Are you eager to get back running after having a baby? Are you back running and suffering from urinary leakage or back or hip pain? Or maybe you just don’t feel your pelvic floor is strong enough to be running?
When can I get back running again? – is a question that I regularly get asked as a pelvic health specialist physiotherapist. Many women love running and use it for many reasons including fitness, pleasure and for their mental health. Whether you are a woman who has had a smooth pregnancy and birth with minimal change to the pelvic floor or if you have had a more traumatic pregnancy and birth experience an assessment of your pelvic floor strength and endurance should be considered. It is now recommended that ALL women returning to running or high impact exercise see a pelvic health or a women’s health specialist physiotherapist. Even if you aren’t wanting to get back into high impact exercise or running it is still really important to make sure your pelvic floor muscles have recovered from the pregnancy and birth so you don’t have any problems in the future.
Earlier this year new guidelines have been published by three specialist physiotherapist which is the first comprehensive look at what should be taken into account when deciding to return to running. Before getting back to running there are several considerations.
- Have you had your pelvic floor thoroughly assessed by a pelvic health specialist physiotherapist?
- They will do an objective assessment to assess the integrity of the pelvic floor muscles – assessing the muscles strength and endurance.
- They will check for prolapse.
- They will teach you the correct technique for engaging pelvic floor muscles, teach you the correct way to brace prior to increases in intra-abdominal pressure to protect the pelvic floor as it recovers from the birth and start you off with some basic exercises.
- Once your pelvic floor muscles are at an optimal strength and endurance they will progress you to more high impact exercises and back to running in a progressive manner.
You may be wondering how you would know if your pelvic floor isn’t functioning at its best. The key signs and symptoms that the pelvic floor may not have fully recovered from the birth of the baby are;
- Urinary or faecal incontinence (leakage)
- Urinary or faecal urge that is difficult to defer
- A heaviness/pressure/bulge/dragging sensation in the pelvic area
- Pain with intercourse,
- Separation (feels like a gap between the muscles) of the abdominal muscles often referred to as the “mummy tummy”
- Hip, lower back or pelvic pain
If you are suffering from any of the above a trip to see your specialist physiotherapist is a must. A good time to get your pelvic floor assessed is at 6-weeks post-natal however if you are further along from having baby you can still have the assessment. It is good to remember that once you are post-natal you will always be post-natal. And you can start working on the pelvic floor muscles at any time and still see results however as with most things in life the sooner the better! In regards to running you should definitely not consider returning to running until you are at least three months after having the baby. However, it is good to remember that everyone is an individual and for many different reasons return to running at a different time. Even at three months there are other factors to consider before getting back into running like sleep, general fitness, weight, breathing, breastfeeding, supportive clothing, scar mobilisation. Seeing your specialist pelvic health physiotherapist will work with you to help you achieve your goals taking the above factors into consideration.
Another aspect of post-natal running that needs to be considered is buggy-running. The general advice given to women regarding buggy-running focuses on the baby’s health. The effects on the postnatal mother running with a buggy is limited and variable. This limited research suggests that if you are running with a buggy working on hip/spine flexibility and gluteal (bum muscles) strengthening is a must. Running with two hands on the buggy resulted in a speed and stride similar to non-buggy running so this would be a good place to start. If you are considering buggy running it is important that the buggy is designed for running and as per the manufacturers guidelines the baby should be at least six-nine months.