As a physical therapist who treats a lot of patients pre and postpartum, I get many questions regarding return to sport after a baby. This is an important topic as the process one’s body goes through from pregnancy to delivery, no matter what form of delivery, is no small feat. The body does amazing things to make room for and provide for the baby. Then, after delivery, the body works to heal itself and return to a functional and productive state. This is not dissimilar to what the body goes through after any other surgery or injury. Therefore, it is important that similar steps are taken to rehab the body to prepare it not only for return to daily activities, but return to higher level activities, such as running.

The ACOG recommends that “all women should ideally have contact with a maternal care provider within the first 3 weeks postpartum. Scheduling with a pelvic health physical therapist is a great way to meet this need and continue with ongoing care throughout the 4th trimester (the first 12 weeks postpartum). An internal pelvic examination will not be completed until a patient has been seen by their provider for their 6-week checkup. However, one can get a head start on regaining stability, strength, and coordination throughout their core, pelvis, and hips for a quicker return to previous activity levels. It is important to build a proper foundation prior to progressing into more demanding recreational activities. In this way, you will be setting your body up for SUCCESS!

In order to allow for proper healing from delivery, a good time frame to start thinking about returning to running is 3-6 months postpartum.

However, some signs that your body may not be quite ready for the intense activity of running include:

• Urinary or fecal leakage
• A sensation of pressure/bulge/dragging in the vagina
• Vaginal bleeding that is unrelated to your menstrual cycle
• Pelvic (or other) pain.

If you experience any of these symptoms currently, or if you start to experience them once you start a running program, your body may not be quite ready. You may need to decrease the intensity or duration of the activity/run. OR you may need to focus on something else, such as strengthening, breath control, or manual therapy to better support your body. Other factors that may help determine your readiness for running are your overall fitness levels, mode of delivery if you have diastasis recti, if you are breastfeeding, degree of scar tissue that maybe be present, your sleep and energy levels, etc. The good news is that a skilled physical therapist can assist with most of this!

Some things a physical therapist may assess prior to clearing an individual for return to run include but are not limited to:

• Pelvic floor and core strength
• Risk for pelvic organ prolapse
• Strength of primary muscle groups throughout lower extremities.
• Single leg stability, both static (not moving) and dynamic (with movement)
• Single leg jumping/bounding

Once you are ready and cleared for return to running, here are some general tips to get you going:

• Start small, running 1-2 minute intervals at an “easy” pace or a pace at which you are able to carry out a conversation.
• Increase distance/time prior to increasing intensity/pace
• Make sure to complete a proper warm-up and cool down
• Wear appropriate, supportive gear.
  • Sports bras offering support versus compression have been shown to be beneficial due to comfort levels
  • Your foot size may permanently change postpartum, therefore new shoes may be a necessity.
• If you are still breastfeeding, you may find it more comfortable to feed the baby or pump prior to beginning your run.
• Listen to your body
• Check-in with a PT

Working with a PT and checking in at regular intervals throughout your training process can help to keep you on track towards reaching your goals as well as address any problems or questions that may arise. Some people are afraid to jump back into activity following childbirth, and having access to a PT can allow one to feel safe in their progressions while not feeling restricted from the activities in which they are desiring to partake.

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care#:~:text=All%20women%20should%20ideally%20have,than%2012%20weeks%20after%20birth.

https://absolute.physio/wp-content/uploads/2020/01/returning-to-running-postnatal%E2%80%93ACPSEM-endorsed.pdf