You’re six weeks postpartum and you’ve just been cleared for exercise. You may be wondering if you are ready to get back into running. Or maybe you’ve gone for your first run after having a baby and you’re wondering why it feels so hard. Either way, the purpose of this article is to tell you NOT to run as soon as you’re cleared for exercise, and to encourage you to take the proper steps so your first return runs feel good.

Unfortunately you can’t search the internet for standardized postpartum running guidelines. You may find blogs with suggestions and advice, but research-backed guidelines are hard to come by. The best ones I’ve found were created by Gráinne Donnelly, Emma Brockwell, and Tom Goom in 2019, which I will summarize in this post. The following information is to help you 1) determine if you’re ready to run 2) make you aware of concerns, and the suggested progression of exercise leading up to running.

Running is a high-impact activity requiring core strength and function. To manage the intra-abdominal pressure that stabilizes your body during running, your abdominal and pelvic floor muscles need to be strong and functional. These muscles are weakened during pregnancy and can be further impacted during labor and delivery (cesarean and vaginal). Therefore, incontinence and prolapse can be a concern in postpartum running. You have to allow yourself enough time to heal and strengthen. How will you know if you have pelvic floor or abdominal wall issues? The following is a list of symptoms that could indicate dysfunction and should be addressed with a pelvic floor physical therapist before running.

• Urinary and/or fecal incontinence

• Urinary and/or fecal urgency

• Heaviness/pressure/bulging in the pelvic area

• Pain with intercourse

• Separated abdominal muscles and/or decreased abdominal strength and function

• Low back/pelvic pain

Based on evidence, these experts state that return to running is not advised prior to 3-6 months postpartum or beyond if any symptoms of pelvic floor dysfunction are experienced before running or after attempting to run. Furthermore, even if you don’t have symptoms, 3-6 months is still a minimum guideline to allow your tissue and muscles time to heal and strengthen. For example, it’s been found that after a c-section, your abdominal wall has only regained 51% of its tensile strength by 6 weeks postpartum, and reaches 73-93% only at 6-7 months postpartum.

After (or while) addressing any pelvic floor and/or abdominal concerns, it’s time for you to focus on building overall strength, with a focus on the core and lower body (I recommend glutes for all moms!). Stronger muscles will allow you to better manage the load/demand running puts on your body. If you’re able to work with a qualified postpartum exercise professional they can lead you through the proper training progression. When I work with people I start with making sure all of the muscles that attach to the pelvis are strong, functional, and know how to work together. I then move on to bigger movement patterns like squats, hinges, and lunges. The guidelines referred to in this article use the following exercises to assess readiness to run:

• 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’10 repetitions each side

• Single leg calf raise 20x

• Single leg bridge 20x

• Single leg sit to stand 20x

• Side lying abduction 20x

Keep in mind that this is not a prescriptive list, but it gives you an idea of what you should be working toward. You want to be able to do these exercises (or exercises that require similar load and strength) without pain or incontinence before returning to running.

So mama, before you break out the running shoes (which by the way, make sure they support your new postpartum feet), take the time to heal, strengthen, and get assessed by a pelvic floor PT if you have access to one. You have your entire life to be active (with your children!) and you don’t want to have any setbacks…so remember progression is essential.

And PS. This article doesn’t account for other factors like sleep, scar tissue, weight, breathing, breast size/breastfeeding, jogging strollers, or emotional readiness, which all will factor into your readiness and ability to run.

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