Six Things You Need to Know When Returning to Running After Giving Birth

As a coach, I often hear, “I don’t know what is happening but my running feels different.” For many runners, this sensation of feeling “off” is because their body has changed in some way. That could mean a runner experiences a growth spurt or their body gains or loses weight. If you’re a runner who recently gave birth, you may relate to feeling “off.”

The good news? This feeling is very common as you’re learning to run in a body that has experienced changes. With time and great guidance, you can re-learn how to run and feel “on” again.

To get that great guidance, I connected with Dr. Ellen Casey, an Associate Attending Physiatrist at Hospital for Special Surgery and she broke down exactly what you need to know to get back running safely and healthily after having a baby.

1: You’ll Have to Go Your Own Pace

Just like running a marathon requires going at your own pace, every person needs to go at their own pace to return to running postpartum.

“In general, the postpartum period ranges from 8 to 12 weeks, but some consider that it continues for the duration of breastfeeding,” Dr. Casey says. She stresses that just because your doctor clears you to exercise at 6–8 weeks, you still may not be ready to run. “Recovery and full return to running can take up to 12 months and there is no evidence-based guide to determine readiness to run postpartum,” she says.

2: Running Doesn’t Increase the Risk of Stress Urinary Incontinence

She notes that around 33% of all women and 27% of runners experience stress urinary incontinence (SUI), which can be leaking of urine when coughing, sneezing, running, or jumping. “Running doesn’t seem to increase the risk of SUI, but if runners are having leaking, they should seek medical attention,” says Dr. Casey. She recommends pelvic floor physical therapy.

3: You’re Not Alone if You Experience Diastasis Rectus Abdominis

Dr. Casey reports that diastasis rectus abdominis (DRA), or the stretching or separation of the tissue that connects the rectus abdominis muscles (front part of the abdominal wall), occurs in almost all pregnant women to accommodate the growing fetus. “30-60% of postpartum women have a persistent DRA and it can lead to cosmetic concerns,” she says, adding, “but some studies show that it is linked to low back pain and SUI.”

What treatment options do runners have? “Specific core muscle strengthening, activity modification, abdominal binder, and sometimes surgery,” says Dr. Casey.

4: Running Doesn’t Impair Breastfeeding, But Know Your Risks

“There is no evidence to suggest that running impairs milk production,” says Dr. Casey. However, due to the nutritional demands of breastfeeding, postpartum runners are at risk for developing stress fractures, including sacral stress fractures. She says, “Runners who are breast feeding may be at even higher risk due to bone loss and nutritional demands related to lactation.” If postpartum runners experience bone pain that worsens with running or other weight-bearing activity, they should seek medical attention.

5: Pain May Be Common, But It’s Not Normal

According to Dr. Casey, musculoskeletal pain, such as low back and pelvic girdle pain, occurs in 45% of pregnant women and continues into the postpartum period in 25% of women. Risk factors for musculoskeletal pain, or pain in your muscles, ligaments and tendons, and bones include muscle weakness, running too much too soon, life stressors, musculoskeletal pain during pregnancy, and pelvic floor trauma in delivery.

“Time, energy, mood, irregular schedule, sleep deprivation, and availability of childcare can also affect your return to running,” says Dr. Casey.

“Pain is common, but it doesn’t mean it’s normal and women that just have to deal with it,” she stresses.

6: Sports Medicine Experts Can Help!

Dr. Casey’s advice for finding your own pace and staying healthy during this time? “Get an assessment from a sports medicine physician with expertise in working with postpartum women or a women’s health physical therapist.”

A medical expert can work with you on a plan for gradual return to running by addressing the presence of a diastasis rectus abdominis (DRA), stress urinary incontinence, as well as pain-free walking and activities of daily living.