high level, repetitive activity. Your body has just gone through enormous changes to grow and birth a baby. Depending on how active you were during pregnancy, it may have been several weeks or months since you have done any high level activity. Unfortunately, our bodies don't just bounce back. Just like anything else, it takes some training and steady progression to build up to higher level activity. Yes, running is considered high level activity, even if you don't feel like you are very fast.
Why shouldn't I run yet?
You may be thinking, "But I feel like I'm ready to run" and "Won't running help me get stronger?" Although, these things may be true, if your body is not ready for the demands of running, you may be looking at more problems down the road. You may even be able to go out and run for a few weeks, or months without any noticeable problems. At least not any problems you relate to running. But let's take a deeper look.
Problems that may happen if you return to running too early after giving birth:
Increased vaginal discharge
Back pain
Pelvic organ prolapse
Increased Diastasis Recti
Incontinence - leaking urine
Pelvic pain
SI joint pain
Foot dysfunction - collapsed arches, shin splints, plantar fasciitis
Other problems related to posture and biomechanics
Let's discuss what these are.
Increased vaginal discharge - If you notice any increase in lochia, or postpartum bleeding, this is a sign that your body is taking on a little too much. Use this as a gauge to help you heal.
Back pain - although this is common in many populations, it is important to check this out when you are postpartum and increasing your activity. After 9 months of stretching and changing, your core needs to find it's new optimal positioning. With loss of strength or ability to coordinate movement, the back often takes over as a way to stabilize the spine. This may lead to overuse of back muscle or less than ideal pressure through the spine.
Pelvic Organ Prolapse - this is a descent of the pelvic organs into the vaginal wall. This can occur with the bladder, urethra, vagina, uterus, rectum, or intestines. Often this may feel like pressure or something is falling out. It is caused by a combination of increased laxity of tissue and too much pressure downward on the pelvic organs. Running increases this pressure even more, and so it is unlikely to improve without proper training.
Incontinence - leaking urine. After the first couple of months postpartum, leaking urine is not considered normal. Even if it's just a drop or two. Because running combines higher level forces with a need for good control in single leg stance, and potentially abnormal pressure downward on the abdominal and pelvic regions, it is a major culprit for incontinence.
Pelvic Pain - pain or discomfort anywhere around the pelvic region is something to take note of. This may be caused by weakness in some of the larger hip muscles. When the larger muscles don't do their job, the smaller muscles in and around the pelvis work overtime to stabilize the core. This leads to muscle that are sore and too tight.
SI Joint Pain - the joint between the end of your spine (the sacrum) and the pelvis (ilium) makes up the SI, or sacroiliac joint. Often pain here is from too much movement, or instability, at the joint. This may be due to the still higher levels of the relaxin hormone in your body, or due to general muscle weakness after months of being stretched and not being able to workout at the same level.
Foot dysfunction - collapsed arches, shin splints, plantar fasciitis. Just like your upper body, your feet change shapes and stretch out during pregnancy due to increased weight and hormones. Without proper preparation, these changes can lead to pain and dysfunction at the feet at lower legs.
Other problems related to posture and biomechanics - With the changes your body has recently gone through, your posture and biomechanics have likely changed from your pre-pregnancy body. This means certain muscles don't want to engage the way they used to. Other muscles may be tight or weak and this changes the way your body moves, which could cause pain or injury.
How will I know when I am ready to run?
The answer to this can be a little complex. Current research shows that postpartum women should wait at least 3 months, and maybe 6 months, before returning to running. The reason the answer is complex, is because it depends on your individual situation - What is your exercise history? What kind of delivery did you have? How many pregnancies have you had? What are your genetics? And many other factors.
But that doesn't mean you can't start working toward running. In fact, you should be working toward running, if that is your goal. You should start building strength throughout your body in the weeks leading up to running. Start with the exercises that require the least amount of load, eventually progressing to plyometrics. Progression is based on being able to perform the exercise with good form and without increase in symptoms. If you can not maintain good form or have increase in pain, heaviness, dragging, or incontinence you are not ready to progress to running.
According to Goom, et al. 2019, these are some exercises to help determine if you are ready to run:
Walking 30 minutes
Single leg balance 10 seconds
Single leg squat 10 repetitions each side
Jog on the spot 1 minute
Forward bounds 10 repetitions
Hop in place 10 repetitions each leg
Single leg "running": opposite arm and hip flexion/extension (bent knee) 10 repetitions each side
In addition you want to aim for 20 repetitions of each of the following:
Single leg calf raise
Single leg bridge
Single leg sit to stand
Side lying abduction
As you get back to exercise after having a baby, take note of how your body is feeling and performing. Just because you can do an exercise, doesn't mean you should do that exercise. The best way to avoid future injuries is to build a strong foundation and progress appropriately. Sometimes the process is slow. That's to be expected. Take some time to appreciate how your body has performed over the last several months and honor that by providing the right kind of activity at the right time.
If you're still not sure where to start a good Pelvic Floor Therapist is a great resource to help you get back to the pavement while avoiding problems. Contact Core & Restore Physical Therapy below to get started today!
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