What to consider before returning to running postpartum

At least one third of women experience incontinence after childbirth, but it seems like 100% of women expect it as just a part of having kids. Well we are here to tell you that there is life after having kids that does not always have to include peeing yourself. We would like to rewrite the script on how we talk about incontinence and turn our passive acceptance of leakage to active responsibility with knowledge that it can get better.

Incontinence with running is a type of incontinence we call “stress urinary incontinence”. And happens due to the impact of running on your pelvic floor and its inability to respond appropriately. If you think about the mechanics of running, it is a very single leg focused activity, this is why it can be a more difficult activity for you to get back to. It requires far more work to be able to handle the impact well and additionally it requires a different type of muscle performance from your pelvic floor. Then when you layer in the fact postpartum recovery is not easily expedited, it makes sense why getting back to running postpartum can be so confusing. To help manage this gray area, we have 3 major factors that we look at in order to assess the readiness of a postpartum mom to get back to running. We are going to lay out each and tell you exactly why we think each one is important. 

TIME

Time is your best friend when it comes to managing postpartum return to activity in a healthy and productive manner. This is true for any woman no matter exercise background, how you delivered your baby or even how “ready” you feel. Research has shown us that when it comes to returning to high impact activities like running, we are looking at a minimum of 12 weeks postpartum before it is healthy to return due to the effects of pregnancy and birth on your pelvic floor. When you think about it, rehabbing postpartum is about more than just the time spent delivering your baby but also the 9 months that lead up to that moment where your body was constantly and rapidly changing. So in order to do that well, it means you have to be patient. 

Single Leg Strength

As discussed previously, running is a continuous sequence of single leg movements, consisting of one leg taking on the full impact of your body again and again. If you have leg strength that is very imbalanced from left to right or leg or strength that is overall pretty weak, the impact of the movement can be almost too challenging on the body. So in order to get an idea of what this strength and left to right difference looks like, we take our postpartum moms through a series of movements that challenge them to isolate one side at a time. 

20 single leg glute bridges

20 side lying hip abduction

20 single leg calf raises

20 single leg sit to stands

There is no magic in these 4 movements but they help identify the strength of target muscle groups that we need to run as well as how they perform from left to right. 

Pelvic Floor Control

Last, but surely not least, we need a coordinated pelvic floor. You read it correctly, coordinated. While having a pelvic floor that is strong is helpful, it also needs to be able to contract and relax at the appropriate time. With an activity like running, our pelvic floor muscles are very anticipatory and need to react more like a reflex rather than a voluntary contraction. that tested the muscle activity of the pelvic floor during running. A study was conduction in 2020 and they found that the contraction of the pelvic floor was at its highest, right before the runner's feet would hit the ground, not after. This tells us that the role the pelvic floor rehab has to play needs to do more with training up impact and timing of contractions than it does to just strengthen alone. 

As you can see getting back to running without leaking is a big task postpartum but it is absolutely possible. And if you can’t figure it out on your own, find a provider who can create your specific road map on how you can get back symptom free. 

Be patient, give it time and put in the work and you will not be upset with the results.