Return to Running Postpartum
I am excited to have Montana DePasquale as a guest blogger! Montana is a private running coach who has coached women training for their first run as well as women training for their fastest runs. Recently, Montana has added pre and postpartum strength coaching to her offerings. Montana and I have similar views on the importance of taking a whole person approach to health and wellness. We also both believe in the importance of long term goals with fitness/exercise. You can find Montana at www.apres-run.com You can also follow her @montana.depasquale
Returning to Running Postpartum: How to Do it Safely, and What New Research Says
Prior to getting pregnant, I had no idea how many considerations went into returning to running postpartum. It should be pretty much like returning from an injury or extended time off from running, right? Wrong.
Now I'm working towards my Pre- and Post-Natal Fitness Certification because I've learned not only is there such a gap in the medical system about postpartum care, but there's also not a lot of running coaches who are specialize in this, or are actually up-to-date on the newest research.
In 1967, Katherine Switzer ran the Boston Marathon as the first woman ever to complete the distance in a sanctioned event. Before that, it was thought that a woman's uterus would fall out if she ran long distances. Now, increasingly more women are lifting, training for endurance events, and pushing their bodies in intense ways. And this includes pregnant women, and women who've had babies.
Finally, research is being done on these populations, and antiquated myths about what is safe (or not safe) is giving to way to empowering, evidence-based information about women's bodies across their lifespans. Recent findings suggest that women can safely handle a lot more (and more vigorous) activity while pregnant. However - findings also show that postpartum recovery is a lot more complex and lengthy than previously thought. This period should be treated with seriousness, respect, and a careful, periodized return to activity.
It's estimated that 85% (AKA the majority) of women will have a baby at some point in their lifetime. Even if you don't have kids or don't plan on having kids, maybe you know a runner in your life who is pregnant and recently postpartum. I hope you'll share this blog post with them so we can keep spreading good information out there!
What you need to know about returning to running postpartum
1. The new recommendation: 12 weeks vs. 6 weeks. 6 weeks after having a baby, a woman has her one and only postpartum doctor's appointment. There she'll either be cleared for exercise or not - and it's made out to be as simple and straightforward as that. As you can probably imagine, it's usually not quite that black and white. At 6 weeks postpartum, most women are not ready for a complete return to physical activity. While walking and some strength training may be fine, high-impact exercise like running requires longer recovery.
In March 2019 a groundbreaking new study was released by PTs in the UK. Their research found that at 6 weeks postpartum, the soft tissues are just finishing their healing process from birth and are still far from prenatal strength. For women who have a C-section, recovery is even longer, as the uterine scar is still thickening (AKA healing) at this time.
Tom Goom, Grainne Donnelly, and Emma Brockwell released a comprehensive set of guidelines for a graded return to running after having a baby. It's extremely in-depth, and Jen and I break those guidelines down here.
Will every woman need to wait a full 12 weeks before returning to running? No - some may be able to run earlier than that and be fine. But this is the new recommendation, and the protocol I now use with all postpartum women I work with. (Side note: You can read more about my run coaching here!)
2. Enlist the help of a really good pelvic floor PT. Clearly there are some gaps in our current medical system for new moms. Besides for a great OB, I highly recommend all women find and work with a pelvic floor PT postpartum. Nothing can replace getting a hands-on assessment of how your pelvic floor really fared after birth, what state your core is in, if you have any ab separation, if there are any other issues you should be aware of, etc. Obviously I'm biased, by I highly, highly recommend Jen for women in the Rhode Island area. If you're not native to Rhode Island, www.pelvicguru.com is a great directory for finding pelvic floor PT providers.
3. These things are no-gos. Turns out, the health of your pelvic floor is a really good indicator of the readiness of your body to resume or advance training. Know what symptoms and sensations are red flags and mean you need to scale things back. These include:
An increase in bleeding (if you're still bleeding post-delivery), or a return of bleeding (if you're not)
Urinary or fecal incontinence (peeing yourself when you run is NOT just a "normal" thing that happens to women who've had babies)
Urinary or fecal urgency that is difficult to defer
Heaviness, pressure, bulging, or dragging in the pelvic area
Pain with sex
Obstructive defecation
Persistent low back and/or pelvic girdle pain
4. Don't trust anyone who speaks in absolutes. You will hear a lot of polarizing information about training during the pre- and postpartum period. Clickbait-y blog titles and captions that say "Why You Should Never Do ____ Postpartum" or "10 Things All Women Should Do After Having a Baby" are very trendy - but it's almost never an all or nothing situation. Everyone will be different. Every individual pregnancy, labor, and recovery will be different. This is because there are SO many factors that go into a woman's readiness to exercise postpartum - including but not limited to: birth trauma/outcome, sleep status, breastfeeding status, how active they were pre-pregnancy, how active they were during pregnancy, their genetics.
You may see women running 2 weeks after having a baby and claiming they have no issues. You may see women running marathons 4 months after having a baby and seemingly crushing it. That may or may not be right for them, and they may or may not have issues from that down the road. Working with a pelvic floor PT, following real, evidence-based guidelines, and committing to a smart, patient return to running (with no shortcuts) will ensure you ultimately have the smoothest and best recovery for YOU.
5. Postpartum is a great time to add strength training to your routine if you don't already. Getting physically stronger has so many amazing benefits for runners. It can help you to get faster, more powerful, more efficient, more resilient to injury. It also has so many amazing benefits for moms - and women in general. Lifting weights builds muscle (which is active, calorie-burning tissue). It builds bone (which prevents stress injuries, and prevents osteoporosis as you age). It's also enormously functional. Being a new mom means bending over, squatting, and carrying a 6-10 pound baby all day long. Not to mention heavy carseat and play equipment, diaper bags, groceries, and mounds of laundry. Getting your trunk and 'prime mover' muscles strong will help prevent back pain and other ailments that plague new moms. And lastly - it will be a tremendous asset in your postpartum recovery overall, getting you feeling 'back to normal' more quickly than other forms of activity.
In conclusion...
Depending on how your pregnancy and birth went, you may be very eager to return to running postpartum. I get it. If you were able to run through your pregnancy, you will probably be very eager to feel what running without carrying a 6-10 pound medicine ball out front feels like. Still - do NOT rush it. It's just not worth it, I promise. The risks of returning to running postpartum too quickly? Not only bleeding, cramping, pain, and/or leaking… but your pelvic organs can quite literally fall out of your body. (This is known as pelvic organ prolapse, or POP.)