How Physiotherapists Determine your Readiness for Running Postpartum

Historically, a new mom would visit their health care provider at about 6 weeks postpartum for a check up. At this appointment, there is typically a discussion about symptoms, a quick visual check of the vaginal tissues, and then they are “cleared for return to running”. However, return to running looks different for each individual. Is this someone who has the goal of returning to a 5k jog once a week or someone who wants to return to half marathon training? Regardless of your goal, it is extremely helpful to get specific guidance on readiness for running postpartum  in order to safely avoid development of pelvic organ prolapse, incontinence and/or pain.

Here are some of the factors we discuss and assess to determine your readiness for return to running postpartum. This information is based on the “Return to Running Postnatal- Guidelines for medical, health and fitness professionals managing this population” which was published in 2019:

  • Timeline
    • 3-6 months postpartum is the earliest that a patient would be safe to attempt running
  • Symptoms
    • a patient should not be experiencing leakage, heaviness/pressure or lumbo-pelvic pain prior to attempting running
  • Pelvic Floor Muscle and Tissue Testing
    • The pelvic floor needs to achieve certain levels of strength, endurance and coordination
    • More importantly, these tests should be completed in a standing position
    • Testing the fascial support helps indicate likelihood of developing pelvic organ prolapse
    • If fascial support is reduced, the use of a pessary is strongly recommended
  • Load/Impact Testing
    • Your therapist will take through a series of exercises that load and increase impact through the body and pelvic floor
    • These activities include activities like walking, single leg squats, single leg hops, etc
    • Your therapist will assess your form and ask for your feedback on any development of symptoms during these movements (ie. leakage, heaviness, urgency, pain, etc)
  • Strength Testing
    • Your therapist will also look at the strength of other muscles that are important for return to running
    • These muscles groups include glutes, quads, groin, hamstring and calves
  • Other Factors
    • There are additional factors to consider that may impact your ability to return to running safely. These include: being overweight, poor fitness, breathing pattern, psychological status, diastasis rectus abdominus, scar mobility, breastfeeding, supportive clothing and sleep

If your therapist has determined that you are ready to return to running, they will then give you specific recommendations for an initial running program. They will give you goals on duration, intensity, frequency and give you guidance on how to progress. You will also be given information on what to monitor for during this process to make sure your pelvic floor muscles and tissues aren’t being impacted negatively. While running can be a very valuable form of cardiovascular exercise, it is important to remember that it is also a high impact activity that needs to be trained for appropriately – especially for the postpartum population. If you are interested in getting an pelvic physiotherapy assessment to determine your readiness for return to running, click here.

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