How to return to running after pregnancy: 10 tips to make it work for you
02 September 2020
For some, running is a great way to get endorphins flowing and to sneak in some well-deserved alone time. And after you’ve had a baby, those things sound pretty appealing. But running is a high-impact sport and it’s important to be careful after you’ve had a baby.
Running is a great way to get fit, enjoy the fresh air and boost positive emotions. But if you’ve recently had a baby, you must take the time to recover properly. Whether you’ve completed numerous marathons or you’re a first-time runner, having a baby puts a huge strain on your body. Building strength back into your core muscles and pelvic floor will mean you’ll reduce the risk of injury and hopefully enjoy running for many years to come.
We spoke to leading postnatal physiotherapist Emma Brockwell, New Balance running shoe expert Liz Ellyard and consulted the Mumsnet forums to bring you these top tips for getting back into running.
When can you start running after birth?
NHS guidance advises that you wait until after your six-week postnatal check-up before starting any form of high-impact exercise like running or aerobics, but the latest research endorsed by the Association of Chartered Physiotherapists in Sports and Exercise Medicine suggests that you should wait at least 12 weeks before starting to run after you’ve had a baby, regardless of what type of delivery you’ve had.
Emma Brockwell, co-author of the Postnatal Running Guide (written by Emma Brockwell, Grainne Donnelly and Tom Goom), recommends visiting a pelvic health physiotherapist before returning to running, (you can ask your GP for a referral).
Emma says, “If you have any symptoms of leaking urine, or faecal incontinence, urgency of urine or bowels, dragging or heaviness in your vagina, lower back or pelvic pain or a doming tummy then don’t run until these symptoms have resolved. It’s a sign that your body still needs more time to heal. And if you experience any of these symptoms when you do start running, stop straight away and see pelvic health physiotherapist.”
Every woman’s body responds differently to pregnancy and childbirth and heals at a different pace. When it comes to postnatal exercise, the best thing you can do is take it slow and listen to your body.
Here are our top 10 tips for returning to running after pregnancy.
1. Take it slow
This really can’t be stressed enough. Even if you were running long distances during pregnancy, you shouldn’t push yourself too hard when you return to running after having a baby.
Start with walking or a short, gentle jog and work your way up from there, Couch to 5k is a good place to start
What Mumsnet users say:
“Don't just jump back into your normal routine – you need to work up slowly. You might find it a bit frustrating, but you can cause long-term problems if you don't.”
“You may find you bounce straight back, you may take some months to get going again. It's worth just taking it slow to find out what your body can do.”
2. Pelvic floor exercises are your friend
You’ve probably received a leaflet from your health visitor about the importance of pelvic floor exercises after giving birth. But with all the drama, joy and tears of having a newborn baby, it’s something that can easily slip off your lengthy to-do list.
It’s really important to get into the habit of doing your pelvic floor exercises, even if you eventually change your mind about this whole running lark.
Emma says, “Ideally we should start exercising our pelvic floor from puberty and continue throughout adulthood- like any other muscle in our body it needs a daily workout. After having a baby these exercises from the Pelvic Obstetric and Gynecologic Physiotherapy association can get the ball rolling.”
What happens to your pelvic floor during pregnancy and birth?
In case you’ve forgotten, your pelvic floor is the group of sling-like muscles that support your uterus, bladder and bowel.
In pregnancy, these muscles can become stretched and weak because of the continual weight that your bump is putting on them. As your baby grows bigger, the pressure increases, making it harder for them to do the job of preventing incontinence, treating prolapse and improving sex.
Childbirth compounds these problems and can do some real damage to the pelvic floor. Nearly a third of women develop some level of stress incontinence after giving birth.
The good news is that you can rebuild strength in your pelvic floor. For most women, it’s a matter of practice and patience. But if you’re struggling with leaks, don’t be afraid to speak to your GP or health visitor about it. They’ll be able to give you extra support or refer you to a specialist.
Running is considered a high-impact activity that puts extra strain on your pelvic floor, that's why it’s important to keep up with regular pelvic floor exercises. If you feel any heaviness in your pelvis (or any kind of dragging or pain), visit your GP straight away.
What Mumsnet users say:
“I did pelvic floor exercises every time I was feeding the baby.”
“Be careful with your pelvic floor. Too much running too soon can cause trouble – not being able to stop yourself peeing during a run, for example, it happened to someone I know.”
3. Core is key
Your core is the set of muscles surrounding your pelvis, hips, lower back and abdomen, it includes your pelvic floor, diaphragm, deep tummy and deep back muscles. They support you in almost everything that you do. Your core is put under a lot of strain during pregnancy and birth – and more so if you’ve had a c-section or perineal vaginal tear. Taking the time to strengthen these muscles will allow you to run further and prevent back, knee or hip injuries in future.
Try some postnatal yoga or Pilates as a starting point, and avoid intense core exercises like the plank and sit-ups. When you start running, try to incorporate some gentle exercises that will build strength in your core to reduce the risk of injuries.
