César García Urbano Taylor: Running after having a baby: physio advice

Running after having a baby: physio advice

I saw Niamh at 8 weeks and 6 months post delivery. And, as I found her guidance invaluable, I asked her to write a few words of advice for new mums.

By Niamh Burn MSCP Pre and Postnatal Pelvic Health Physiotherapist

When can I run after having a baby? That’s a question on many a new mum’s mind. Running is so convenient and reasonably easy to fit in around a baby.

Running can also be an integral part of a mum’s mental health and it’s always good to get back to doing what you love, but hopefully in a safe and effective way.

Most mums are keen to get back out there as quick as they can, really craving the head space that running gives. However, as women we are also invested in our body, its recovery and willing to future-proof ourselves physically, so that running can always be a part of our lives.

Like most tricky questions, there is a different answer for everyone when it comes to getting back to running post pregnancy. It’s really an individual thing.

Firstly, we need to ask yourself a few questions:

• How was the pregnancy?
• Did we suffer from pelvic pain?
• How was the delivery?
• Have your scars healed ok?
• Did we have any infections?
• Are we eating in a balanced way?
• Are we hydrated enough?
• Are we getting any sleep whatsoever?
• Are we having bladder or bowel issues?
• Do things still feel a bit strange down there?!

The answer to these questions will and should influence our timeline to getting back to running. We also need to feelrecovered, be getting some decent patches of sleep and eatingsome nutritious food on a regular basis so that our transition to running will be injury free and more enjoyable!

Since March 2019, we now have the ‘Returning to running postnatal – guide for health professionals’ which is useful for both practitioners and runners alike. It looks at the available evidence out there and came up with an educated guide to help women back to running post baby safely.

According to the guidelines, we need to wait for 3-6 months for all of that initial post-delivery recovery to happen. Therefore, our bodies will be more on-board with the demands of running.  Pregnancy places strain on the pelvic floor. And whatever way your baby entered the world (from your vagina or your tummy), there is going to be some fallout for the muscles. So, let’s give our bodies the time that it deserves to recover from this.

Running is demanding on your body. Did you know we exert 2.5 times your body weight every time you land whilst running? So we need to train to run, not run to train. Your body will thank you for it in the long run!

Here are some of the boxes we need to tick, before we put on those trainers and go running.

•  Adequate pelvic floor strength (in standing). You should be able to feel your pelvic floor engage as you exhale in standing even If you need lift it consciously, that’s fine. Then you should feel like you can do 10 slow lifts (try to exhale of the lift and inhale to relax) and 10 quick lifts.
• Good single leg balance.
• No pelvic floor symptoms (like heaviness, pain or leaking down there).
• No pain anywhere in your body.

Then see if you can physically do the following without experiencing leaking, pain or heaviness in the pelvic floor or falling over!

• Walking 30 minutes ⁃ Single leg balance 10 seconds ⁃ Single leg squat 10 repetitions each side ⁃ Jog on the spot 1 minute
• Forward bounds 10 repetitions ⁃ Hop in place 10 repetitions each leg ⁃ Single leg ‘running man’: opposite arm and hip flexion/extension (bent knee) 10 repetitions each side  ⁃ Single leg calf raise 10 reps each  ⁃ Single leg bridge 10 reps each side

These are good tests to do to see if your body is ready for running. If you find it hard, don’t worry, just practice them until you improve.

Breastfeeding and running

Breastfeeding women will have a lower level of oestrogen and increased level of relaxin. However, so far, the evidence isn’t there to say that higher levels of relaxin cause increased joint laxity. Moderate to vigorous exercise hasn’t been shown to affect the quality of breastmilk which is reassuring for mums who want to run.

Breastfeeding mums should consider feeding or pumping before a run for the sake of comfort. You should also ensure that you are drinking enough water to compensate for the breastfeeding and the run.

Tips to try when you get back to running

• Lean into the run. Bobbing up and down while running will place more exertion on the pelvic floor and not allow the glutes to fire up well. So, lean into the run, pretend you are running uphill (or practice this posture whilst actually running up a hill).
• Don’t grip. Avoid gripping the abdominals or pelvic floor whilst you run. As this will prevent your core system (diaphragm, pelvic floor and abdominal muscles) working together like a team.
• Good stride length. Don’t be afraid to let the legs drift out behind you as you run. This will reduce your impact and help those glutes to their job.
• Breathe. It’s amazing how many of us hold our breath, especially when concentrating during a run. Encourage yourself to inhale and exhale deeply into your ribcage and belly. Its good for getting the pelvic floor to work and keep you oxygenated!

Signs to watch out for when you start running

• Leaking. urinary leaks and having to use a pad to run
• Urgency. needing to stop for a wee or having a strong urge to urinate
• Ongoing or increased blood loss, that is not linked to your monthly cycle
• Pain -anywhere!
• Vaginal heaviness- a dragging or bulge feeling in your vagina

IF you experience any of these symptoms, then seek the help of a Pelvic Health Physiotherapist (or womens health physio)via your GP, CSP “search a physio” engine or Mummy MOT list of practitioners. A postnatal check with a pelvic health Physio is a great way to assess how all of the above is functioning before starting to run

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Sources

Marnach, M. L., Ramin, K. D., Ramsey, P. S., Song, S. W., Stensland, J. J. and An, K. N. Chatacterization of the relationship between joint laxity and maternal hormones in pregnancy. Obstetrics & Gynaeocology 101(2), 331-335.nning(2003)

Gottschall JS et Ground reaction forces during downhill and uphill running al J Biomech. 2005 Mar;38(3):445-52

Returning to running postnatal- Guidelines for medical health and fitness professionals managing this populations By Grainne Donnelly, Tom Goon and Emma Brockwell. Published March 2019

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