By: Rebecca A.H. Schwender, PT, DPT, MedStar Health
1. Safety first
For uncomplicated pregnancies, regular participation in aerobic and strength training weekly is recommended during pregnancy. Comfortably holding a conversation while running is an appropriate intensity level of training surrounding a pregnancy.
2. Timeline
Expert opinion recommends returning to running no sooner than 12 weeks post-partum for recreational runners. Mothers who delivered via Cesarean section may require longer before return to running is safe. Complications, such as diastasis recti or an episiotomy, may also influence a longer return to running timeline. Elite runners may consult with a health care provider regarding returning sooner on a case-by-case basis. Exercise may begin sooner than 12 weeks, to include low-impact aerobic conditioning and low resistance strength training. Be sure to follow guidelines set forth by your OB-GYN.
3. Hormonal changes
During pregnancy, the hormone relaxin is released at higher levels than if you were not pregnant. This hormone is responsible to relax the pelvic ligaments in preparation for childbirth. This hormone continues to be produced in higher levels if you are breastfeeding. The presence of relaxin has the potential to affect other connective tissues, such as the ligaments and joints used when running.
4. Shoe fitting
During the third trimester, you may have experienced swelling in your feet. Your previous running shoes may no longer be the best fit for you. A professional shoe fitting by a running expert can help you determine an appropriate size and model that works for you.
5. Core stability
Several muscle groups in your torso are responsible for providing stability to your spine during movement. These include your abdominal muscles, gluteals, back muscles, as well as your diaphragm and pelvic floor. The muscles of the pelvic floor may be weakened from supporting the weight of your developing child or may have been disrupted during a vaginal birth. Retraining the muscles of the pelvic floor to be strong, to have endurance, and to contract timely may be necessary. If you are experiencing incontinence with daily activity, return to running is not recommended. Consult with a pelvic health trained physical therapist to guide your return to physical activity.
6. Lower body strength
An integral component of any running training program includes strength training, whether prior to or following childbirth. Abdominal muscles, gluteals, and calf muscles are particularly important for stability and power when running. To test your strength and motor control, you should be able to complete 10 single leg squats prior to returning to running.
7. Running partner
Do you plan to return to running with your baby? Current guidelines recommend that a child should not be subjected to the bounce of a running stroller prior to 6-9 months. Consult with your pediatrician regarding a safe timeline to begin running with your child. And be sure to have your child safely restrained in a stroller designed to absorb the forces generated during running.
8. Load management
Prior to resuming running, expert opinion recommends that you can walk for 30 min comfortably and without incontinence. As you transition into running, the load placed on your body can be further managed by adjusting running mileage and speed. Running mileage should be increased by 10% per week in a building phase, although mileage may be increased up to 30% safely when beginning at low weekly mileage. Increased speed is associated with increased load, so the muscles of the legs and pelvic floor must be prepared to absorb the added load.
If you are experiencing pain related to running, you can call 888-44-SPORT to schedule an in-person evaluation or a video visit with one of our MedStar Health sports medicine providers.
