August 2024 - Lauren Davenport, DPT - Uplift Pelvic Health and Performance
Pregnancy and childbirth are transformative experiences, but they can also take a significant toll on a woman’s body. For many new mothers, one of the most exhilarating milestones is returning to running. Running not only helps with physical fitness but also offers a mental and emotional boost. However, jumping back into this activity requires careful consideration, especially regarding pelvic health.
Running is considered a high impact activity that increases loading on the pelvic floor muscles and increases intra-abdominal pressure which can lead to incontinence (leakage). For 1 in 2 women, pelvic floor dysfunction like urinary incontinence negatively affects exercise participation causing females to abandon sport or limit their activity level causing a cascade of health risks. The prevalence of urinary incontinence in female runners is 30-60%. This incontinence can often occur during the end of a running session, running downhill, or with increased running speed.
Pelvic floor physical therapy (PFPT) plays a crucial role in helping new mothers navigate these challenges and return to running safely and effectively. Here’s why integrating PFPT into your postpartum recovery plan can be a game-changer and how it can support your running goals.
Understanding the Impact of Pregnancy and Birth
During pregnancy, your body undergoes numerous changes. Hormonal fluctuations, weight gain, and the growing baby can all affect the pelvic floor—a group of muscles and connective tissues that support the bladder, uterus, and rectum. During labor and delivery, the pelvic floor experiences intense strain, which can lead to issues like pelvic organ prolapse, urinary incontinence, and diastasis recti (abdominal separation).
Even if you had a relatively straightforward delivery, the postpartum period often brings challenges, including muscle weakness, altered biomechanics, changes in core stability, sleep deprivations, and nutritional inconsistencies —all of which can impact your ability to return to running safely.
What is Pelvic Floor Physical Therapy?
Pelvic floor physical therapy is a specialized branch of physical therapy focusing on the pelvic region. It addresses the unique needs of individuals experiencing pelvic pain, incontinence, prolapse, and other related issues. For postpartum women, PFPT can help:
Strengthen and Coordinate the Pelvic Floor: This area needs to regain its strength and functionality post-birth. PFPT includes functional exercises (more specific than kegels) and breath work to enhance pelvic floor muscle strength and coordination, which is essential for maintaining continence and supporting pelvic organs during physical activities. Having a proper internal assessment by a pelvic floor physical therapist will provide direct feedback on these measures.
Improve Range of Motion: Pregnancy can alter mid back, rib, and hip alignment to accommodate for the growing baby leading to a lack of movement like trunk and hip rotation and extension. This can result in poor movement patterns and imbalances.
Improve Core Stability: A strong core is vital for running, and postpartum changes can impact core strength. PFPT helps in rehabilitating the core muscles, addressing issues like diastasis recti, and ensuring proper muscle engagement without increasing pressure in the core canister (review previous blog on proper breathing mechanics).
Movement and Running Analysis: Pregnancy and birth can alter your body mechanics. PFPT assesses your movement patterns and provides strategies to correct any imbalances, reducing the risk of injury and improving running efficiency. This can include a running analysis looking at trunk position, hip drop, stride length, foot strike, and more.
Address Pain and Discomfort: Postpartum women may experience pain or discomfort in areas such as the lower back, hips, or pelvic region. PFPT helps in managing and alleviating this pain through targeted therapies like soft tissue manipulation, trigger point dry needling, cupping, joint mobilizations, and exercises.
When to Start Running Postpartum
Returning to running is a personal decision and should be guided by both physical readiness and medical advice. Here’s a general framework for considering when to start:
Immediate Postpartum Period (0-6 weeks): Focus on breath work and gentle activation of deep core and pelvic floor. Begin walking short bouts and slowly increase every 24-48 hours based on symptoms and tolerance. Think of an easy effort where you can carry on a conversation (RPE 0-2). Get assessed by a PFPT for more guidance during this period. You do not have to wait until your 6 week postpartum visit with OBGYN to begin therapy.
Early Postpartum (7-12 weeks): Continue walking and must be able to walk 30mins without symptoms and tolerate more horizontal impact training prior to any interval jogging. Interval work to rest ratio 1:2. This work is in conjunction with a tailored running specific strength program.
Return to Running (3-6 months postpartum): This timeline can vary depending on individual recovery. Once you’ve built a solid foundation with pelvic floor, core, and hip strength and upright impact tolerance, and if you’ve been cleared by your PFPT specialist, you can start gradually introducing running. Volume increases 2-10% weekly with symptom monitoring.
Tips for a Safe Return to Running
Start Slow: Begin with walking and light jogging intervals. Gradually increase your running distance and intensity based on how your body responds.
Pay Attention to Symptoms: Watch for signs of pelvic discomfort, urinary leakage, pelvic pressure, bleeding, or other symptoms. If these arise, consult with your PFPT specialist.
Incorporate Strength Training: Complement your running with specific strength training exercises that focus on the core, hips, and legs to support overall stability and reduce injury risk.
Proper Recovery: Proper hydration and nutrition are essential for recovery and performance. Make sure you’re fueling your body adequately. Sleep hygiene also plays a vital role in the recovery process. If you are struggling from a marathon of sleepless nights, consider other forms of active recovery movement like yoga or a walk.
The Bottom Line
Pelvic floor physical therapy is a vital component of a safe and successful return to running after childbirth. By addressing pelvic floor strength and coordination, core stability, and overall biomechanics, PFPT helps ensure that new mothers can resume their running routine with confidence and minimal risk of injury. Remember, postpartum recovery is a journey, and integrating PFPT into your routine can be the key to a healthier and more enjoyable return to running.
Comments