Throughout the years of working closely with mothers, it seems that running is one of the most preferable exercises they want to do after pregnancy. I totally get this, as I did the same after having both of my children. It is easily accessible and convenient for our lifestyles and of course it is free! I loved the fact that you could slot it around the family routine. Running feels liberating and helped me to clear my head of all the stresses that motherhood brings.
Running gives mothers a sense of freedom while burning calories and offers a cheap effective cardio workout that works all the muscles in the body. There are no commitments to any classes, you can run alone or with a friend.
What changes are there in the body after pregnancy and birth?
The Pelvic Floor is a very important muscle that we don’t tend to think about and appreciate unless you have been pregnant and had a baby. The Pelvic Floor acts like a sling in the base of the pelvis supporting all lower abdominal organs including the bladder, uterus and bowels. The Pelvic Floor muscle plays a critical role during exercise. After pregnancy and child birth the pelvic floor becomes stretched and weakened which makes the pelvic organs vulnerable to trauma. One in three women will experience bladder leakage after having a baby. Mothers need to take time to strengthen and rehabilitate the pelvic floor to respond to impact; otherwise women can become at risk to incontinence and prolapse.
Relaxin hormone relaxes the joints and ligaments in the body in preparation for childbirth. Relaxin can be present up for up to a year post pregnancy. Relaxin remains in the body even longer in breast feeding mothers. It can take up to a year for relaxin to disappear after birth or breast feeding. Hormones produced in pregnancy make the ligaments soften, muscles more lax including the pelvic floor and joints hyper mobile. All of these can make the body more vulnerable to injury. Knee, back, hip and ankle pain are common complaints, so ensure you have a good pair of running trainers that absorb the impact keeping the joints safe.
Throughout pregnancy the body physically changes externally with postural shifts due to the baby bump growing, and also internally as organs move and muscles shift to allow room for the pregnancy. Once the baby is born there is no force to correct this, so as practitioners we focus on realigning mothers’ posture through movement, strength and release work. It is essential to get the brain communicating and reconnecting with the mother’s postnatal body, especially the core muscles which include the pelvic floor. If you can’t stay aligned and engaged through your core while running, the impact can increase abdominal pressure which can create force into the pelvic floor and weak connective tissues in the abdominal wall.
When can you start running again?
Most mums should expect to take around six months to return to high impact exercise, only if the correct rehabilitation steps are slowly taken. The length of time can depend on the type of birth you have had but all mums need to begin slowly. The 6 week check after having a baby doesn’t give us the green light to start any exercise or as we were before. It is essential that after birth you complete a postnatal rehab programme. Even more so if you are looking to return to an active lifestyle.
Even if you were a runner before pregnancy or a new runner you still need to start at the beginning. If you enjoyed running prior to pregnancy, it can be hard to know where to start. The best way to guide a mum is to ask them to think back to when you first started running and working from there.
What foundations do you need to put in place first?
Function exercise integrated with core and pelvic floor work is an essential component of the postnatal rehab & recovery programme programme. This can be slowly integrated with steps 3 and 4 below.
It is essential to gain back core strength and function after having a baby. If our core isn’t functioning properly, this can cause an array of pain and discomfort. This means that other muscles have to compensate by stepping in to do the role. If the core and pelvic floor doesn’t respond to the abdominal pressure caused by high impact movement it; it can cause incontinence, prolapse or prevent abdominal separation from healing. Our cores are our power houses and are responsible for most of our movements. This is why it is initially important on a recovery programme to get mothers cores functioning through daily motherhood movements.
If you’re a runner who finds yourself dealing with the following issues: core weakness, lower back pain, incontinence, diastasis recti, or uncomfortable c-section scars, then it is crucial for you to take a break to address those issues with a core rehab/ postnatal specialist. Rebuilding your inner foundations will protect you to perform safer and more effectively as a runner. Unfortunately general exercise will not eradicate theses symptoms if you have had a baby.
Another muscle that can become weak throughout pregnancy due to postural shifts are the glutes. When we combine core rehab with glute strength work together, this then supports the pelvis and helps to reduce postnatal pain in back and pelvis area. Our glutes hold our pelvis level steady when we run; they also propel us forward and keep our legs, pelvis and torso aligned. So if our glutes are weak post pregnancy it can affect our entire kinetic chain. The pelvis, knee and back pain due to postural shifts happen during pregnancy; these need correcting and the body to be realigned. Modify activities for a while until you get optimal strength back.
Steps to take:
I would strongly advise having a check up with a Women’s Health Physio for a postnatal pelvic health assessment. You can do this via the NHS but there may be a 6-9 month waiting time. Another great service is the Mummy M.O.T or a private Women’s Health Physio. They will want to know about your births and assess you for pelvis mis-alignment, posture, core/ pelvic floor function and follow up on any physical issues you had during pregnancy.
