How to Start Running After Baby According to Physiotherapists

If you’ve had a baby in the last year or so, you may have noticed by now that there aren’t a lot of nuanced guidelines for getting back to your exercise routine. At your 6-week check up, you’ll probably get the green light from your doctor to start working out again. The American College of Obstetricians and Gynecologists gives a general guideline of engaging in moderate-intensity aerobic activity, like brisk walking or cycling on a level surface, for 150 minutes per week. Want to do something more intense? Check with your doctor.

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Running is a unique activity because it is high impact and therefore doesn’t quite fit into the general guidelines. Realizing that information for moms who wanted to get back out the road was lacking, a group of physiotherapists from the UK, Tom Goom, Grainne Donnelly and Emma Brockwell, created recommendations for postnatal running based on quality research and field expertise. They published “Returning to running postnatal guidelines for medical, health and fitness professionals managing this population” in March, 2019.

In the report, they first point to the impact running has on the pelvic floor. “High-impact activity, such as running, is associated with a sudden rise in intra-abdominal pressure” (Leitner et al. 2016), it can also cause “ground reaction forces of between 1.6 and 2.5 times bodyweight” (Gottschall and Kram 2005). The authors assume that this force is being absorbed solely by the pelvic floor. Because of this, the specialists’ first recommendation is for all women to get an individualized assessment of the pelvic floor after childbirth.

It is very common for women to experience “musculoskeletal pain, urinary incontinence, abdominal separation and pelvic organ prolapse,” after having a baby. These conditions can make a running program unmanageable, which is why the physiotherapists advise that women should wait until 3 months postpartum and after getting a screening for pelvic floor issues to resume running. They also advise that doctors should consider other factors such as weight, fitness, breathing, psychological status, Diastasis Recti, breast support and feeding, and RED-S before giving the OK on a return to running.

The authors list the following as risk factors for potential issues when returning to running postnatally:

  • Less than 3 months postnatal

  • Pre-existing hypermobility conditions

  • Breastfeeding (due to increased joint laxity and injury risk)

  • Pre-existing pelvic floor dysfunction or lumbo pelvic dysfunction

  • Psychological issues

  • Obesity

  • Caesarian Section or perineal scarring

  • Relative Energy Deficiency in Sport(Red-S)

  • Sleep deprivation

Once you’ve worked with your pelvic floor specialist and doctor to determine your ability to get back into your running shoes, the physiotherapists recommend starting back into your running program slowly, taking walk breaks if necessary. They also recommend running with a jogging stroller, but note that it may cause changes in the trunk, pelvis and hips.

This is my favorite jogging stroller, in case you’re in need.*

They do not advise resuming a running program if you experience the following symptoms:

  • Urinary and/or fecal incontinence

  • Pressure/bulge/dragging in the vagina

  • Vaginal bleeding during or after exercise

  • Pelvic pain

If you are experiencing any of these symptoms, check in with your doctor.

Get the full report here.

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