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HOW TO INTRODUCE IMPACT AFTER PREGNANCY



I have rarely come across an activity like running or HIIT (High Intensity Impact Training) that makes a woman`s eyes light up more. It can provide the perfect endorphin release and a great way letting off of steam! Something that many new mums crave, right? It is also quick and convenient to fit around a young family too.


However, running and other high impact exercise is harder than you think. The physical and repetitive demand of running can take a toll on a body that hasn’t got adequate post-pregnancy foundations yet. So, its not a case of 6 weeks check done, off you go!


What do I mean by foundations?

Source: www.balance365life.com

Well, I`m talking about your pelvic floor, diaphragm & abdominal muscles. All the elements of your core system that help you to run better and feel stronger. Pregnancy is a great way of interrupting those foundations! Pelvic floor stability, breathing patterns and overall strength can be knocked out of stride after having a baby and whilst being a sleep deprived mum.

Did you know that you exert 2.5 times your body weight every time you land when running on the flat?

So, it’s a good idea to train to run, not run to train. Work on those foundations a little, before adding the impact of running in – you will be a much more efficient runner, enjoy it better and your body will also thank you in the long run.


The Guidelines

We now have some running guidelines put together by an excellent team (see sources below) based on current research about running after a baby. The guidelines suggest waiting for 4-6 months after delivery, to start running. This will allow your body and mainly the connective tissue time to heal before introducing impact.


There are some good tests to see if your body has the stability and power it needs to be run-ready like:

⁃ Walking 30 minutes

⁃ Single leg balance 10 seconds

⁃ Single leg squat 10 repetitions each side

⁃ Jog on the spot 1 minute

⁃ Forward bounds 10 repetitions

⁃ Hop in place 10 repetitions each leg

⁃ Single leg calf raise 10 reps each

⁃ Single leg bridge 10 reps each side

⁃ Single leg ‘running man’: opposite arm & hip flexion/extension (bent knee) 10 repetitions each side


If you can achieve the above with good control (maybe film yourself and check) , then that’s a good sign you are ready to introduce running. You can also use these tests as an exercise to improve your control and get run ready.


How is your pelvic floor functioning?


During pregnancy, the pelvic floor muscles are under some additional pressure and strain with the weight of the baby, placenta and extra fluid, which can all be equivalent of an extra 5 kgs in the last few weeks! So, pelvic floor dysfunction can still be common even after a C section.

Vaginal delivery places an additional stretch on the pelvic floor muscles, sometimes stitches and repairs are needed. You wouldn’t start running on an injured muscle straight away, without some proper rehab first, so we should think along the same ways after vaginal delivery. I would highly recommend having your pelvic floor muscles checked by a pelvic health physio before starting impact based exercise to see how your floor is functioning.


Other pelvic floor questions to consider are:

- Are you having any leaking? - Do you have vaginal heaviness? - Have you got ongoing constipation? - Are you struggling with pelvic pain? - Is sex painful since having your baby?

These can be signs that your pelvic floor is not working as efficiently as usual . So adding running into the mix too soon may not help and wont make an enjoyable run! Build up your foundations if you are having these issues and see a pelvic health physiotherapist to help guide you.


In summary, wait 4-6 months, do some strengthening exercises first and be pelvic floor symptom-free before running. There are some other more low-impact activities you can use pre-running, as a way of strengthening and getting your cardio fitness improved. These include, cycling, swimming, elliptical training, yoga, Pilates, low impact training or rock-climbing. Walking up hills is also a great way to improve your cardio capacity and get your glutes working in lower impact way



When you do get back to running, here are some of the signs that it may be too much, too soon:

- Urinary Leaks - Increased urinary or faecal urgency - Vaginal Heaviness - Bleeding (that is not associated with a period) - Pain (anywhere!)

These are indications that some further strengthening may be required or maybe you have added in too much, too early. Cut back your distance/time or add in some walk/jog intervals. See if that helps.


Find a pelvic health physio help


Here are some options: - CSP.org (search: womens health physio) - Themummymot.com - Or ask your GP to refer you for womens health physio on the NHS


Sources:

  • GottschallJS et Ground reaction forces during downhill and uphill running al J Biomech. 2005 Mar;38(3):445-52

  • Returning to running postnatal- Guidelines for medical health and fitness professionals managing this populations By Grainne Donnelly, Tom Goon and Emma Brockwell. Published March 2019 https://www.juliewiebept.com/tag/running/

Niamh Burn

Women's Health Physiotherapist

@Maternity Physio


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