Returning to running after birth isn’t just about fitness, it’s often about reclaiming a part of yourself, but it’s important to approach it carefully to support your body’s recovery.
We’ve put together some of the most commonly asked questions and looked at the research to provide you with the best answers.
What are the risks of returning to running too soon after birth?
Something all runners should be aware of firstly, is that even though you ran before birth and often through
pregnancy, and your head feels ready to return, your body may not be ready. Think about your pelvic muscles, the organs in the pelvic region, the nerves, tendons, ligaments and connective tissue.
All of these structures need time to heal and the reason you get told time and time again to ‘wait until your 6 week check up’ is because this is the minimum time it takes to heal from soft tissue injuries.
Your body has to stop bleeding, clear the damaged cells, build new tissue to fill any ‘gaps’ / tears and strengthen the damaged tissues by remodelling it into scar tissue. If you do any ‘vigorous’ exercise before this you could potentially disrupt this process and prolong the healing time, leading to injuries, pelvic health issues and pain.
What conditions could returning to running after birth too soon lead to?
- Pelvic girdle pain
- Low back pain.
- Urinary incontinence.
- Abdominal rectus diastasis.
- Pelvic organ prolapse.
When can I start running again?
Research suggests that it is less about time when returning to running after birth, and more about strength and fitness levels. Delphi consensus recommends a minimum of 3 weeks after childbirth prior to return-to-running but only following a period of relative rest and a gradual progression of cardiorespiratory fitness and strength training. If you have any signs of pelvic issues then allow more time for these to resolve first.
Natural birth guidelines:
Guidelines generally suggest that recovery of the pelvic floor muscles (levator ani and associated connective tissue) is thought to be complete by four to six months postnatal, although unrestricted clearance to activity is typically obtained well before this point with caution, always bear in mind that the healing process is still taking place during this period so you will be more vulnerable to injury. Therefore, four months postpartum would be a good aim to return to running if you are symptom free.
A study looking at elite and sub-elite athletes concluded that a return to running in the postpartum period is a highly individualised process which must take into account nutrition, core and pelvic floor function, bone reloading, muscle and tendon reloading, and breastfeeding care when applicable.
Caesarean birth guidelines:
With caesarean section delivery, uterine scar thickness is still increased at the six-week postnatal point indicating continued remodelling (still healing), despite the fact that many women are told that they may begin unrestricted activity at this point. There is also evidence of notable pelvic floor dysfunction, including weakness and difficulty with coordination, still present at the 6 week mark, following caesarean sections. Therefore return to running after surgery or large tears where scar tissue might be abundant will take longer and should be done with additional caution. Consider return to running after 7 months following a C-section (if you remain symptom free).
Guideline summary;
You could consider some light exercise at 3 weeks, like walking, Postnatal Pilates and resistance band training (following an uncomplicated delivery). Building strength and cardio endurance gradually from 6 weeks, this could include treadmill work (on an incline), swimming, light weights and more advancing Pilates. If you had a caesarean section then consider building your strength from a slightly later stage at 7-8 weeks. Aiming to return to running between 4-6 months (if you are symptoms free with no pelvic health issues).
If the option is available to you, then please have a Women’s Health Specialist Physiotherapist check you over and guide your return to sport.
It is also worth noting: studies have shown that, when prescribed appropriately, performance of deep core exercises during pregnancy results in significantly fewer incontinence symptoms during late pregnancy and the postpartum period.
How to spot signs of pelvic health issues early?
These are symptoms you might notice during or after pregnancy. The sooner you get the symptoms assessed and treated, usually the better the outcome:
- Leaking in your underwear (urine or faeces)
- A sudden urge to go to the toilet with no prior warning
- A feeling of heaviness or dragging in your pelvic or vaginal area
- Pain during sex that is new
- Abdominal doming (abdominal separation)
- Lower back pain
- Pelvic pain, either above your buttocks or around your pubic bone
If you have any of these symptoms, whether running or not, seek medical advice.
What can help speed up my recovery?
There are lots of things that can help you recover from your birth, whether it was ‘natural’ or caesarean section, but healing takes time and no one can speed that initial part up for you, soft tissues have to go through the bodies healing phases and that is a process our bodies are good at – if left to it and supported correctly. So TLC is best in your first 6-8 weeks along with exercises like Kegels / pelvic floor strengthening (read more about that here) plus you could consider introducing some yoga / Pilates (as long as it is specific to postnatal recovery, check out our recommended online programmes for yoga and Pilates).
Check out our research into c-section recovery aids here.
We have a page on research into recovery aids following an episiotomy here.
Also have a look at our research into recovery following a tear during birth here.
Can I run while Breastfeeding?
Of course you can, there are just a few additional things to consider when you are breastfeeding.
- It can be uncomfortable. Try to time runs for immediately after a feed / or after you have expressed to give you the biggest window of reduced ‘fullness’.
- You are at a slightly higher risk of injuries like stress fractures and tendinitis. Changes in hormone and calcium levels in breastfeeding mums can cause temporary bone loss.
- Sports bras are a must! The development of breastfeeding friendly sports bras has come on a lot in the last few years, do some research into this as it can quickly become your best item of clothing (and one of the most expensive).
- You will need to drink more water than you used to. Both exercise and producing milk requires extra fluid so drink before and after (or take a camel pack with you like these).
Should I get a Physiotherapy assessment even if I have no symptoms?
Physiotherapy isn’t just for people with injuries. Women’s Health Specialist Physiotherapists are trained to give
full assessments to check that everything is working as it should be and give advice on what to look for that might not be ‘normal’. They can also advise you on your own personal return to running plan and advise you on the most appropriate exercises to suit your own personal recovery needs. Have a look for a qualified Women’s Health Specialist Here orHere.
Returning to running after birth: What is the best way to get back to it?
First and foremost start slow.
- Walking with your pram will be one of your first activities post birth. Have a look at our ‘sporty prams’ guide here. Initially plan short flat walks then progress to walks with some inclines.
- After your initial healing phase, introduce some exercises with your pram (lunges, squats, and faster walks / inclines), read more on this here.
Invest in equipment:
- Look for suitable sports bras and PLEASE invest in good trainers (this is essential as bad trainers can cause lots of different issues including plantarfasciitis, hip and lower back issues).
- Consider abdominal binder or support if you feel weak or like you need some extra support initially but this should only be used along side a good exercise regimen.
- Invest in a really good all-terrain pram / stroller. Check out our favourites here.
Get checked out by an expert (invest in YOU):
- Once you’ve had a check up and feel you are symptom-free – introduce some light jogging without the pram (this will build strength in your back and abdominals without relying on the pram for the additional support).
Build up gradually:
- I would advise continuing only with hill walks and fast paced walking for the first 6 months when using the pram as it is not advised that you should run with a baby until they are past 6 months of age.
- Introducing runs with the pram/ stroller at 6 months (once you’ve built some fitness) is such a good way to add extra challenges to your runs and build on your fitness as the weight of the pram provides resistance and weight.
Conclusion
Take your time returning to running, there are many benefits to taking it slow, in the long run you will be better off. Listen to your body and if anything doesn’t feel ‘right’ then get it check out.