Ready to run after having a baby but need a better plan on how much and how to progress your running? Read on to find a template at the end.

The 6-week postpartum doctor’s visit is when women are often “cleared” for activity and are often advised to start slowly and gradually building exercise volume but left in the dark on how to do so. The demands of running on the postpartum body are strenuous, with loads exceeding 2-3 times body weight with each foot strike. The pelvic floor muscles must contract and relax in response to this load to maintain continence and lumbopelvic stability. And outside just the pelvic floor, the body needs to be strong everywhere up the kinetic chain to help handle the load of running.

In March 2019 international experts in the fields of women’s health and running physical therapy published guidelines to help the general public, fitness and health care professionals become more educated on safe and evidence-based return to running after having a baby. 

The Guidelines recommend: 

• Do not wait until 6 weeks postpartum to begin moving. Start small, slow and as soon as you are feeling up to it. This figure provides further information on progressions starting in the first week postpartum.

• All women should consult with a women’s health physical therapist trained in pelvic floor examination/treatment at 6 weeks postpartum to prevent stress urinary incontinence, pelvic organ prolapse and to improve sexual function. 

• Return to running is not recommended until 3 months postpartum given the recovery timeframe for the pelvic floor and abdominal wall after vaginal or Cesarean delivery. This timeframe may be longer if symptoms of pelvic floor dysfunction are present (incontinence, painful intercourse, dragging or heaviness in the pelvic floor region) 

• Assess pelvic health, strength and load impact management to determine readiness for return to running. We have put together the following videos outlining strength and load impact management tests you can easily perform at home to determine your readiness to run postpartum. All tests should be completed without urinary or fecal incontinence or urgency, lumbopelvic pain, heaviness/pressure/dragging in the pelvic region. 

Strength criteria: single leg calf raise, single leg bridge, single leg sit to stand, sidelying hip abduction (complete 20 reps of each movement per side)

Load impact management criteria: walk 30 min, single leg balance 10 sec, single leg squat 10 reps, jog in place 1 min, forward bounds 10 reps, single leg hop 10 reps, running [wo]man 10 reps.

So you have passed these tests, now what? How much should you run and how quickly should you progress? At Mend, our pelvic health physical therapists have created a 6 week return to run template. Whether you ran during your pregnancy or haven’t run in 9 months, follow this template to gradually increase your running amount. Remember, other factors such as fatigue and breastfeeding can influence your return to run ability in the postpartum time frame, so slow progression is key. Our template contains walking and running intervals with a static total time to build you up to 10 straight minutes of running over the course of 5 weeks. Within each ‘level’ you can decide how many times per week you want to complete the run.

We recommend seeing a pelvic health physical therapist at Mend to get a thorough pelvic health and full body exam to help guide you through your own postpartum return to run journey. Schedule at our Boulder or Lafayette clinic today!