Are you super excited to start exercising again? Or are you completely overwhelmed right now at the mere thought of putting on a sports bra? I completely get it! After having each of my three children, I had totally different levels of excitement but also some/lots of hesitation over returning to my regular fitness routine.
Am I really ready to run?
When my OBs, three different providers in three different states, cleared me to start exercising again at 6 weeks postpartum, they each gave me a vague “listen to your body” description of how I would know if what I was doing was ok or not.
Is that really the best recommendation we can give women in 2019? This is the type of recommendation that leads to injuries. I know from listening to countless patients there is a HUGE frustration about the lack of information given when returning to exercise. Women need/want more guidance and expertise on exactly how to return to fitness safely and where pitfalls could occur.
Here is what you REALLY need to know before running that first mile.
Birth recovery should be treated the SAME as recovering from a significant injury
It’s not surprising to anyone who has given birth that injuries occur, even during the most uncomplicated births. Women are pushing, stretching, and straining to push a baby’s head, the size of a cantaloupe, out of a hole that is normally the size of cherry. The majority of women continue to bleed for 4-6 weeks post delivery as the uterus shrinks in size and heals from the placenta tearing off the wall during the delivery.
On top of the natural injuries that occur with all births, researchers from University of Michigan found at 7 weeks after delivery, 29% of the 68 women studied had pubic bone fractures and 41% had pelvic floor tears that they were unaware of. Would a doctor advise you to start running on a fractured ankle or a torn hamstring? Of course not.
We need to completely get rid of this 6 week “all clear” recommendation as it is not safe for women who want to return to a higher level of fitness than walking. We need specific programming depending on your current fitness level and what you want to return to doing.
Incontinence and prolapse can be consequences of running before your body is ready
I can’t even count how many women I have heard that have gone back to running, crossfit, and orange theory and experienced symptoms of incontinence and prolapse, myself included! Symptoms of incontinence and prolapse are your body’s way of shouting, “I AM NOT READY FOR THIS!” I do not blame any woman who has continued to run and ignored these symptoms because no one warned you/is warning you about the risks! I am here to say from my personal experience with both prolapse and incontinence and my 13 years of working with women, incontinence and prolapse symptoms should NEVER be ignored and are treatable by the right provider.
If you are experiencing leaking or heaviness or bulging, you are not alone. In a study published in the PLos One journal in June 2015, 49% of the 1500 mothers studied had urinary incontinence at 1 year post childbirth. In the United States, just under 4 million babies are born per year. So if we do the math, we are talking just under 2 million women per year, every year, are experiencing incontinence daily. That is a sobering statistic.
The two best types of providers to help you with incontinence or prolapse symptoms are your OBGYN and a women’s health/pelvic health trained physical therapist. At Proximity, we have treated patients as soon as 1 week post delivery and a far out as 35 years post delivery, and have completely eliminated leaking and prolapse symptoms in many women. It is never too early or late to resolve these issues.
Return to running is NOT recommended for at least 3-6 months after having a baby
Running is a dynamic, single leg, impact heavy activity that requires strength, coordination, and balance to perform without sustaining an injury. Running before you are are strong enough, not only in your pelvic floor, but your abdominals and leg muscles, puts you at greater risk for developing incontinence and prolapse especially if this is after your 2nd or greater delivery. But we do not base return to running only on time. We base it on the current fitness level of the person who wants to get back to running.
Running before your muscles are ready also increases your chances of back and hip pain, the most common conditions we find in our clinic postpartum.
At a minimum here are 5 things I make sure that all of my postpartum clients have MASTERED before I even think about clearing them to run.
- NO signs or symptoms of incontinence or prolapse- Running is NOT appropriate for a woman until these symptom are eliminated
- 360 Breathing Pattern Established- Breathing is essential for high level exercise and a balanced abdominal and core symptom. This balanced system is often lost during pregnancy. (See Video Below)
- Alignment of Ribcage over Hips- This is needed for a balanced system and for the diaphragm to function correctly. Many women stay in a pregnant alignment with hips thrust forward after having a baby.
- 30 Single Leg Calf Raises- Proper strength, coordination, and control for the push off phase of running is essential for proper form and reducing chances of knee, hip, and back pain.
- 30 Single Leg Squats- You land in a single leg squat every time you transfer from one foot to another during your run. You must be able to perform at least 30 of these on each side WITH control of your hip and knee.