Return to running (after baby)
Updated: Oct 18, 2020
Hello friends! For all you healthcare providers and fitness professionals, this one is for you (but of course, this information is free and accessible to anyone that is interested!).
There she sits. Looking at you. Expecting you to have all the answers. Hoping you can help her return to what she loves. But she’s afraid. She’s having pain and heaviness. She doesn’t want to do anything harmful to her body. But she NEEDS to return to running for her mental health, physical health, and quality of life. What is your action plan? You have several options. 1. You could tell her that she shouldn’t run because running is high impact and places more strain/demand on her pelvic floor. 2. You could tell her that she can run but just “go slow” and “be careful.” You leave it up to her to determine what slow and careful is. 3. Or you could pull out these guidelines and go through them with her. They give you an excellent evidence-based framework to follow for SAFE return to running after baby. What evidence do you have for options 1 or 2? I HOPE you choose option 3 friend! As healthcare providers and fitness professionals, the onus is on US to guide, steer, and help our clients achieve their goals with the highest quality of life possible! What if there was a path with objective criteria that could guide you and her to safely return to running? These guidelines were released in 2019 and were created by three passionate physiotherapists in the United Kingdom. “Goom, T., Donnelly, G and Brockwell, E (2019) Returning to running postnatal - guideline for medical, health, and fitness professionals managing this population.” Open access is via Researchgate.
You can obtain a free version of these guidelines here.
There are many components to the guidelines, but I have broken them down into sections. Download here the link to the scorecard that my colleague Dr. Charley Peterson and I created.
Before beginning Is the client at least 6 weeks postpartum? Due to tissue healing times, we recommend you wait until at least 6 weeks. Has the client completed a pelvic health outcome questionnaire? Here is a link for the Australian pelvic floor questionnaire referenced in the guidelines: Download now. Has the client received a pelvic floor Physiotherapy assessment? ALL postpartum clients would benefit from a physiotherapy assessment! Is the client currently symptomatic? Low back pain, pelvic pain, urinary or fecal leakage, and pelvic heaviness are all cautionary signs and symptoms. Does the client have any other factors to consider? Other factors to consider: BMI<30, lack of postpartum exercise routine, diastasis recti, C-section, perineal scars, lack of sleep, post-natal depression, prolonged bleeding, obesity, RED-S For all 4 sections below, it will be essential to indicate whether or not the client could complete the activity as well as whether or not symptoms were present. We left you a section for comments, as well. If the client can’t complete an activity, that guides you on where strength work can be directed. If the client can complete an activity but has symptoms, that guides you on where strength work can be directed. From the authors: “Weakness should not be considered a barrier for return to running but instead identify where strength work can be directed.” Section 1: Load and impact management
Here is a link of my 17-year-old daughter performing a demonstration of these:
Section 2: Strength testing