During early days after birth focus on gentle stretching and mobilisation of the body. Encourage the brain to reconnect with the core and pelvic floor with some diaphragmatic breathing exercises. We need to focus on the muscles fibres in the pelvis starting with slow conscious movements reconnecting the brain to these responses. Short and gentle walks are a great way to introduce cardio into your weekly routine. I highly advise some soft tissue work from a specialist pregnancy and postnatal massage specialist. This will help free up stuck tissue, aches and pains and assist in postnatal posture correction.
Video of breathing integrating core & pelvic floor
New mum movements
Focus on strength and resistance work by incorporating functional moves to push, pull, bend, squat, and lunge and rotate. We integrate core function and train the pelvic floor to respond to movements that involve more pressure within the core.
What symptoms should you look out for?
Running is a high impact exercise and can cause trauma and stretch your pelvic floor and the connective tissues in the pelvis area. Running causes an impact of at least 2.5 more time on the pelvic floor than compared to walking. The pelvic floor works hard as it also needs to contract thousands of times to support internal organs when we are running. Following pregnancy it is reported that 30% of women cannot voluntarily activate their pelvic floor. If you are leaking or lose full control of your bladder while running, this is a red flag that shouldn’t be ignored. This is a serious sign of a dysfunction, and a problem which needs to be resolved. Many mums think leaking after having a baby is normal; yes it is common but not normal. Symptoms will not get better on their own, without intervention this problem can escalate and can become a lot worse.
If your pelvic floor is damaged, it will not be able to carry out its role in supporting the organs in the pelvis such as the bladder, uterus and bowels up in the pelvis correctly. As someone who has worked within the fitness industry for many years, I have often heard from some very fit and active mums unfortunately have some form of prolapse from doing too much too soon after birth. Some common symptoms to be aware of are a heavy dragging feeling, pressure, painful sex or the sensation of sitting on a ball. A postnatal specialist can advise on exercise and restorative movements but cannot diagnose. At this point I would refer my client out to a G.P, or a women’s health physio to confirm diagnosis. A specialist will be able to check the performance of the pelvic floor muscle, examine the function and diagnose a prolapse.
If you have had a C-section it is unfortunately common to have poor sensation/ numbness/ ongoing pain and a feeling of tightness. Some of these symptoms can be local to the scar but can also affect other areas in the whole body. There has been trauma to muscles, nerves and blood vessels. Your core muscles and a number of organs are potentially affected by this. One of the most important recommendation I advise my c-section clients is to massage on or around the scar area, this can make a huge difference to the healing process. This can be done by yourself or by a soft tissue scar specialist that has been trained to do this
The scar is far deeper than we can see. Scar tissue formed as part of the healing process, we call these fibres which knit together adhesions. These adhesions cling internally in all different directions to other tissues, such as skin, muscles and other organs.
What can adhesions lead to?
Low back and pelvic pain- adhesions can affect area with movement and core function
Frequent urination- adhesions can affect bladder expansion and sensitivity
Tight quads- scar tissue can pull due to lack of flexibility
Discomfort/pulling when exercising
Diastasis- Recti (abdominal separation)
If there is bulging, straining, protrusion or doming anywhere on or from within your abdomen you may have Diastasis (abdominal separation). Our connective tissue between our abdominal wall stretches in pregnancy to allow room for the baby to grow. After birth it usually takes around 6-8 weeks for the gap in the abdominal wall to come back together. If the gap does not close or there is a depth down the midline, you may have Diastasis. This connective tissue takes up to 2 years to return to pre pregnancy state. So if you not have a diastasis after birth the connective tissue is still vulnerable.
Diastasis leads to a weak and dysfunctional core, no amount of exercise including running will fix this and may make symptoms worse. It is essential to seek rehabilitation work from a specialist postnatal instructor or as before a womens health physio.
How old should baby be before you can run with a buggy?
It is recommended that babies should be old enough to sit up, hold their heads and have good neck control. Running with a baby in a standard buggy can cause shaking and vibration, it can be painful and cause injury to your little one. So it is usually around the 6-8 months mark that a child should be ready, which is also a similar time to when mums can start back up to high impact/ plyometric exercise.
A Jogging buggy is essential if you want to run with your little one. There are some great affordable ones now on the market but always keep an eye out on the second hand sites. You should buy a specialist running buggy, which should have suitable suspension and shock absorption. These are designed to keep your baby safe while you are able to run comfortably with ease. Also ensure that the handle bars have a handbrake and wristband.
Pay attention to your form when running with a jogging buggy. Running with a buggy can put your posture in a forward bending position. This causes your shoulders to roll forward and creates tension in the back and neck. Leaning in this position tends to deactivate the core muscles and prevent them from functioning properly, which can also have an impact on the pelvic floor. Try to maintain a good running form by running more upright, relax your shoulders and use a light grip on the handle bars. Keep your running stride as normal as possible with feet under the handle bars and use a good arm swing to encourage good torso rotation.
There is some good news! With time and patience you will run again. There is no right answer when exactly you should return to running, everybody is different. Listening to your body is vital, invest in yourself. It does take time and patience but honestly is really worth it. Running also has some great positive effects on your aerobic fitness, cardiovascular health and wellbeing. Psychological and physical gains keep us mothers strong through those challenging days of motherhood.