Considerations for return to running postpartum

For many of my clients, being able to return to running is their top goal after having a baby. Running not only provides physical benefits, it also provides mental health benefits which are essential to many parents postpartum. However, without careful consideration of one’s physical and mental condition and without the preparation to prepare the body and mind, running may put one at risk for musculoskeletal injuries and pelvic floor dysfunctions.

In 2019, Goom, Donnelly and Brockewell published their landmark guidelines for returning to running in the postnatal period (up until this point, there was no guideline). Other than suggesting that women should resume running 3-6 months postpartum (at the earliest), these guidelines also suggest a series questionnaires and screening tests which allow physiotherapists to assess the physical aspects of the pelvic floor, the abdominals and the lower extremity in relation to running.

Some of the physical assessments include being able to:

• Do single leg: squat, heel raise, bridge

• Walk 30 minutes without heaviness/bulging in the vagina, leaking, or pain in the low back or pain in the pelvic girdle

• Stand on 1 leg for 10 seconds without feeling unsteady

• Jog one the spot for 1 minute without leaking or pain

• Hop in place 10x/leg without leaking urine or pain

• Do 10 lunges without pain

In addition to these important assessments, they also suggest that we consider the following factors which may put our client at risk for developing injury with running:

💙 Postnatal depression - which may lead to overtraining if running is the only coping mechanism

🤱 Breastfeeding - which may increase the risk of connective tissue laxity (leading to joint injury and pelvic floor dysfunction)

🥱 Sleep Deprivation - which impairs muscle recovery and increases physical and psychological stress

🏃‍♀️Relative Energy Deficiency in Sport (formerly known as the Female Athlete Triad syndrome)- which refers to impaired physiological functioning from excessive exercise, inadequate rest and poor nutrition.

I have seen moms who passed the physical screenings at 3 months postpartum, but start to develop pelvic organ prolapse 3-6 months later. I believe this is due to the risk factors mentioned above.

If you want to learn more about how to return to running safely, please consider consulting with a pelvic floor physiotherapist like myself.

Mia Dang, PT, is a pelvic physiotherapist with extensive supplementary training in pelvic floor physiotherapy and perinatal care