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
Here is a link of my 17-year-old daughter performing a demonstration of these:
Section 3: Pelvic Floor Strength
***If permitted within your scope of practice.
Here is a link for the modified Oxford MMT:
Here is a link for assessing the POPQ GH+PB:
Section 4: Pelvic Floor Endurance
***If permitted within your scope of practice.
Here are a couple links of me performing these with biofeedback:
And here is a link of me performing these with a turkey baster!
Are you interested in the shorts with built-in perineal support discussed in the guidelines? They are by EVB sport, and you can find them here!
Here is a link to the Instagram interview I conducted with 2 of the authors! It is now on YouTube:
WHEW friends! I KNOW this is a lot to take in, but I hope that it will help serve as a valuable reference for your postpartum clients. I would like to give a HUGE shout out to the authors for creating these guidelines; you can find their Instagrams at @absolute.physio, @physiomumuk, and @running.physio. I would also love to give a shoutout to my lovely daughter for being a fantastic demonstration model. Lastly, thank you to each of YOU for your help and support with myPFM. Together we CAN achieve our goal of Pelvic Health for All. Everyone. Everywhere. Every Language. ♥️ Jeanice and the myPFM team
Want to learn even more about running and the pelvic floor? Register for our upcoming course on September 15th at 1 PM EST with Dr. Amanda Olson, PT, DPT, PRPC.
If you are (or register) to become a myPFM pro or pro plus+ ambassador, this course is free!