Running after giving birth is a process. When done safely, it can be an incredibly helpful exercise regimen and stress reliever, with both physical and mental health benefits. Whether you were a runner before you had a child or you want to pick it up as a new activity, be sure to consider all of the factors that play into postpartum running.

Considerations for Returning to Running Postpartum

First and foremost: talk to your health care provider. Your exercise routine (past and present), your delivery, and your emotional well-being are all personal to you and can impact your process of getting into postpartum running. For example, weight gain, breastfeeding, and mental state can affect the steps you should take, and women recovering from a C-section birth may have to wait additional time to recover. Post-delivery, your body is readjusting all over again.

General Recovery

Before you can get back into running—or any type of exercise—you need to go through general recovery from giving birth. This will vary depending on if you birthed vaginally or had a c-section. Either way, you'll likely experience heavy vaginal discharge called lochia that is comprised of blood and mucus membrane, and wearing pads will be necessary. Cramping is common and can be painful. If you had any stitches, that area will be sensitive. Pain and soreness is to be expected. Trying to jump back into exercise while your body is still trying to recover is dangerous and not advised.

Hormone Shifts

Your hormones will also be in flux so you may not have proper stability, leading to orthopedic issues such as low back pain or unstable joints due to relaxin released during pregnancy.

One thing that also may affect returning back to running is the presence and/or severity of Diastasis Recti. It is common knowledge that we are all in need of core stability for exercise. If you have a Diastasis, you will not be able to properly provide support to your joints and posture.

Diastasis Recti is the separation of abdominal muscles during pregnancy. Specifically, with Diastasis Reci, the distance between the rectus abdominis muscles at the midline of the body increases, which can cause weakness and bulging in the abdominal muscles, back pain, and urinary stress incontinence.

Breastfeeding

Breastfeeding also impacts your return to running, but it doesn’t have to impede you. Breastfeeding does not have to limit one’s ability to participate in an exercise or running program. Regular aerobic exercise in lactating women has been shown to improve maternal cardiovascular fitness without affecting milk production. A supportive bra is key—some women may benefit from a personally fitted sports bra offering compression. Adapting the baby’s feeding or pump schedule may be something to consider as well. Some of my patients report they like to pump before running.

Ultimately, your health care provider will be able to help get you on a safe path to postpartum running; however, you will have to continue listening to your body.

When Can You Start Running Postpartum?

The timeline for running after giving birth is not linear because it depends on the individual. Some research has suggested that running and other types of exercise after giving birth have positive effects. Physical activity can be an essential factor in the prevention of depressive disorders in women in the postnatal period. Some experts say that 4 to 6 weeks postpartum is safe, assuming clearance from your doctor. Other providers recommend that postpartum women wait a minimum of 12 weeks before returning to higher intensity exercises like running.

The timeline for returning to running after giving birth is not linear because it depends on the individual. Some medical professionals and OB-GYNs give the green light at 4 to 6 weeks postpartum; however, many pelvic floor specialists advise waiting until 12 weeks postpartum to return to running.

All three pelvic floor specialists who contributed their expertise to this article advise waiting 12 weeks. Kristin Sapienza comments, The first 12 weeks after giving birth, the body is still undergoing significant changes due to hormonal levels fluctuating wildly, muscular length changes, body composition, and weight distribution changes. Running is a higher impact activity that places a lot of stress and load on the body. There needs to be adequate time for the body to heal and regain strength in the core, more specifically in the pelvic floor. In order to be confident your body is ready to meet the high demands of running, a screening performed by a pelvic floor specialist is crucial. You need to be able to walk before you can run!

This doesn’t mean you need to lead a sedentary life in the first three months of your child’s life. Lower impact postpartum exercise is generally permitted and even recommended. Kristin suggests walking and moderate stair climbing.

Postpartum Running Preparedness Self-Test

Although every person is different, generally speaking, you may be able to gauge your strength and preparedness to run after the three-month mark by doing these actions without pain or discomfort.3

1. Jog in place for 1 minute.
2. Balance on each leg for 10 seconds.
3. Hop on one leg 10 times without losing your balance.
4. Perform the “running man” (standing opposite arm and leg extension) 10 times on each side.
5. Do 20 each: calf raises, sit-to-stand movements, and a bridge while lying on your back.

When To Stop

Even if it’s been three months, you’ve been cleared by your doctor, and you’re mentally prepared to get back on the road, trail, or treadmill, your body may have other ideas. If you feel any leaking, pain, or prolapse symptoms (pressure in your vagina or rectum like something is going to fall out), then stop what you are doing. Pushing too fast or too far can be traumatic to your body, even if you think you are ready.

