Written by Mariam Kilpatrick - Physio, Clinical Pilates Instructor, Mum and Ultra-marathon runner
One of the most common questions I hear from new mums after giving birth is, “When can I start running?” A fair question, as it’s one of the simplest forms of exercise to fit in around your baby, no gym membership required and a good way to burn off that extra baby weight. We’ve all been there.
There are however some important things to consider in order to safely return to running and any other high impact exercise after having your baby. Returning too soon can cause long term implications causing pelvic floor dysfunction, pelvic girdle pain and other musculoskeletal issues. This usually happens because you haven’t adequately rehabilitated your body following the huge stresses placed upon it during pregnancy and childbirth. Giving birth (either vaginal or C-section) can be considered equal to a major sports injury which would require the same attention, specific rehab and a graded return to any sport. It is just as important to work on muscles affected by pregnancy and childbirth (such as the pelvic floor and abdominals) as it is to work on the muscles around your knee if you’ve had a knee injury/surgery.
My baby is 6 weeks old now so I’m good to go…right?!
Healing of the body after childbirth goes well beyond the traditional 6-week timescale that many health professionals go by.
Did you know…
The levator hiatus, the opening between the levator ani muscles (which forms part of your Pelvic Floor) stretches and widens significantly during pregnancy and childbirth. This can take between 4-6 months to recover (Stær-Jensen et al 2015)
After a C-section, the abdominals only regains 50% of its original strength by 6 weeks postpartum and 73%-93% of original strength by 6-7 months postpartum (Ceydeli et al 2005)
Up to 30% of first time mums will experience urinary incontinence (Milsom et al 2004)
Up to 56% of new mothers between 3-6 months postpartum demonstrate pelvic organ prolapse where one or more of the pelvic organs (bowel, bladder or uterus) descends downwards to the vaginal opening (Bø et al 2017). This can result in incontinence issues and the feeling of heaviness/dragging in the vagina.
You can’t go wrong with strong!
Your Pelvic Floor is a hugely important part of your body. It is made up of layers of muscle and connective tissue. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in the front. They support your pelvic organs and control your bladder and bowel movements. The front passage (pee hole), the vagina and the back passage (poo hole) all pass through the pelvic floor muscles. Throughout your pregnancy, your pelvic floor has carried the weight of your baby, the placenta and a 50% increase in blood volume! As such, this will greatly affect its ability to do its job properly compared to pre-pregnancy function. It is therefore vital to work on these muscles after having a baby, regardless of the type of birth you had (whether vaginal or C-section).
In the latter stages of pregnancy, the connective tissue or fascia between your outermost abdominal wall (your six-pack muscles) can thin out/stretch to allow for a growing baby bump. After giving birth, you can be left with a gap between the two sides and sometimes it can look like you are still pregnant i.e. the dreaded “mum-tum”. This is called a Diastasis Recti or abdominal separation, a common condition that causes a lot of grief for many mums. However, like any muscle in the body, these can be addressed and worked on with specific corrective exercises targeting your deep abdominals.
When you are running, multiple times your body-weight in the form of ground reaction force is produced on impact with the ground. This has to be absorbed and controlled by the tendons, muscles and joints in the legs. Strengthening the muscles of the lower legs and core help prevent injury and increase the muscles’ load bearing capabilities.
Guidelines for postnatal exercise progression
Week 0-2: Walking, pelvic floor muscle strength and endurance exercises, basic abdominal exercises
Week 2-4: Introduce functional body weight exercises such as squats and lunges
Week 4-6: Introduce low impact cardio such as static bike, rowing machine or X-trainer
Week 6+: Progress to resistance training such as Pilates for pelvic floor/core and weights training
Week 12+: Graded/progressive return to running (e.g. Couch to 5K)
Some expert physiotherapists have developed a free guidance to help health and fitness professionals who work with postnatal runners which can be found here.
Postnatal Pilates
Pilates is a great form of rehabilitation to target the working relationships of your pelvic floor and core muscles (abdominals and diaphragm) especially in the first few months after having your baby. The benefits of Pilates include:
Strengthening your Pelvic Floor
Targeting your deep abdominal muscles to help heal Diastasis Recti (abdominal separation)
Addressing muscle imbalances that may be contributing to lower back pain or pelvic girdle pain
Targeting postural muscles of the back, neck and shoulder girdle
Postnatal Pilates Class at Physio Effect
Pilates for Runners
Try these free sample routines for strengthening your legs and gluts:
Pilates legs workout
Pilates Gluts Workout
We Want To Help You Get Your Body Back On Track
Physio Effect specialises in helping mums recover their health, fitness and confidence after having a baby. Our Cry-Baby Pilates classes where new mums attend with their babies has been a great success and very popular!
Want to read some REVIEWS about our classes from other mums? Click the links & read below: Yell.Com Reviews or Facebook Reviews
The cry baby Pilates classes led by Mariam were an absolute highlight of my maternity leave. They offered important rehab for all the changes to my body left by pregnancy and a c-section and the strengthening work got me back safely running sooner than I expected - yay! The classes were warm, friendly and supportive and my baby Helena loved meeting the other babies too (as well as getting cheeky cuddles from Mariam). Couldn’t recommend more highly to new mums!
Katherine C via Facebook reviews
I’ve recently completed 2 blocks of Crybaby Pilates with Mariam & would highly recommend it for postnatal recovery. Mariam was great at making you feel relaxed, gradually building up the intensity of the exercises over the weeks so it wasn’t too daunting in the beginning. I liked how the exercises also allowed you to interact with your baby. The classes are small enough that you get the opportunity to get to know the other mums & babies, which helps you feel completely at ease in the class too. I now feel back to my pre-baby self & body, ready to start running & hitting the gym! Thank you!
Keri. L.K via Facebook reviews
Seek Help & Advice Sooner Rather Than Later
As with everything in life, there isn’t a one size fits all when it comes to returning to running after pregnancy. Factors that need to be considered include:
Type of birth you had; was it a straightforward vaginal birth, a vaginal birth with complications such as forceps delivery/episiotomy/tears, a C-section? The timescales may be different for each case!
Previous level of exercise (e.g. were you a runner before pregnancy?)
Experiencing symptoms of lower back pain, pelvic or pubic pain, leakage and/or feeling of vaginal heaviness (which could be a sign of pelvic organ prolapse), coccyx/tailbone pain (which could be a sign of a hypertonic or tight pelvic floor)
Are you currently breast-feeding? Pregnancy hormones stay in the body for about three months postpartum, continuing to loosen joints, muscles, tendons and ligaments as they did in preparation for delivery. For those breast-feeding, hormones can still have a loosening effect even months after you stop.
Lifestyle changes such as sleep deprivation, lack of routine, demands of breastfeeding and altered eating habits which can cause energy deficiency and fatigue.
If you are unsure, it is advisable to seek help from a specialist trained physiotherapist or a pelvic health practitioner.
If you would like to chat to one of our physiotherapists you can use the link below to book an appointment. Or if you prefer send us a message with any questions you have and we will get back to you as soon as we can.
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Please subscribe for regular updates and advice on everything health and fitness related - Zero spam promise.
Postnatal Pilates at Physio Effect
