There’s no one-size-fits-all approach when it comes to returning to running postpartum. However, there are some helpful guidelines and criteria that we like to use to help clients safely return to running. Below, I’ll outline key considerations and expand on each of them further in the post.
Pelvic Health Symptoms to Watch For
Before we dive into the specifics these are the pelvic health symptoms we are looking for:
- Heaviness or dragging sensation in the pelvis
- Urinary urgency or leakage
- Inability to control urine or bowel movements
- Low back, pelvic, or hip pain
- Any other lower extremity musculoskeletal pain
Subjective Readiness Criteria
These are things you can assess yourself, but we would also ask them at a visit as well.
- At least 10-12 weeks postpartum
- Able to walk for 30+ minutes with minimal or no pelvic symptoms
- No pelvic health symptoms at rest
Let’s dive into these a bit: the timeline is often surprising to people, given that most people get the “all clear” to return to exercise at their 6 weeks postpartum visit. However, at 6 weeks postpartum your body is still very much healing. Especially if you had a c-section or perineal tear, 6 weeks is just the initial phase of healing the wound. 10-12 weeks allows any incisions, the uterus, and the musculoskeletal system time to heal and adjust to postpartum.
Regarding the pelvic health symptoms at rest or with walking; if you’re still experiencing symptoms during basic activities like standing or walking, it’s a strong indication that your body isn’t ready for running yet. In these cases, it’s best to work with a pelvic floor physical therapist to help build a solid foundation first.
Objective Readiness Criteria
These are typically assessed in a physical therapy setting and are important for determining physical readiness. We’d love to help and you can schedule an evaluation with us HERE.
- Pelvic floor awareness – Ability to contract and relax the pelvic floor. Many people have an overactive pelvic floor and may need help relaxing/lengthening. Returning to running isn’t just about kegels!
- Pelvic floor strength – At least a grade of 3/5
- Pelvic floor endurance – This can vary by individual, but I typically look for:
- 3–5 submaximal contractions held for 30–60 seconds
- 10 fast reps
- ~10 reps of maximal voluntary contractions
- Single-leg strength tasks (with minimal or no symptoms) – Examples include single-leg bridges, lunges, single-leg squats, single leg RDLs, and single-leg “running man” exercises
- Basic plyometric drills (with minimal or no symptoms) – Such as heel slams, “bouncing baby,” line hops, forward bounds, mini squat jumps, and jogging in place
Why do we look at these things? Let’s start with the pelvic floor: The pelvic floor is like a trampoline—it needs to contract, relax, and respond to pressure changes and movement. If you do not have a basic pelvic floor awareness and strength (which is common postpartum), you are more likely to have symptoms when returning to running.
Single leg strength and plyometric tasks are a great way to assess readiness for running. They need to come before running. Running is essentially an alternating single leg hop over and over again. If you do not have the ability to perform single leg tasks or tolerate impact drills, your pelvic floor likely needs more training.
These strength and endurance benchmarks are based on a mix of clinical experience and research, including guidelines from Goom et al. While not an exact science, they offer a helpful framework for gauging readiness.