Returning To Running After Having A Baby

If you just had a baby and enjoy staying active, you may wonder when you can safely return to running and other types of exercise. Kendall Seiler, PT, DPT, an orthopedic physical therapist specializing in pelvic health at Franciscan Health Indianapolis, provides some guidance to get you moving again after having a baby.

Key Takeaways: Running After Pregnancy

• Allow time for recovery. Because pregnancy alters the core, abdomen and pelvis over nine months, expect to give your body at least nine months to fully bounce back. Light exercise like walking is fine early on, but full recovery requires patience.
• Wait 3 to 6 months after pregnancy before restarting running. Postpartum women should generally wait 3 to 6 months after delivery before resuming high-impact running. This timeline applies provided you are entirely free of pelvic floor dysfunction or other post-birth complications.
• Stop running immediately and consult a physician if you experience red flags like urinary/fecal urgency, pelvic pressure, back or pelvic pain, or abdominal separation (diastasis recti). Listening to these body cues prevents long-term joint and muscle issues.
• Seek professional PT guidance. A specialized physical therapist can assess your core stability, lumbopelvic strength, and overall movement before you log miles. They can also provide guidance on proper nutrition and fitting resized gear, like new running shoes for feet that expanded during pregnancy.

Pregnancy And Your Body

Pregnancy and childbirth can have a significant impact on your body, including your abdominal wall tissues, skeletal muscle and connective tissue on  the pelvis. The fourth trimester, also known as the 12 weeks after the mother gives birth, is an important time to let your body heal and regain strength.

"Pregnancy and childbirth have such a significant impact on the body," said Seiler. "Your muscles, abdomen, pelvis, everything changed. If it took nine months for your body to change to accommodate a growing baby, you should expect to give your body at least nine months to return to normal."

Before Restarting Routines

Your exercise level before pregnancy and delivery should be considered when returning to exercise after having a baby. If you weren't training for marathons prior to pregnancy and childbirth, don't let that be your first go-to exercise postpartum.

But that doesn't mean you should lace up your shoes for a jog just yet.

Meeting with an experienced physical therapist is a great way to determine if you can safely return to running or other high-impact exercise. Pelvic health physical therapists at Franciscan Health are specifically trained to treat pelvic floor dysfunction and evaluate and treat joint dysfunction, muscle tightness, and muscle weakness that affects the function of the pelvic floor. They will conduct a thorough evaluation and develop a plan to get you back to your exercise goals. Your physical therapist will talk with you about your childbirth experience, past medical history, and psychological and physiological health. 

The physical therapist will assess your:

• Musculoskeletal system, including your back, pelvis, and hips
• Flexibility of muscles
• Strength of lumbopelvic muscles including core, hips, and pelvic floor

Once you begin exercise or running, you can continue to work with a physical therapist who can also help you safely and gradually increase your running stamina or exercise intensity. Your physical therapist also can provide tips on getting adequate nutrition during the postpartum period especially since exercise results in higher energy expenditure.

They can also recommend sportswear and clothing to support your still-changing body. For example, a physical therapist can help make sure your exercise shoes fit correctly since many women's feet grow during pregnancy. You'll want to use a supportive yet not compressive sports bra during physical activity.

Returning To Running Postnatal Guidelines

These signs and symptoms of pelvic floor or abdominal wall dysfunction indicate seeking medical treatment:

• Urinary and/or fecal incontinence
• Urinary and/or fecal urgency
• Heaviness or pressure in pelvic area
• Pain with sexual intercourse
• Difficulty with defecation
• Diastasis recti
• Lumbopelvic pain

Before 3 Months Postpartum

In the first few months after giving birth, most moms women can engage in light to moderate exercise, such as walking. Return to running is not recommended prior to 3 months postpartum or beyond this if experiencing any of the previously listed symptoms of pelvic floor dysfunction. 

As long as your doctor hasn't advised you not to exercise, you can try the following:

• Deep breathing
• Bridges and clamshell exercises
• Walking or other light cardio such as cycling or elliptical
• Body weight squats and lunges
• Standing on one foot to build strength and balance

If you begin to exercise after having a baby and experience any of the symptoms below, listen to your body and stop. Consult your doctor as you may need to seek medical attention.

Symptoms of pelvic floor dysfunction include:

• Diastasis recti (separation of the "six pack" abdominal muscles during pregnancy)
• Difficulty having a bowel movement
• Heaviness or pressure in the pelvic area
• Lumbopelvic pain (pain in the lower back and pelvis)
• Pain during sexual intercourse
• Urinary or fecal incontinence (inability to control)
• Urinary or fecal urgency

3 to 6 Months Postpartum

"In general, postpartum women can return to running three to six months after giving birth - as long as they aren't experiencing any pelvic floor dysfunction symptoms or other abnormal issues," said Seiler.

Return to running is recommended to start between 3-6 months postpartum and after an individual has passed specific tests directed by a physical therapist that evaluate walking, single leg balance and strength, and strength of abdominal muscles and key hip muscles. If a woman is at least 3 months postpartum and has passed the testing that is recommended in the Return to Running Guidelines, it is appropriate to plan a graded return to running exercise program.

6 to 9 Months Postpartum

At the 6 to 9 month mark, you may be able to introduce running with a buggy. Buggy running should not occur until the baby is between 6-9 months old to protect the baby’s neck and spine.

If you are considering running with a buggy, it is recommended that the buggy follows the following settings:

• Five-point harness for the baby
• Fixed front wheels
• Hand-operated breaks
• Rear wheel suspension
• Pneumatic tires
• 3 wheels
• A wrist strap

Find Support From Franciscan Health

Work with a qualified PT at Franciscan Health to help you safely return to running after having a baby.