I come from a running background. I started athletics before I started school, and competed twice a week until I was 18. In young adulthood, running was my go to form of exercise, infact, I didn’t really know how to do anything else.
However, I have also experienced pregnancy and childbirth twice. And I can honestly say that running was one of the last things I wanted to do for exercise. In saying that, there are some women who have even run marathons during pregnancy, and if you google “running and pregnancy” mostly you will find answers like: “Running is okay during pregnancy if you were regularly running before you got pregnant and you feel good”. It’s also free, and requires zero equipment. So if you are a pregnant or postpartum runner right now, or are thinking of becoming pregnant, there are a few things to consider first. (that you won’t hear from Dr.Google or from your real Doctor.)
#1. During pregnancy the pelvic floor tissues or pelvic floor muscle group (PFM) soften in preparation for childbirth. They are also placed under strain from the mother’s increasing body weight and the weight of the growing baby and maternal weight gain (which at full term is an extra15-20kg on average) and carrying it around in a stretchy balloon for nine months. The pelvic floor is very vulnerable at this time and by the time your baby has been born, your PFM group has taken quite a beating. Literally.
#2. If you delivered vaginally, you need to be aware that childbirth is one of life’s most brutal feats. Birth is a physical marathon that results in tenderness, soreness, grazes, difficulty pooping, swelling, fatigue, blood loss, and dehydration. Some women also suffer tearing during delivery to the perineum. These tears can be mild (1st degree) to severe (4th degree). Tearing to the pelvic floor muscles means that the way it functions and it’s strength has been compromised. Most people are not aware that having a baby requires rehabilitation, but if you tore a muscle or ligament in your leg, would you be able to run on it again with out resting and rehabilitating it first?
#3. You may be dying to ask your doctor at your six week check up – when can I start exercising? However, most GP’s at this check up do not check for diastasis recti or screen for pelvic floor function. Most women will think they feel fine, and the approval from the doctor at the postpartum check up confirms this belief. Fitness centres and Mummy bootcamps are encouraging the dangerous “ get your body back” culture and social media is compounding this message worldwide!
#4. And if you are already highly conditioned before and during pregnancy, you are most likely used to pushing your body. However, despite your high level of fitness you have probably never been taught how to use your pelvic floor or TA and are awesome at compensation patterns. You probably feel strong and healthy, and an easy birth can cause some of us to think we don’t need rehab. However, don’t make the mistake that because your other muscles are strong, that your pelvic floor is just as strong. In fact, athletes need a much stronger pelvic floor than those of the rest of the community.
#5. Pelvic health has a huge impact on a woman’s quality of life.
#6. Running is a high impact exercise (which are generally inadvisable during pregnancy and postpartum). When the heel strikes the ground during running, the physical force associated with landing passes down through the pelvic floor and then to the ground via the lower limbs. This impact can have the effect of stretching the pelvic floor muscles and when repeated over time the pelvic floor can become progressively stretched and weakened. In actual fact, the force behind hitting your heel to the ground is 3 x your bodyweight!
#7. Just because you have zero current symptoms does not mean there is no potential to develop some in the near future. This advice is not designed to scare you away from running. The intention is for you to evaluate the risk vs the reward. Is running going to help you or hinder you? What is the implications for your long term pelvic and back health? Could you wait a little bit until you start running again? Have you seen a pelvic physio for an internal pelvic floor assessment first?
#8. Pelvic floor problems can mean this- leaking urine, leaking or not being able to hold in bowel movements, pelvic organ prolapse, lower back, hip or knee injury, weak or dysfunctional core abdominal system, constipation and urinary tract infections. Not all women experience these symptoms. Many do in some way or another. Running may just make these symptoms worse.
Now I know it’s nearly impossible to prevent a runner to stop running unless they lose a leg. And as I said, maybe not all pregnant runners will experience pelvic floor dysfunction during or post pregnancy. And since running is not harmful to the baby in utero, you may be determined to keep it up. Well that is your choice and I commend you for staying active! So here a few ways you can reduce the likelihood and severity of PFM dysfunction.
- Book a Pelvic Physio appointment during pregnancy to discuss the risks for you, and as soon as your postpartum bleeding has ceased for an internal assessment of your pelvic floor muscles.
- Begin Pelvic floor and TVA activations with diaphragm breathing as soon as you can after birth, and practice them throughout your pregnancy (this will ensure a smoother recovery postpartum as well as keep you strong during pregnancy.)
- Once you have the all clear from your Physio to begin running, build up slowly. Begin with soft surface jogging for 30secs, walking in between each 30sec bout of running, and build up the distance/duration gradually. For pregnancy, you may be able to continue running in your first trimester and then gradually regress the duration and distance as your bump grows.
- Build up your glute and leg strength after pregnancy and keep them strong during pregnancy. Strength based exercise should be done with core and pelvic health in mind (with functional Pf activation and diaphragm breathing). Unlike running which breaks down muscle tissue, lifting weights builds muscle tissue, thereby supporting your joints and ligaments, increasing metabolism, reducing the effects of ageing, increasing muscle tone, bone density, strength and improves muscle power and endurance (side benefit to improve your running when you do return to it!) Love your cardio? No problem! Turn your weights routine into a circuit and feel your heart rate soar! There are so many more benefits to weight lifting for women! So why not give it a go?
- Reduce the length of your strides and try not to run with a heel strike. Also, high speed, downhill and hard surface running will be more likely to cause greater pelvic floor impact and downward pressure on the pelvic floor so slow down your speed wherever possible and run on grass or sand. Begin with a slow shuffle and land on your midfoot.
- How is your posture? Do your run with your butt tucked under? Optimise your diaphragm to pelvic floor connection (and your glutes) by utilising the ski jump posture from Julie Wiebe (more on this in my ebooks or you can google julie weibe PT).
- Hill walking or hiking is a great way to stay conditioned in late pregnancy (unless you have pelvic girdle pain) and postpartum.
Would you like more information on pregnancy or postpartum exercise? I have created programs for all stages from pregnancy to beyond for restoring the core and pelvic floor to enable you to have a smooth birth and recovery and return to your previous athletic activities! Click Here.