This graphic shows how the muscles connect the spine, pelvic floor, hip, and knee.

How soon can I run after delivery?

This is one of the most frequently asked questions we receive from our patients! Several of our postpartum individuals are 'cleared' to return to exercise at their 6-week postpartum OBGYN visit. Typically this clearance is issued due to a lack of issues from a medical standpoint, however this does not reflect the continued tissue healing that is occurring nor does it take into consideration if your system is ready for a high-impact activity like running (this applies to any high-impact activity, including high-intensity interval training and jumping/plyometrics).

Per the review guidelines above, it is recommended to wait until at least 12 weeks after giving birth to initiate a graded return-to-running program, and only as long as there are no signs of pelvic floor muscle impairment (see our list below). We recognize that everyone heals at their own body’s pace and while some patients feel ready to return earlier, others may need more time to feel physically, mentally, emotionally, or energetically ready to return to higher level activities. Further, it is absolutely okay to not feel ready to return to a high-intensity activity like running at the 3-month mark, and it is normal to allow your brain and body more time for healing and recovery. 

So how do I start a running program?

• Begin slow! Start with a gradual return to cardio via lower-impact exercise like walking. Once you feel ready to add in running, try to incorporate intervals of walking and running as you test the water and build your endurance up.
• Try not to progress or change several variables in your exercise routine at once. This includes frequency, duration, intensity, and terrain of your runs. 
• Cross-training is an important component of tissue healing and lumbo-pelvic support which can optimize outcomes with return to high-impact activities such as running.
• Utilizing an interval training program such as Couch to 5k can be a helpful place to start if you are feeling overwhelmed or afraid to start.

Signs and symptoms that may indicate pelvic floor impairments that should be addressed:

• Leaking urine or feces, at any time but especially when running
• Heaviness, pressure, or bulging sensations in the perineal or vaginal region, at any time but especially when running
• Joint or muscle pain, including to the pelvis, hip, and/or low back areas, at any time
• Difficulty emptying bowels or constipation
• Pain with sex or insertional activities

Additional risk factors:

When reading through the literature while designing the return to running guidelines, the authors also paid particular attention to the following as signs to be considered when returning to running:

• Being less than 3 months postnatal
• Pre-existing pelvic floor issues or lumbopelvic dysfunction
• Delivery via cesarean section or perineal scarring with vaginal delivery
• Currently breast- or chest-feeding
• Pre-existing hypermobility conditions (e.g. Ehlers-Danlos)

If you find you're experiencing any of the above pelvic floor symptoms we encourage you to work with a pelvic health therapist to create a treatment plan tailored to you and your exercise goals. Your pelvic floor therapist will complete a comprehensive evaluation of your core, hips, spine, and pelvic floor looking particularly at your mobility and strength as well as perform an assessment aimed at determining your body’s ability to perform the necessary movements for safe and successful return to running. After this assessment, your therapist will provide you with specific recommendations and establish a cross-training program to optimize your postpartum recovery journey!

tl;dr

• The ideal time to return to running is 3 months postpartum
• Don’t do too much, too soon! Start slow, add gradually, and be mindful as you increase the duration and intensity of your program
• If you are experiencing any pelvic floor symptoms, see a pelvic health therapist to address these issues and help you reach your goals
• Keep in mind, all postnatal individuals can benefit from seeing a pelvic health therapist within the first 6 weeks post-delivery for prevention, management, and support