One of the most requested desires from women after having their baby when they see us at our clinic, Sue Croft Physiotherapy (except for ‘I wish I could get a decent night’s sleep’) is “When can I start running again?”
Many women love running and use it for many reasons: recreational enjoyment; to exercise for fitness and many for their mental health. If they have had a smooth birth process, with minimal changes to their pelvic floor, then they may hardly give returning to running a thought – they just do it!
For others, who may have had a traumatic vaginal birth they realise there needs to be careful consideration of the pros and cons of returning to running.
Recently there have been new guidelines written and published by three physiotherapists and these running guidelines are really the first comprehensive look at what should be taken into account when deciding whether and when to run again. You can click on the link above and enter your email and the guidelines will be sent to you. They have been written by three physiotherapists Tom Goom, Emma Brockwell (from the UK) and Grainne Donnelly (from Ireland). You can hear more about the guidelines from the authors themselves by listening to the Pelvic Health podcast by my friend and colleague Lori Forner
Over the years I have seen many, many girls addicted to running. It’s definitely seems to be one of those things that if you get the bug, it’s difficult to let go of (a little like me and chocolate). This was brought home to me when watching a story on (the brilliant) @Australian Story on our ABC. This particular episode grabbed my attention because of the determination of Mina Guli, a 48 yr old who decided to run 100 marathons in 100 days to draw attention to the growing global water crisis. It was excrutiating to watch toward the end, but it wasn’t her pelvic floor that let her down, but terrible hip pain. She basically ended up in a wheelchair due to stress fractures and pain, but just when she finally thought that her mission had to be aborted, suddenly the power of social media took the campaign in a totally different direction. The link to this episode is below. I won’t spoil the story.
https://www.abc.net.au/news/2019-04-29/how-mina-guli-change-the-world-one-step-at-time/10799874
But back to running after having a baby. There should be some real considerations prior to you commencing a return to running.
- Have your pelvic floor thoroughly assessed by a Pelvic Health Physiotherapist (with an internal examination)
- They will do objective measurements to assess the state of your pelvic floor (such as the dimensions of your genital hiatus plus the length of you perineal body and ask you to perform a valsalva)
- They will assess the strength and integrity of your pelvic floor muscles (looking for indications that there may have been levator avulsion)
- They will look at the distensibility of the pelvic floor
- They will check for prolapse
- After considerable education from your physio, teaching you the correct action of the muscles, how to brace them prior to increases in intra-abdominal pressure (called the knack), they will send you home to practise for a few weeks.
- Once those strategies have been learned and implemented, they may discuss the value of being fitted with a pessary (once discussing with your urogynaecologist or Obstetrician and Gynaecologist as required) to give extra support with higher impact exercise such as running.
At our clinic, the next stage may be undertaking a Running Clinic. A number of my physiotherapists conduct these clinics – videoing you as you run on a treadmill and then taking you through some adjustments to things like breathing, stride length and how you are holding yourself. Then with correction, re-videoing you to show the more relaxed and improved style of running.
So think carefully before rushing back to running and I wouldn’t consider it until at least 3 months. A good time to get your pelvic floor assessed is at 6 weeks post-natal.
A greater explanation of the pelvic floor, bladder and bowel function, prolapse and pessaries and much more can be found in the latest edition (2018) of my book Pelvic Floor Essentials which can be purchased from the books website.
And in keeping with the theme of post-natal recovery, a big congratulations to the Duchess of Sussex and Prince Harry on the birth of Archie. (I am rightfully placing her first in order, as he excitedly acknowledged how amazing she was with the whole birth process).
Meghan, Harry and Archie – I already love the name – very Australian to end it in ‘ie’
(Official photo released 9/5/19)