Running after baby pelvic floor postnatal

I get asked this question a lot, so I think it deserves a blog!

Unfortunately there is no simple answer, because EVERYBODY’S DIFFERENT! So you need to start listening to those motivational memes on Facebook telling you not to compare yourself to others- it doesn’t matter that your friend was back running 3 months after giving birth. Someone who was fit before and during her pregnancy, and had a quick labour with no tearing will recover a lot faster than someone who isn’t a regular exerciser and/or had a difficult labour. This is about what’s right for you.

It Takes Longer to Heal Than We Realise

postnatal recovery

I have seen it advised that it takes at least a year for the pelvic floor to return to full strength , and if you look at the graphic above, you can see why that is! Connective tissues, such as tendons and ligaments, have a slower healing rate than muscle, and there’s a lot of this within the pelvic basin.

This doesn’t necessarily mean you can’t run for a year though!

Here are some guidelines to help you decide whether to start running yet, and signs that you need to slow down.

We’ll start with a hormone called relaxin which is released into your system in the early stages of your pregnancy. Its job is to relax your ligaments to help prepare your pelvis for childbirth, but relaxin doesn’t just affect your pelvis, it affects every joint in your body. And it stays in your system for up to 6 months after birth, or until you stop breastfeeding.

As a result your joints aren’t as stable as they once were. When you run, your entire body weight lands on 1 leg with a G-force of 2-3. So there’s a lot of impact going through those unstable joints. Plus, for those of you who no longer have relaxin circulating: I’ve assessed a lot of clients over the years, and most people have poor alignment in a 1 leg stance. If you wobble when standing on 1 leg, how well will you cope with impact?

Next up is your pelvic floor.

If hasn’t recovered yet, chances are, you’ll wee yourself the first time you go out for a run, and could do yourself some everlasting damage. Even if you don’t suffer any incontinence, if you feel a heaviness down there: stop.

Unfortunately incontinence is accepted as normal by many women. Common, yes, but not normal, even if you just leak a “little bit” when you sneeze or jump. In the majority of cases it can be resolved, so if you have any doubts about your pelvic floor see a Women’s Health Physio and follow an appropriate exercise routine. And no running! If you place pressure on a dysfunctional pelvic floor it’s never going to heal.

Do you still have diastasis recti?

Your abdominal wall forms a sort of pressure system with your pelvic floor, low back muscles and diaphragm. And if you have diastasis, there is a weakness in that system, which means your back is going to be less supported while you run, and potentially there’s going to be more pressure on your pelvic floor too. So focus on restorative core exercises before starting anything high impact.

I know the idea of no running can be hard.

For many it’s not just the physical side (although it does feel good to go for a good run and feel like you’ve worked) but the mental side, as it relieves stress and gives you time to yourself. But remember: this is a phase of your life. It will pass, and it is so small compared to the bigger picture. At some point you will be able to run and jump again, just as long as you don’t rush things now.

Jenny Burrell of Burrell Education explains this brilliantly: You brush your teeth every day, even though you could get dentures implants if all your teeth fell out, but there is no replacement for your pelvic floor!

So, you can start running again, if:

  1.  Your pelvic floor is in check.
  2. Your diastasis recti is healed.
  3.  You’ve done a couple of months’ worth of work on restorative core exercises, and some whole body strengthening.
  4. You’re at least 4, if not 6, months post partum. This is a minimum- some will need longer.
  5. You’ve invested in a good sports bra (always a must with impact exercise, but especially when breastfeeding!)

What if you’re not yet ready to run?

I have a few blogs to get you started- this one has training tips to get you fit to run, and this blog has my top 5 postnatal core exercises. You can also download my top 10 tips for getting in shape after having a baby here.

Should postnatal mums do ab curls?

I’ve talked a lot on social media about crunches and sit-ups being a no-no when you’re postnatal, but a video I shared on my Facebook page recently seemed to really hit the mark. Aside from the comments and shares, I had quite a few mums tell me how clear it made things for them.

So I thought it was about time I wrote a blog on this. Unfortunately there’s a lot of bad advice out there when it comes to postnatal exercise, and many new mums do crunches to try and flatten their tummies, so we need to keep spreading the word that IT DOESN’T WORK!

Before I carry on, here’s the video:

 

Sit-ups, or any variation of this movement that works the six pack muscle, can cause more harm than good.

So, if you’ve recently had a baby and you’re doing sit-ups, STOP them immediately!

During pregnancy the first thing your six-pack muscle (Rectus Abdominis) does is lengthen, vertically. Then, as your pregnancy develops, and your baby grows and your bump gets bigger, this muscle starts to separate around your belly button.  This is referred to as Diastasis Recti. The abdominals can take time to re-align after your baby has been born, so for several weeks and indeed months (or for some, years) after birth, your six-pack muscle remains in a lengthened, separated state.

The first thing we need to do regarding this area is actually focus on connecting to your pelvic floor which is a bit like a sling of muscles supporting you from underneath, and the deep abdominal muscles which lie under your six-pack muscle.  This deep muscle is known as the Transversus Abdominis (TVA).

Strengthening the abdominals after birth, and specifically the TVA and pelvic floor, is a bit like building a house.

If your house has a solid framework and foundations, it will always be strong.  If you work on strengthening the deepest muscles first, then focus on the next layer, then the next layer after that, then your abdominals will re-align to their original structure.

What do crunches do?  They strengthen and work the six-pack muscle.  During pregnancy, we know that this muscle has lengthened and separated.  If you don’t have a solid foundation underneath this six-pack muscle before you work it (I’m talking about your core and pelvic floor here), then by doing crunches, you’re actually going to make your separation worse.  In other words, any separation you had after birth, will now be wider, because you’re forcing the muscle to strengthen, when it’s still in a weakened, separated state.  The amount of abdominal pressure placed on the six-pack muscle when performing a sit-up, forces it to separate further apart. As shown in my video.

And here’s what the pressure can do to your pelvic floor:

 

I follow a system with postnatal clients which involves locating the TVA first.  We connect to and strengthen that, along with lots of focus on the pelvic floor.  Once function in these muscle groups has been gained, then strength work can be done.

So, I hear you ask: “Why do people do sit-ups?”.  Well, in most cases, people do sit-ups in the hope that they will get themselves a toned, flat stomach and a noticeable six-pack.  I’m here to tell you that doing sit-ups AREN’T going to help you (as a postnatal woman), or anyone you know, male or female, get a six-pack.  Your body needs to be extremely lean to do this, which has nothing to do with sit-ups! (See this blog for my thoughts on having visible abs as a fitness goal.)

As a final point: I don’t even use sit-ups for clients who don’t have diastasis recti. As explained on athletic coach Eric Cressey’s website here:

“World-renowned low-back researcher Dr. Stuart McGill says that we have a finite number of flexion/extension cycles in our back until injury is caused. That number is different for every person, but the bottom line is that by performing exercises like crunches and sit-ups, you’re increasing your risk for injury with every rep!”

Plus, they’re promoting a rounded posture, which is the very one I’m usually trying to get clients out of, after too much time sat at a desk!

I do sometimes use crunches, but never in the early postnatal phase, and doing a crunch where you are engaging your transverse abdominis is very different to an uncontrolled crunch. So I recommend having a professional (physio, trainer) teach you how to do one properly, and also assess whether you need to do them.

Please share this blog and forward it to anyone you think might find it useful, as unfortunately I still see a lot of ab dominant work recommended for postnatal women- this myth needs busting!

For help with your postnatal fitness click here to find out more about my next Restore My Core course, or get my 10 Tips for getting back in shape here. You can also read what core exercises ARE safe and effective when you’re postnatal here.