A physiotherapist’s advice on running during pregnancy and postpartum

Pregnancy and running. Let’s talk about it!

I originally became a pelvic floor therapist to understand the role of hip performance in sport. Since 60% of the muscles within the pelvic floor control the hip, I knew that if I educated myself about the pelvic floor I would ultimately understand the hip better. Being a pelvic floor therapist in sport has also brought me into the scope of pregnancy — especially pregnancy and running. Here’s some of the advice I give to my pregnant and postpartum clients.

Running during pregnancy

I have often thought of pregnancy as a poker game. You never know what cards you are going to get. That babe has a plan and you have to follow it. When it comes to running while pregnant, it is important to receive medical clearance from your family doctor as well as listen to your body. If you do not have the energy or feel as though your body doesn’t have the capacity it is OK not to run during pregnancy. The goal is to listen to your body.

Women often come to see me during pregnancy to ensure they are running safely. We always go over their training program to make sure they have optimal rest and recovery days as well as progressing no more than 5-10% per week. I also educate women that it is OK not to progress during their pregnancy, keeping their runs at status quo (not focussing on running further or faster). Some women will train with a pregnancy belly belt that acts as an extra support system to help support their core and pelvic floor.

Postpartum Recovery

It is the postpartum recovery that is the most important. Often women see their family physician or OBGYN at six weeks postpartum and are given clearance to return to the activities they love to do. However, running is not a typical low-key activity. It requires stability and coordination to run well and prevent injury.

The pelvic floor has gone through a very big experience. If you have had a vaginal delivery, your pelvic floor muscles can stretch 80% during labour and delivery. If you have had a Cesarean-section, the layers of the abdominal wall have been surgically repaired, which I consider a big surgery.

Normal tissue timelines of healing suggest tissues don’t heal until 12 weeks postpartum, not six. This does not mean you cannot do anything during the first two to three months, you just need to gradually load the pelvic floor and rebuild its stability and connection. I typically return most runners to running at 12 weeks postpartum.

Sometimes it takes patience to rebuild something important.

There are a couple considerations I think of postpartum:

  • The diaphragm has a tendency to be quite low postpartum, which creates a large amount of pressure on the pelvic floor. If there is too much pressure on your healing pelvic floor, you can end up with complications such as hip pain, low back pain and possible urinary leaking with sport over time. Regular strengthening exercises can help lift the diaphragm back up. Modified Child’s Pose is a great exercise you can do to find an ideal diaphragm position and recruit the deep inner core. When you get in this modified child’s pose position, the goal is to breath 10 times focusing on expanding the sides of your low back, followed by 10 breathes focusing on expanding your hips and pelvis.
Kim Fraser demonstrates the Modified Child's Pose.
Kim Fraser demonstrates the Modified Child’s Pose.
  • The transverse abdominis, a corset-like muscle that is the main muscle of your trunk, is significantly stretched during pregnancy. It is important to turn this muscle back on after pregnancy to ensure the core is supporting your body during running. This is also something that can be aided by specific strengthening exercises.

At my clinic, I teach women four main exercises to lift the diaphragm back up, restore spinal alignment and rebuild that deep core corset. When all of these exercises are performed, you can start to move in a safe posture with ideal stability which will ultimately keep your pelvic floor, hips and low back happy and keep you in the running game.

Still Physio offers a six-week online Postpartum Rehabilitation Program called Postpartum Comeback that you can do at home to help rebuild your core and pelvic floor postpartum. The program costs $199 and it is recommended people begin at 12 weeks postpartum. Classes are 15 minutes long, which is sometimes all the time you have with a young kid or kids at home.

Kim Fraser is a physical therapist and owner of Still Physio in Saskatoon. Kim’s focus on understanding the technical side of movement while supporting the Well Athlete creates an environment which helps individuals move forward physically and mentally.