Welcome to the three part series on ‘When is it safe to run after having a baby?’ This is the first of three blogs that will open up the discussion about some of the things to consider before returning to running after having a baby.
Is the regularly given timeline of six weeks after having the baby safe enough for your pelvic floor and pelvis to run on? Well there is good news! There have been new guidelines that have been released from international leading physiotherapists who have special interests in running and the postnatal population. This document is one of its firsts looking at the most current clinical research as well as expert opinions. So what are the recommendations?
When is it safe? Well the simple answer is, it depends. First of all, are there any current or previous issues of incontinence, prolapse or pelvic pain? If the answer is yes there needs to be extra caution taken before going back to a pelvic-floor-intensive-activity such as running. Because you have carried a baby for 9 months or so, it is recommended that before taking on running, that a pelvic floor assessment is completed to ensure there is minimisation of the risk of prolapse or incontinence even if there are no current issues. Proper rehabilitation of the pelvic floor muscles needs to be undergone to ensure the pelvic floor can undergo the demands of running. This is especially so if there is incontinence, prolapse or pelvic pain issues. A pessary or continence aid like specialised running shorts are also options where stress incontinence or a prolapse can be better supported while you run.
The general guideline given in this document is to wait 3 months after having a baby before running. Of course, this depends on your rehabilitation of your pelvic floor whether you can go sooner rather than later or later rather than sooner. Breastfeeding is also a factor that can affect your pelvic floor. The hormonal effect of breastfeeding tends to give less support for your tissues that hold up your bladder and organs, hence increasing the risk of incontinence and prolapse. If anyone does decide to commence running and there are symptoms of incontinence, prolapse or pain, it is strongly recommended that you cease running and see a pelvic floor physiotherapist. It doesn’t mean you can never run again, but there are treatment options that can get you back to running safely without detriment to your pelvic floor.
Things that a pelvic floor physiotherapist will look at are pelvic floor strength, pelvic floor support, pelvic floor loading, strength testing of your other muscle groups like your gluteals, how you breathe, abdominal separation and running technique. She may look at any wounds like perineal tears or your Cesarean scar. Scar tissue from these wounds can impact on how the muscles around it glide and contract. Scar mobility is important to enable proper function of muscles and nerves. Sleep is very important to enable your muscles to recover from the day’s demands. Lack of sleep can fatigue your muscles and open yourself to injury when returning to running. This needs to be balanced with the needs of mental health, especially when mothers often need the physical outlet of running to feel mentally strong. Post-natal depression occurs in 20% of mothers and needs to be supported in conjunction with appropriate physical activity such as meditation and counselling.
Stay tuned for the next blog that will talk about when is it safe to run with the baby in the buggy and the last blog in the series will discuss further what functional tests can be used to help decide whether you are ready to go back to running or not.
Reference: Returning to running postnatal- guideline for medical, health and fitness professionals managing this population. Authors: Tom Goom, Grainne Donnelly and Emma Brockwell March 2019.