When Can You Safely Run Again After Having a Baby?

Wait at least 12 weeks 
New mothers are typically cleared to return to exercise during their 6-12 week postpartum check up and are advised to return gradually. The advice “return gradually” can be confusing. How much is too much is a common question asked in Pelvic Floor PT. Recovery from childbirth takes time, whether it was vaginal delivery or cesarean. The body has its own timeline for healing. Running is a high impact sport that places a lot of strain on the body. Postpartum mothers need adequate time to heal, so they can regain strength in their abdominal and pelvic floor muscles. These muscles are part of the foundation of muscle innervation for pretty much every single movement or activity. Recent studies have noted that the muscles and soft tissue structures of the pelvic floor continue to heal past the 6-8 week mark and are nowhere near prenatal strength. 

Warning signs 
Many mothers return to running before their bodies have fully recovered and may be asymptomatic. It is also likely that mothers ignore the warning signs, chalking it up to, “I just had a baby and this is normal,” or worse, being told “It’s normal. It happens to every mother.”  Pelvic floor dysfunction is never normal. Seek out an assessment from a pelvic health specialist if you have noticed any of these warning signs: 

• Leaking pee while running (or sneezing or coughing or jumping) 
• Pain during or after intercourse 
• Feeling pressure or bulging in the pelvic area
• Low back pain or lumbo-pelvic pain 
• Doming or separation of the abdominals

What to focus on in the first 12 weeks
Sleep, Nutrition, and Hydration: These are essential for recovery and not easy to prioritize during periods of stress. If given the option, choose sleep over returning to exercise too quickly. Focus on healthy nutrient dense foods to ensure optimal healing, and make sure to stay hydrated.  

Diaphragmatic Breathing: Simple breathing exercises help to establish a core connection and work to strengthen the pelvic floor. A diaphragmatic breath involves contracting and relaxing the diaphragm. As you inhale the belly expands and the pelvic floor relaxes. As you exhale the pelvic floor contracts upward in synergy with the diaphragm, forcing the breath out. Practice 1 x 10 breaths 3 times a day. 

Walking or Treadmill Hiking: Low-impact exercise during the first 12-weeks builds strength, promotes tissue healing, and has enormous mental health benefits. Gentle walking can be resumed whenever ready. Gradually increase walking distance prior to building up intensity. More vigorous walking or uphill walking on a treadmill can be introduced at 4 to 6-weeks postpartum, but keep an eye out for pelvic floor warning signs. 

Build Core Connection: Core strength begins with creating body awareness. Start with diaphragmatic breathing and then progress to deep abdominal activation exercises. Try lying on the floor with knees bent, followed by a slow exhale as you try to draw your abdomen towards your spine. Progress core exercises by adding dynamic movements like bent knee drops, heel slides, or trying core activation while sitting or standing. 

Full Body Strength: Begin introducing gentle body weight strength training around 2-4 weeks. Make sure to include core connection and breath control. If you have to hold your breath to complete an exercise, it is too challenging! This can include squats, lunges, bridges, and light upper body weights. As healing progresses, compound movements and light weights can be added around 6-8 weeks. 

Specific Postnatal Return to Run Requirements If you are at the 12 week mark and are feeling ready to return to running, here is a simple checklist to see if your body is ready. The following criteria should be pain free, no feeling of urgency or pelvic pressure and no incontinence (bowel or urinary leakage)

• Walk 30 minutes
• Single Leg Stance 10 sec bilaterally
• Single leg stance squat 10 reps bilaterally
• Jog in place for 1 min
• Forward bounds: 10 reps bilaterally. Hop (vertically): 10 reps bilaterally
• 20 reps of Single Leg Stance calf raise
• 20 reps of Runner’s bridge
• 20 reps of Side Lying hip abduction  If you can complete the above list without symptoms, you are ready to start running! I would recommend starting with a 4:1 ratio. If 4:1 pain free for 3 times, then move to 2:1 ratio than 1:1 before full 20 mins of running. 

As always, talk with your doctor before implementing anything new to your routine and please reach out to us if you have questions or you feel we can help you on your wellness journey!

phone: (212) 604-1316 | email: info@tula.nyc | www.tula.nyc

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