Returning to Running Postpartum: A Step-by-Step Guide
In my experience working with runners, returning to running after any forced time off can be exciting. When working with my postpartum population, I always feel the need to remind them: returning to exercise is one hurdle, and returning to running is another.
Running is a more complex exercise requiring a lot from the body. Cardiovascular stress aside, running requires your body to respond to increased gravitational forces, sometimes putting 2-4x your body weight into one leg. It requires your muscles to be explosive and responsive to your environment. As postpartum mothers and birthing parents return to running, it is important to take steps to get there safely so we can minimize injury.
If you’re unsure about starting with basic exercise, check out my Returning to Exercise Postpartum post. I cover what happens to the body during pregnancy and delivery and some steps to get back to basic exercise safely.
First, let’s go over some basics of running.
Running consists of transferring your weight from one foot to the other, separated by a “flight” phase.
Flight phase is what differentiates running from walking and is also what makes running more impactful on your body. You’re essentially hopping from one foot to the other on repeat. Depending on your run form/speed, the amount of force going through your joints varies. Regardless, if you’re doing anything that looks like running, you’re likely putting increased force through your body.
Torsion (rotational force) also goes through your body with each step. Without going too heavy into biomechanics, understand that running requires control in multiple planes of motion even though you’re moving your body straight forward.
What does this mean for the postpartum body?
During pregnancy, the body adapts to accommodate the growing baby, which can change the muscular system and overall posture. After the labor and delivery process, the body not only has to heal and recover, but also adapt to no longer being pregnant. Certain muscles may get over-lengthened/weak, while others can become tight/overworked. Relaxin, the hormone that increases laxity during pregnancy and delivery, may also be present in your system.
Due to the increased demand and force placed on the body while running, we want to ensure your body starts in a balanced, stable state.
Where to start?
Rehabilitation
Muscles need proper rehabilitation to function effectively when returning to exercise. It’s important to note here that the trauma of the labor and delivery process matters. Cesarean section, grade 3, and grade 4 tears are all treated differently when it comes to returning to high-impact exercise.
Before returning to any exercise, especially a high-impact activity like running, we must focus on:
We must ensure these muscles contract, relax, and function properly. If you are unsure about rehabilitation, reach out to a professional or contact Fortify PT to learn more.
Getting strong
Running requires a lot of control against gravity, so a baseline level of strength is a must. You want to ensure your core, hips, and legs are conditioned enough to allow you to participate in more running-specific exercises.
Core work can progress from basic breathing to more dynamic movements, such as dead bugs or dynamic planking.
Leg strengthening can start with bilateral activity (2 legs on the ground - think squats and deadlifts).
Running is effectively a single-leg activity, so ensuring you feel stable with single-leg squats or lunges is key. This will also help you uncover any right-to-left muscle imbalances, which can help you avoid injury.
Feeling stable in your body is the theme here. Your body has undergone several transformations in a relatively short time. Before getting into running, you want to feel comfortable moving your body through space.
Return to running specifics
Triplanar strength
Running is a predominantly sagittal plane activity (meaning you only run in the forward direction). However, as you land and push off, your body still adapts to rotational and side-to-side forces. Training the muscles that help stabilize you in the other two planes of motion can help make you a more efficient runner and will help prevent injury.
Start incorporating variability in your strength training, including rotational and side-to-side movements. This can include:
Side lunges
Medicine ball rotational chops
Overhead side-to-side reaching
This type of training will not only help improve your stability postpartum but also prevent injury during your running journey.
Speed
Running is a fast-moving activity (even if you’re not running fast). Your body is required to adapt and respond to forces in a very short amount of time with each step.
Incorporating a speed component into your strength training can be a great way to start to see how your body responds to faster activity. Try these:
Moving faster through your strength movements
Changing the tempo of the movement (think 4 counts into the movement, 1 count to explode out)
I find this most helpful for patients who may be struggling with incontinence or the “feeling” of having to urinate with impact. This can be a great place to start, not only for low impact but also for training your body to respond quickly.
Jumping
Impact comes with the territory when it comes to running, and this can be where issues start to arise.
Training jumping and hopping in isolated exercise is a great way to stimulate stabilization and endurance in your body before demanding it for a long period of time.
Like triplanar strengthening, jumping in multiple planes of motion is a great way to train those ankle and hip stabilizers:
Start by seeing how light “bunny hopping” on two feet feels
Make sure to jump forward, side-to-side, and in a circular/twisting motion.
Once this feels good, start to see how single-leg hopping feels.
Checking in with your body at this point is key. Do you have any urinary urgency? Is there any pelvic pressure? Do you feel in control? Any hint of instability or lack of control may be a sign to spend a little longer with strength or speed.
Drills
Running is a skill. Running drills are a great way to build proper movement patterns and specificity in your body. Drills can be a really helpful way to check in with your form postpartum. Some common changes to form that I see postpartum are less knee drive, poor pelvic drive, decreased arm swing, and decreased cadence (steps per minute).
Running drills can help work on all these so that your form can be as efficient as possible. Drills can include:
High knees
Butt kicks
Skipping
They can be performed, again, in multiple planes of motion to ensure you’re getting all the stabilization training you need.
Intervals
And now we run! Intervals are my top choice for getting back into running (at any point, really). Intervals of walking and running allow your body to be focused and strong for a condensed period of time, followed by low-impact recovery.
Depending on the above steps, the intervals can be 1:1 (run/walk) or 1:2.
The progression from here will be dependent on how much you can get out there to practice, how things are feeling, and your goals.
Some things to remember
Running takes a lot of energy, so your recovery and fueling process may be different compared to pre-pregnancy with the addition of childcare and potential breastfeeding status.
Running may feel different compared to before. That’s okay! It takes time for your body to recover from pregnancy and labor/delivery fully.
Be gentle with yourself. I know it seems like a lot of training to get back to something that seemed so effortless before, but these are also the steps that I’d say everyone needs to take to get into running safely, not just postpartum.
Each step, and the time you need to spend at each step, can be unique to you. Your training pre-pregnancy and during pregnancy will affect how your muscles respond to work. How you’ve recovered from your particular labor and delivery also plays a big role.
Overall, checking in with your body every step along the way is KEY. Aches, pains, or pelvic symptoms are all signs you want to pay attention to. If the goal is to get back to running, we want to ensure we get there safely and injury-free.
If you have questions, contact us! You can also explore Fortify PT’s specialized physical therapy services, as well as our curated wellness packages. We are here to help you feel empowered and confident in your body as you get back into any goal you have for yourself.
