Guest Blog by: Janette Yee, AT

Autumn in Toronto provides the perfect temperature and conditions for outdoor sports. Now you, having just had a baby, can’t wait to get back into running. But, how do you get from loose abs, incontinence, and full-body aches and pains to enjoying the fall weather pushing a running stroller like those other mamas on Instagram?

To be run-ready, your postpartum body needs time to heal and regain strengthen; add an extra six weeks if you’ve had a c-section. The current literature recommends that physical rehabilitation plus exercise be the main focus before returning to running postpartum.

Your #1 postpartum rehabilitation goal?

Learn to control your core and move properly; then strengthen. You don’t have to wait for your 6 week postnatal check-up to start your ABC’s (Alignment, Breathing and Core activation).

The most common mistake with getting back to exercise after having a baby is skipping the first step and going straight to strengthening. While there are benefits to an early return to running (such as maternal mental health, endorphin release), the long term costs can include increased risk of injury and limits to sport performance.

Here are some questions I get asked frequently by postpartum moms:

‘I’ve been seeing a pelvic floor physiotherapist and postpartum physical therapist for the past three months, and I’ve been doing their exercises. What other exercises should I be doing to get ready for running?’

The ‘Return to Running Postnatal Guidelines’ suggest that you should be able to comfortably perform a list of ‘tests’ before you begin a running program, all without pelvic floor heaviness, dragging or incontinence. However, in my professional opinion some of the suggested exercises are challenging even for the seasoned athlete and may be considered too advanced. Trying some of the exercises below can help you gauge your readiness:

• banded barefoot squats x 25

• banded barefoot calf raises x25

• banded barefoot lunges x15 per side

• elevated planks 1 minute

• ball hamstring curls x10

• elevated side planks 30 seconds per side

‘I had a c-section and want to get back into running.
What are my first steps?’

Get that scar mobilized!

In other words: your postpartum or pelvic physiotherapist can perform special techniques on the incision to get it moving properly. This is important because scar tissue is like a powerful glue. It will not only stick an incision together, but it will also stick to surrounding healthy tissue (muscles, tendons, organs), potentially causing dysfunction and pain. Common chronic issues related to c-sections can include low back pain and abdominal weakness.

The best time to start scar mobilization is between 6-12weeks, and the average woman will need a few treatments to feel results. Of course, this is most effective when concurrent with an exercise program. And FYI, this is a necessary part of c-section rehabilitation that isn’t usually discussed during the 6 week postpartum follow up appointment. Tell all your friends!

‘Uh-oh. I started running but I’m peeing myself! Is this normal?

Even after the requisite 3-month postpartum rehabilitation period, you may find that urinary incontinence returns with the onset of a running program. This can range from a few drops, all the way to full-bladder emptying with no ability to stop. This can happen even after months of continence (i.e. no problems with holding your pee, and no urge to pee during exercise). Running is a high-impact sport and can place 1.6-2.5x your body weight through your muscles and joints, including your pelvic floor. The faster you run, the more this load increases.

If this happens to you, it doesn’t mean you have to stop running altogether. But it might. Tell your postpartum health care team and work with them to create a plan while you revisit your core strengthening routine.

Be patient. Your rehabilitation journey will take time, but it’s important that you allow your body to heal. A good routine will aid in regaining your strength and mobility. If you need some guidance or someone to help you create a core strengthening plan, contact Janette at info@janetteyee.com and touch base with one of our pelvic physiotherapists.

References:

Goom, T., Donnelly, G., Brockwell, E. ‘Return to Running Postnatal – Guidelines for medical, health and wellness professionals managing this population’.

Janette Yee is an athletic therapist and massage therapist in Toronto offering in-home pregnancy and postpartum rehabilitation. Over her 15-year career, she has worked with amateur to elite athletes from every sport, specializing in running and rugby injuries. The toughest athletes by far are her moms. She fills her days with mandatory playtime with her two kids aged 1 and 4 and is currently training for her return to competitive 5 km running.