1. Pelvic floor function
The pelvic floor acts like a hammock to support the organs of the pelvis; the bladder, bowel and uterus. The muscles of the pelvic floor also contract and lift to maintain continence (prevent leaking) at rest and during exercise.
When you do high impact exercise such as running, the pelvic floor muscles have to contract to match the increase in intra-abdominal pressure and downward force. In the postnatal period after birth, the pelvic floor muscles are often stretched and weakened. This is due to a combination of them having to support the extra weight of the growing uterus during pregnancy, having to stretch to allow for your baby to pass through the birth canal and a softening of the muscle tissues thanks to hormones such as relaxin (which continue to be present in elevated levels whilst breastfeeding). When the muscles of the pelvic floor aren’t functioning as well as they should, high impact exercises like running could potentially result in incontinence and pelvic organ prolapse.
2. Core strength
Similarly, the muscles of the abdomen have to stretch to accommodate the growth of your baby. Some research suggests that 75 to 100 per cent of women will have some degree of stomach separation (diastasis recti) in the final trimester of pregnancy. Stomach separation is caused by the stretching and thinning of the linea alba. The linea alba is a band of connective tissue that stretches from pubic bone to breast bone and into which your abdominal muscles connect. Having a strong and functioning core is vital for runners. If your core isn’t functioning properly you will probably feel very heavy and awkward when running (like I mentioned above!). You may also experience back pain, hip and pelvic pain or pelvic floor dysfunction. So it’s important to take the time to stop and listen to your body, especially if something doesn’t feel right.
Relaxin is the hormone which is responsible for the stretching and softening of connective tissue during pregnancy to allow for the birth of your baby. Relaxin doesn’t just target the connective tissue in the pelvis, but affects the entire body. If you choose to breastfeed, your relaxin levels will remain elevated and may impact knee and ankle stability. Hormones may also affect the size and weight of your breast tissue which can impact how you feel running
What are your top tips for getting back into running postpartum?
1. See a women’s health physiotherapist
This is always my #1 piece of advice. A good women’s health physio will help to assess your pelvic floor and core and advise you on whether you are ready for high impact exercises like running. They will also show you how to do a proper pelvic floor and core contraction. Studies show up to 50% of women do their pelvic floor exercises incorrectly - don’t let this be you!
2. Build strength from the inside-out
There is a lot of pressure to return to high intensity exercise really quickly after birth. Birth is a huge physical and emotional event and we need time to heal and regain our strength. During the first twelve weeks postpartum, your focus should be on trying to build strength from the inside-out by focusing on pelvic floor and core exercises before building to safe full-body strength. Having a strong core and pelvic floor will give you the foundation strength you need to run well.
3. Start slowly
A recent study out of the UK recommends returning to running between 3-6 months after birth, if you are not experience any complications from your pregnancy. When you are ready to return to running, build slowly. Building slowly will help your body to adjust and will also help you to build endurance through your pelvic floor and core. Aim to start with 5-10 minutes of running for your first run. Build by 10% each week until you have reached your target run length or distance. After each run, notice how your body responds. How do you feel physically and mentally throughout the rest of the day? If you notice you are leaking more or are finding your belly ‘popping’, you may have gone too hard too early. The aim is to create a program that is sustainable for you long-term, so try to resist the temptation to rush back in! You can check out The Fit Mummy Project App, which has loads of safe postnatal workouts from early postnatal to advanced strength and fitness.
4. Get the right support
If you do have pelvic organ prolapse or a weak pelvic floor, your physio may recommend the use of a pessary. A pessary is a small device used to support a prolapse internally. I think of a pessary like a good bra. It helps to reduce the bounce! It is there to support, not to fix your prolapse. It helps to support the prolapsed vaginal wall so that when you bear down or put pressure through the pelvic floor, there is less movement of your vaginal wall. Your gynaecologist or WHP can fit you for a pessary.
What should new mums definitely not do when getting back into running postpartum?
Ignore any leaking! Leaking or urinary incontinence is a sign of pelvic dysfunction. Don’t just pop on a pad and carry on! If you experience any of the below warning signs visit your women’s health physio for an assessment. You may have just pushed it too hard too early. Sometimes it is two steps forward, one step back:
- Feelings of heaviness or bulging in the pelvic floor
- Bulging or popping through your core
- Lower back or pelvic pain.
What are your other tips for running in general and what are the benefits of running?
There are so many benefits to running. It’s such a fantastic way to build cardiovascular strength and fitness. In a time where we are so connected, running is such a wonderful way to get outside and enjoy the beauty of nature. It’s generally free and such a great break from the day to day stress of being a Mum.
Some of my other tips for mums returning to running are to:
1. Register for an event
Running events like the upcoming Blackmores Sydney Running Festival, are such a great way to stay motivated with your training. They give you a purpose and a reason to get out of bed on those cold mornings!
2. Love the hills
Hill training helps you to build your running fitness, but puts a lot less pressure through your body than running on a flat or downhill surface.
3. Hit it soft
Mix up the surface you are running on. Softer surfaces such as grass and even sand are much kinder to your body!
4. Don’t forget about strength
Strength training is vital for women returning to running after birth. Focus on legs, glutes and core work especially.
When you are ready to return to running, connect to your posture. Are you collapsing through the hips? Are you hunching forward through your shoulders? Are you bending at the waist? Practice running with a nice tall posture and staying strong through your entire mid-section. If you feel yourself collapsing through your hips, you may need to work on your glute and butt strength and also your core strength.
Muscle soreness can actually worsen 2-3 days after you’ve run, so take time to listen to your body and don’t overdo it – it’s often working harder then you realise, even when you aren’t working out! Stretching is a vital part of recovery. The four muscles every runner should focus on when stretching are the quadriceps, hamstrings, calves and gluteal.