Are you a new mom that is dying to get back to running after having your kiddo? Are the sunny and blue skies of Northern Colorado calling your name but you’re not sure how to get back out there safely. Were you bummed out not to be partaking in the Horsetooth Half this year (but then maybe secretly relieved with all the wind)? I know how frustrating and slow it can seem on your postpartum journey back to exercising so here are a couple of factors to consider when returning to running postpartum.
One of the first steps towards returning to running “safely” (and by safely, I mean trying to mitigate risk for musculoskeletal injuries, think joint, muscles, or tendons, and pelvic floor dysfunction) is by initiating a progress overload program to achieve your goals. We want to strengthen some key muscle groups that have been affected by pregnancy and childbirth and ones that are important for running. And then, obviously, start to introduce running itself with the same concept of progressive overload.
Beginning a strengthening program for these four main muscle groups and gradually making them more challenging is where we want to start: abdominals, pelvic floor, lateral hip musculature and muscles of the feet. The abdominal muscles have gone through a significant period of stretching during pregnancy which can lead to decreased strength and increased fatigability. This is an important muscle group for trunk rotation as well as stability of the trunk and pelvis. The pelvic floor muscles have also gone through a big change in pregnancy – more pressure has been placed downwards on these muscles throughout the gestational period and during a vaginal delivery or if any pushing occurred during labor, these muscles also get stretched and are subject to tearing in some individuals. Others may need to have these muscles surgically cut (an episiotomy) to assist with the delivery. Therefore, improving our awareness and strength of these muscles is going to be an important part of postpartum recovery and return to running to minimize symptoms such as incontinence and prolapse. Next, we want to address our lateral (outside) hip muscles, specifically one called the gluteus medius, as this is the muscle that stabilizes our pelvis when we are standing on one leg (which running requires). And lastly, we want to address the muscles of our feet. Pregnancy may or may not have caused your feet to widen which may in turn have altered how you walk therefore placing different stressors on different muscle groups. Our feet are important to absorb forces from the ground as we land and then we need to be able to propel us off the ground again as we take another step. So, don’t neglect your feet!
I also want to make sure that you can successfully complete 30 minutes of walking prior to beginning a walk-run program. What does “successful mean?” A successful completion of walking, a walk-run or a run would be one that did not produce any symptoms of pelvic, hip or low back pain, no increase in bleeding, no incontinence and no symptoms of prolapse such as vaginal heaviness. We want to monitor these symptoms throughout both our strength training and our walking or return to running program. If these symptoms do occur, we may need to stay at the same level before moving on or return to the level below until our bodies are more prepared to deal with the increased stress. Progression through the run walk program is going to be dependent on current symptoms as well as previous experience and history of running and mileage prior to and throughout your pregnancy.
Additionally, throughout our postpartum experience and return to exercise and running we want to monitor our sleep (getting at least 6.8 hours/ night), fatigue levels, mood, pain and lactation levels as you progress through the various levels of strengthening and running to make sure that we are recovery sufficiently and progressing appropriately.
Contact us if you would like a more guided, individualized plan to get you back to doing the things you love in a safe, logical and evidence-backed way! We will go over specific exercises for the muscle groups mentioned above with progressions and regressions of each. We will discuss specific mileage that you can be progressing to as well as providing the most idealized schedule to accomplish these goals. We may also perform a running analysis to mitigate symptoms should any arise.
Dr. Sam Greig.
This blog was written by our very own Pelvic/Women’s Specialist, Dr. Sam Greig.