Signs That Your Body Isn't Ready For Postpartum Running

• Urine leakage
• Musculoskeletal pain
• Heaviness or dragging
• Prolapse symptoms (pressure in vagina or rectum like something is going to fall out)
• Vaginal bleeding
• Shortness of breath
• Visual changes
• Pressure in the chest or upper abdomen
• Swelling in legs

There are both obvious and more subtle signs that your body isn’t prepared for postpartum running. Some red flags to be aware of are vaginal bleeding, shortness of breath, visual changes, pressure in the chest or upper abdomen, or swelling in legs. If you are experiencing any of these signs, you should stop and immediately reach out to your doctor for further evaluation.

However, you shouldn’t expect to jump back into running at the same pace as prior to your pregnancy; there will be a period of getting your stride back. Mild soreness and musculoskeletal pain which resolves itself over a day or so can be expected, however, significant musculoskeletal pain, heaviness, or dragging may be indicative that training duration or intensity needs to be reduced.

Be sure to slowly build back training duration or intensity. Starting out too hard or too fast may result in set backs. Many women who ran prior to and during pregnancy may be able to start with shorter duration runs. Women who did not run during pregnancy or prior to pregnancy may want to start with short durations of walk/run intervals.

Tips for Slowly Building Back Mileage

Getting back into running (or starting for the first time) after giving birth is a process: it is not a marathon or a sprint. You’ll have to work at it to build back your endurance and speed. This process can take time. Here are X tips for building mileage back slowly (and smartly).

Walk Before You Run

When you're medically approved to return to running and feel good with low-impact exercise like walking, start slow. Start slow (think a couch to 5k training program) and only progress to the next phase when you are able to run that amount without symptoms.

Prioritize Core and Pelvic Floor Strengthening

Strengthening the core and the pelvic floor is incredibly helpful for prepping the body to return to running. The pelvic floor is made up of a group of muscles that form a sling from the front of our pubic bone traveling back to attach into our tailbone. These muscles are responsible for bowel/bladder control, core strength, support of organs, sexual functioning and proper lymphatic circulation. When you are moving throughout the day, these muscles are constantly adjusting to accommodate for that pressure change and load transfer. This is why many mothers experience urine leakage during running, jumping, coughing, and sneezing. While leakage is nothing to be ashamed of, improving your pelvic floor will help make your running experience much more comfortable.

If these muscles aren’t doing their job, there can be decreased motion, mobility, fatigue, weakness, and even increased load going through your joints contributing to degeneration. After having a baby, pelvic floor dysfunction is very common regardless of delivery type. Pelvic floor strengthening is only helpful if done correctly. Most people need instruction and supervision to be able to perform a correct pelvic floor muscular contraction. Kegels, while well-known, aren’t the solution to every pelvic floor problem, and can even be counterproductive. It’s important to speak with a specialist instead of self-diagnosing.

Practice Proper Running Form and Breathing

Moving with proper form and breathing techniques are also important for getting back into running shape. While many types of exercise recommend breathing in through the nose and out through the mouth, this may not provide enough oxygen during aerobic activity like running, particularly at a quicker pace or when getting back into the practice after a hiatus. Running often requires a combination of nose and mouth breathing to deliver enough oxygen.

Practicing diaphragmatic or deep belly breathing can also help make your breathing more efficient while running. It is best to practice this a few times a day while lying down before progressing to doing it sitting or standing, and then it will help you breathe more efficiently while running.

Running form is much more than just the way you look. The way you carry your body while running makes the workout safer and more effective. In addition to how you place your feet, proper running form includes your posture, the way you hold your arms and hands, and even where you look as you run.

Consider working with a running coach who can help with these things if you feel like you need more assistance to be comfortable.

Incorporate Cross-Training

Regardless of your form or the strength of your pelvic floor, it’s very important not to overdo it. Consider an interval exercise, moving between walking and running. Alternate running days with non-running days—if you want to be active, you can do yoga, lift weights (another exercise that shouldn’t be done until 12 weeks and clearance by a doctor), or keep your pace to a walk.

Wait Before Breaking Out the Running Stroller

Some mothers also use running as a time to bond with baby. Running with a child in a stroller is not generally recommended until the baby is 6 to 8 months old and can hold their head up. Kelly recommends seeking guidance from a pediatrician with specific concerns, and suggests, a nice feature of a jogging stroller would be a ‘leash’ that connects you to the stroller (you loop it around your wrist and the other end is on the handle), so you can push the stroller out a few feet in front of you and then catch up. The leash would make sure you have control over the stroller for safety while maintaining as normal of a running form as possible.

Source: How to Safely Return to Running Postpartum (verywellfit.com) by Meredith Hirth, June 15, 2022