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Guideline for Return to Running Postpartum

hi, i'm dr. kayla!

DPT & mama of three who is passionate about proactive, root-case women’s health care.

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Congratulations on the birth of your sweet baby, mama! Whether that was 3 weeks ago or 3 years ago – your body underwent some significant physical changes, and it’s important to honor that as you return to  impact activities such as running. Even if running isn’t your goal, the check-ins outlined below will still benefit you in returning to your goal activities, whatever those may be for you!

Once postpartum, always postpartum. I have helped so many women through these stages who were 5, 10, 15 years postpartum and finally getting around to investing time in helping their body repair and rebuild. I’m so glad you are here, and hope you will find this information enlightening no matter what stage you are in your postpartum journey!

Let’s lay the foundation, shall we?

Let’s start by laying the foundation. Prior to participating in plyometrics (aka running, hopping, jumping), it’s important to reconnect with your core, pelvic floor and gluteal muscles to optimize support of your pelvis when taking on ground reaction forces that occur as you run. Did you know ground reaction forces over double your bodyweight occur when running? That’s why it’s so important to prioritize strength training first.

To learn about reconnecting with your muscles and laying the foundation prior to impact activities, check out this blog post.

Now that you’ve laid the foundation, we have a few more check-ins prior to a return to running postpartum…

Check-in #1:

Are all of the following true for you?

  • At least 3 months postpartum (recommended prior to beginning impact activities)
  • No feelings of heaviness in the pelvic region
  • No leaking of urine or inability to control bowel movements
  • No notable Diastasis Recti
  • No pelvic or lower back pain
  • No ongoing blood loss past 8 weeks postpartum (not including your menstrual cycle if this has returned)

If not, stop here! You should likely seek out a Physical Therapist who specializes in the treatment of postpartum women. An individual evaluation to help address the above symptoms will help your body prepare more extensively prior to returning to running. While many of the above are common, they are not normal! Seek help – you deserve it, mama!

Those in the state of Ohio can schedule 1:1 physical therapy with Dr. Kayla. Not local? Check out this resource to find a physical therapist near you.

Check-in #2:

Can you complete the following activities without creating any of Check-in #1’s symptoms? 

  • Walking 30 minutes
  • Single leg balance x10 seconds
  • Single leg squat x10 repetitions each leg
  • Jog in place x1 minute
  • Forward bounds x10 repetitions
  • Hop in place x10 repetitions each leg
  • Single leg ‘running man’: opposite arm and hip flexion/extension (bent knee) x10 repetitions each side 

If not, stay in this section!!! Please note that the above exercises should be performed with quality, controlled movement patterns. This helps ensure optimal loading and functional strength prior to heavier impact activities such as running. When you run, you’re taking on average 160 to 180 steps per minute – that’s 80 to 90 single leg hops onto each leg! Breaking it down as such makes it all the more obvious why it’s so important to lay a proper foundation prior to running postpartum. Once again, I highly recommend working 1:1 with a physical therapist to ensure optimal form, technique and body mechanics. The goal here is to prevent the onset of injury, prolapse, pain or leakage with the return to impact activities – so please take this check-in seriously!

Once you’ve successfully completed the above, move on to our walk/jog game-plan below. 

Whew! Now who’s ready to run postpartum?

A graded return to run program is ideal to allow the entire body to learn how to absorb impact again. The last thing you want is to develop a pesky overuse injury by ramping up too quickly! Below is an outline of the programming I often suggest to clients returning to run postpartum. While I am a Physical Therapist and Exercise Physiologist, I am not yours …unless I am, then of course follow the individualized recommendations provided for you

This information is generalized, thus I suggest deferring to your own individualized provider if you are working with one directly. There are a number of protocols out there, but this is one that I have found to work well (and one that I certainly tweak depending on the client’s running history).

Important Return to Running Postpartum Guideline Notes:

  • Warm up for 5-10 minutes prior to running.
  • Familiarize yourself with Check in #1’s symptoms. Should any symptoms onset, do not progress to the next week’s protocol until you can complete the week symptom-free. Should symptoms linger, consult your physical therapist or physician.
  • Maintain comfortable, conversational pace throughout run 
  • Increase duration prior to speed/intensity
  • Utilize flat surfaces, avoid hills and uneven terrain until 30 minutes of consecutive running is achieved. Then, gradually add in varied surfaces and elevations per your goals
  • Cool down for 5-10 minutes post-run (static stretching can be incorporated at that time)
  • Increase weekly mileage by 10-30% after completing the outlined plan below until you have reached pre-pregnancy mileage

Guideline for Return to Running Postpartum:

Please Note: It is important to have a day of rest or cross training between each running day, thus 3 days of running each week. Each run should be preceded by a 5 minute warm-up as outlined above. Remember to reach out to your physical therapist if symptoms onset while progressing into running; each person and timeline to return to run is different. 

Dr. Kayla Borchers Return to Run Sample Guideline

References

Bø, K. Artal, R., Barakat, R., Brown, W. J., Davies, G. A. L., Dooley, M., Evenson, K. R., Haakstad, L. A. H., Kayser, B., Kinnunen, T. I., Larsénm K., Mottola, M. F., Nygaard, I., van Poppel, M., Stuge, B., Khan, K. M. (2017) Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3-exercise in the postpartum period. Br J Sports Med 51(21), 1516-1525.

Evenson, K. R., Mottola, M. F., Owe, K. M., Rousham, E. K. and Brown, W. (2014) Summary of International Guidelines for Physical Activity Following Pregnancy Obstet Gynecol Surv. 69(7): 407–414.

Gooms T., Donnelly G., and Brockwell E. (2019) Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. DOI: 10.13140/RG.2.2.35256.90880/2

Ngoh KJ-H, Gouwanda D, Gopalai AA, Chong YZ. (2018) Estimation of vertical ground reaction force during running using neural network model and uniaxial accelerometer. Journal of Biomechanics. 76:269-273. DOI: 10.1016/j.jbiomech.2018.06.006

Reimers, C., Siafarikas, F., Stær-Jensen, J., Cvancarova, S., Bø, K. and Engh, M.E. (2018) Risk factors for anatomic pelvic organ prolapse at 6 weeks postpartum: a prospective observational study. Int Urogynecol J. DOI: 10.1007/s00192-018-3650-2.

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I'm Dr. Kayla Borchers!

A Holistic Orthopedic and Pelvic Health Physical Therapist, Prenatal and Postpartum Corrective Exercise Specialist, Certified Yoga Teacher and mama of three who is passionate about proactive, root-case women’s health care.