Is it safe to run during pregnancy and postpartum?
Christy is a 32-year-old in her second trimester with her second kiddo. During her first pregnancy, Christy’s family was very concerned about her activity level which caused her to be concerned, so she stopped running. After her first child was born, she waited 6 months before getting back into running. She has been a runner since high school, and it is her favorite way to relax. Plus, the endorphins are a bonus, so she was very happy to get back to it! Now that her morning sickness from the first trimester has stopped, she is wondering if it is safe to run while pregnant and when she should start running postpartum. She made an appointment with her OB who gave her and baby a clean bill of health and no exercise restrictions. However, Christy wanted to be sure her body continued to be healthy throughout the remainder of her pregnancy and appropriate healing postpartum. She decided to reach out to a pelvic floor physical therapist to get an individualized assessment and treatment.
Christy is like many of the moms treated at Pelvic Balance where they want to either remain active during pregnancy and/or understand how to best allow their body to heal postpartum to get back to the exercises and activities they love. We know that exercise before pregnancy, during pregnancy, and postpartum has benefits for both the mother and child.1 For mom, the benefits include improved cardiovascular health, maintaining healthy body mass, psychological well-being, and improved pelvic floor strength. Exercise during pregnancy reduces the risk of pre-eclampsia, gestational hypertension, gestational diabetes, risk of C-section, use of instruments during delivery, and perineal tears. Exercise postpartum has been shown to improve the body’s recovery, increase the likelihood of having active children, and model a positive example of healthy behavior for kids. Women, whether pregnant or not, should get 150 minutes of moderate intensity exercise each week; however, most women are not achieving this recommended amount of exercise.1
Reducing or eliminating exercise during pregnancy can occur for a multitude of reasons including fear that exercise will harm mother or baby, lack of education on exercise recommendations, reduced time available to participate, or feeling unwell during pregnancy.1 Only about 31% of competitive runners continue running into the third trimester despite evidence that running is safe exercise, especially for those who ran regularly before pregnancy. Continuing to run during pregnancy increases the chance of postpartum return running.1
A survey of 883 female runners was performed which showed that 46% did not run during pregnancy and 25% did not return to running postpartum.1 One of the top reasons for not running during pregnancy was feeling unwell such as nausea. The top three reasons for concern regarding return to running postpartum included leaking urine, heaviness or pressure in the vaginal area, and not knowing how to return in a safe manner. Women who were less than 12-weeks postpartum most often reported that it was “too soon post-childbirth”.1
Overall, it is recommended that women be evaluated by a pelvic health therapist at 6 weeks postpartum regardless of whether they are a runner or not.1 However, it would be even more beneficial to be assessed while pregnant and postpartum especially when continuing activity and desire to return to running or other types of exercise. Remember, it is perfectly safe to continue exercise, including running, during pregnancy with a clean bill of health from your medical provider. It is recommended that postpartum women return to low-impact exercise during the first 12 weeks after birth. Emphasis should be on training various muscle groups, especially the abdomen and pelvic floor. After 12 weeks, a gradual and individualized return to running is recommended after an evaluation by a health professional like a pelvic floor physical therapist!1
Every pregnant and postpartum runner should be given a thorough and individualized assessment, including evaluating prior pregnancy/birth experience, prior physical activity, past medical history, examination of the muscles especially hip, foot, and abdominal muscles as well as a pelvic health assessment.2 Other aspects to keep in mind are fatigue, reduced sleep, and reduced nutrition, which can play a role in running capabilities and risk of running related injury. Typically, strength exercises will be recommended 2-3 days/week. The most important component is an individualized program created for you and your body during pregnancy and postpartum, which a pelvic floor therapist is uniquely qualified to help with!2 So if you are pregnant or postpartum and desire to continue or return to running (or any other activity), reach out to a pelvic floor therapist for an individualized assessment and to ensure that your body is functioning at its most optimal level.
Written by Jordan Schmidt, PT, DPT
References
- James, Megan L., Isabel S. Moore, Gráinne M. Donnelly, Emma Brockwell, Joanna Perkins, and Celeste E. Coltman. "Running During Pregnancy and Postpartum, Part A: Why Do Women Stop Running During Pregnancy and Not Return to Running in the Postpartum Period?." Journal of Women's Health Physical Therapy 46.3 (2022): 111-123.
- Christopher, Shefali Mathur, Sandra Gallagher, Amanda Olson, Sara Cichowski, and Rita E. Deering. "Rehabilitation of the Postpartum Runner: A 4-Phase Approach." Journal of Women's Health Physical Therapy 46.2 (2022): 73-86.
