Five Myths About Returning to Run Postpartum

Author: Dr. Blair Green PT, DPT, OCS, PHC

You’ve been waiting for this day for weeks, maybe months. You are enjoying life with your new baby but it’s time to do something for you. It’s the morning of your FIRST POSTPARTUM RUN. Your shoes are laced up, clothes sitting out and playlist perfectly curated. You can’t help but wonder, “Will my body be okay?” “Have I waited long enough?” “Am I strong enough?” “Will I leak?” “Will it hurt?” 

As a women’s health physical therapist, and a mom, I’ve been in your shoes, literally. I know what to do (and I did the things) and the truth is there is no perfect return to run. More than likely, something unexpected will occur. You may have symptoms. You may not make it as far or run as quickly as you intended - and that’s okay! But should you be scared to take that step? Absolutely not!

Here are 5 myths about returning to running postpartum that I want to dispel, so that you can feel more comfortable and confident when that time comes:

1. You must wait 12 weeks before returning to running

In 2019, clinical guidelines were published suggesting that it’s best to wait approximately 12 weeks before returning to run. This timeline is generalized and it’s best to listen to your body. Postpartum healing is necessary. However, every woman is different and there are other factors to consider, including prenatal fitness level, type of delivery, ease of pregnancy, pregnancy exercise, and overall strength. You also need to consider sleep and stress. Energy levels and stress levels play a role in injury prevention and successful return to exercise.

Bottom Line: In the first few weeks and months after delivery, focus on strength: core, pelvic floor, hips and lower extremities. After that, check in with how you feel. If you feel ready, you likely are, even if it’s at a slower pace or shorter time than what you would normally run.

2. If you are leaking urine or experiencing pelvic pressure you must stop

These two symptoms are common in the post-partum period. Without getting too into it or this blog (you can read more about this here), know that physical therapy is a great intervention to address these problems. However, your body may feel ready to run before you have completely eliminated leaking and/or pressure. If you are a seasoned runner, having to shut down until you are completely symptom-free can be frustrating. While I don’t condone starting back before you are ready, or doing “too much too soon,” there is no need to hold off until you are 100% free of symptoms. You can begin a return to run program while simultaneously working to improve and resolve your pelvic floor dysfunction. With the help of a physical therapist, you can design a program that will maximize your running progress while minimizing any leaking or pelvic pressure.

3. Do not run if you have diastasis recti

Again, the last thing I recommend is shutting everything down - unless you are dealing with severe pain or a medical emergency, everything is modifiable. Diastasis recti, or abdominal muscle separation, is common in pregnancy/postpartum and likely will not worsen with exercise. In the past, diastasis recti was seen as a red flag to high impact exercise. In general, addressing any symptoms, such as pain or weakness, is important and physical therapy is a great way to do this. Similar to lingering pelvic floor symptoms, you can work on restoring the form and function of the abdominal wall (with a PT’s help) while simultaneously resuming a running program.  

4. I did all the “pre-running” exercises - this shouldn’t be difficult

Working on the strength of the core, abdominals, and glutes, as well as focusing on breathing, alignment and mobility are all necessary parts of postpartum recovery. Ideally, these should precede any attempt to return to run. You must have a stable base to build from. However, putting in the work during the first few weeks does not guarantee a smooth transition back to running. Some women will do all of this work and still struggle with high impact exercise, including running. Tolerance for exercise involves more than just strength or stamina. You must consider other factors, such as stress, nutrition and sleep. Having a baby is a BIG CHANGE - even if it’s not your first child. Each delivery, and new baby, brings its own set of challenges. Getting back to regular running may be difficult, and that’s okay. Focus on what you can control, including being consistent not only with exercise but also with your diet, making sure you are adequately resting, and asking for help when you need it. Take your time and do what you can. It gets easier.

5. If I can’t run more than once or twice a week, I should not run at all

Bottom line: you just had a baby, give yourself grace!  As I previously mentioned, your physical health may not be your only challenge during this time. Are you nursing? Do you have enough help at home? Are you already back at work? Are you getting enough sleep? It’s hard to fit it all in. A favorite motto of mine is “done is better than perfect.” This is certainly true for new moms. If it’s easier to run in short intervals or less times a week, by all means do that. Nobody is keeping score. If you are keeping track yourself, check a box because you got it done. And, done is better than perfect.

There it is - the good, the bad and the less than ideal. I know you’ve been waiting weeks for this, maybe months. Take a quick inventory of where you are physically, how your mind and body feel, put on those shoes and go for it.