Running Postpartum: Overcoming Incontinence Challenges

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 doesn't 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 into active responsibility, knowing that it can get better.

Leaking while running is a type of incontinence we call “stress urinary incontinence.” It happens because of 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, which is why it can be a harder activity to get back to. It takes far more work to handle the impact well, and it requires a different type of muscle performance from your pelvic floor. When you layer in the fact that postpartum recovery can't be rushed, it makes sense why getting back to running postpartum can be so confusing. To help manage this gray area, we look at 3 major factors to assess whether a postpartum mom is ready to get back to running. We'll lay out each one and tell you exactly why it's important.

Time

Time is your best friend when it comes to returning to activity postpartum in a healthy and productive way. This is true for any woman, no matter your exercise background, how you delivered your baby or even how “ready” you feel. Research has shown us that for high-impact activities like running, we are looking at a minimum of 12 weeks postpartum before it is healthy to return, because of the effects of pregnancy and birth on your pelvic floor. When you think about it, rehabbing postpartum is about more than the delivery itself. It's also about the 9 months leading up to it, when your body was constantly and rapidly changing. Doing that well means being patient.

Single-leg strength

Running is a continuous sequence of single-leg movements, with one leg taking the full impact of your body again and again. If your leg strength is very uneven from left to right, or just weak overall, that impact can be too much for your body. To get an idea of your strength and any left-to-right difference, we take our postpartum moms through a series of movements that work one side at a time:

• 20 single-leg glute bridges
• 20 side-lying hip abductions
• 20 single-leg calf raises
• 20 single-leg sit-to-stands

There is no magic in these 4 movements, but they show the strength of the muscle groups we need to run and how each side performs.

Pelvic floor control

Last, but surely not least, we need a coordinated pelvic floor. You read that correctly: coordinated. A strong pelvic floor is helpful, but it also needs to contract and relax at the right time. With an activity like running, the pelvic floor muscles are very anticipatory and need to react like a reflex rather than a voluntary contraction. A 2020 study that measured pelvic floor muscle activity during running found the contraction was highest right before the runner's foot hit the ground, not after. This tells us pelvic floor rehab for running needs to train for impact and the timing of contractions, not just strength.

As you can see, getting back to running without leaking is a big task postpartum, but it is absolutely possible. If you can't figure it out on your own, find a provider who can create your specific road map to get back symptom free. For the full checklist we use, including the symptoms that mean it's not time yet, read 5 things to consider before returning to run postpartum.

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