What Mumsnet users say:
“Make sure your abdominal muscles are healed before doing crunches or planks. Do Pilates to help heal diastasis recti (a postnatal class or just from Youtube will help). But also make sure your pelvic floor is solid before doing anything with impact or you will regret it later!”
“Work on your pelvic floor and core first, for sure. It helps massively with learning to breathe well whilst running and improves your posture after pregnancy.”
4. Check your shoes
Your growing bump and the increased levels of the hormone Relaxin, which relaxes the ligaments in the pelvis and softens and widens the cervix in preparation for childbirth, can have a surprising impact on your feet.
It’s very common for shoe size to alter with pregnancy – sometimes permanently. So before you head out on your first run, make sure your footwear is supportive and comfortable.
Liz Ellyard (Senior Category Manager for Running Footwear at New Balance) says, “After birth stability from your footwear is key. With increased levels of the Relaxin hormone still in your body and your core and pelvic floor muscles still recovering you’re more prone to injury, so it’s really important that your shoes give you sufficient support.
I’d suggest visiting a specialty running store or website because you’ll get a customised service. They can explain what foot type you have and your running style and then advise the best shoe for you. If you’re not able to visit a specialist, look for shoes with good cushioning and a stable base."
What Mumsnet users say:
“Go and get your feet measured at a proper running shop that does gait analysis. Pre-pregnancy I was a 7D. Post-pregnancy I am a 8.5EE.”
5. Invest in a new sports bra
Your boobs grow and change shape as pregnancy progresses and, even after birth, they’ll continue to change. Investing in a good sports bra or two will keep you comfortable and feeling secure as you start running. Make sure you find one that securely fits you, but doesn’t squash your boobs. One that comes off quickly for post-run feeds can be helpful too.
What Mumsnet users say:
“Think about bra options. I found a Boobuddy invaluable helpful because I could get support while moving, but could remove it quickly once I'd finished my run! Very handy once I started driving places to run between feeds.”
“Running was a huge part of my life before having a baby and has continued to be important to me. I bought Syrokan bras from Amazon. Similar to Brooks Juno bras, they have adjustable Velcro straps that make them perfect for breastfeeding.”
6. Get some sleep – or at least try!
Exercise can be a surprisingly efficient way of boosting energy levels, even when you're feeling tired, but research has found that sleep is key for recovery from both physical and psychological stress.
With a newborn in the house, catching up on zzzs can feel like a tall order. But as you start introducing gentle runs into your routine, aim to piece together seven to nine hours of sleep in your day. Trying to nap when your baby sleeps in the day can help you catch up on some much-needed rest.
If you’re struggling to get to sleep, take care to avoid screens before sleeping, invest in a good maternity pillow, and avoid alcohol or caffeine. Even though it may feel counter-intuitive, prioritising sleep will help you return to running more effectively in the long run.
What Mumsnet users say:
“I wanted to wait, not only because I needed to recover, but also because I needed to prioritise sleep!”
7. Time your feeds
Feeding your baby before you head out on a run will mean they’re more likely to settle while you're away and your boobs will feel a little less full. Alternatively, you could try expressing milk using a breast pump and allowing your partner or a family member to feed while you’re gone.
What Mumsnet users say:
“If you're breastfeeding, feed just before you go for your run. Running with big heavy boobs is not comfortable!”
“Feed before you go. I would get into kit, feed baby, put bra on and go”
“If you’re breastfeeding, timing runs for shortly after a feed so your boobs aren’t like leaky rocks is a good tactic.”
8. Stay hydrated
Any mum who’s been there before will tell you that breastfeeding makes you seriously thirsty. Add in a 30-minute run and the thirst kicks up to astronomical levels.
There’s no set minimum amount of water you should drink, but as a rule of thumb, aim to drink around 50% more water than you normally would on the days that you're exercising.
9. Avoid time goals
Once you’re in the habit of regular runs, you might be tempted to start aiming for your new PB. Try and avoid setting time goals for yourself as it’s easier to overexert yourself if you're up against the clock.
If you're feeling well and want to set yourself a challenge, focus on increasing the distance and frequency of runs rather than your speed.
A good way to monitor whether you're overexerting yourself is to use the Rate of Perceived Exertion Scale – an RPE of 1 means very easy and 9 to 10 means you’re so out of breath you can’t speak.
When you first start running after pregnancy, you should be able to maintain a conversation with someone while you’re running. If you’ve been exercising a lot and have a higher fitness level, aim for an 8 or 9 during the work intervals. If you’re still building up your fitness level, aim for 6 or 7.
10. Take breaks
Start off by running two or three times a week. Taking breaks in between runs will help your body to recover and give you a chance to make sure you’re not pushing yourself too hard too fast.
The impact from a run can cause the muscles you’re strengthening to become strained and weakened. By taking days off, you’ll allow those muscles to rest and restore.
Is incontinence while running normal?
One in three women experience urinary leaks post baby, and running can exacerbate this. But it doesn’t need to become a fact of life. For most women, taking the time to build strength in their pelvic floor should result in regaining full control of their bladder.
Some women suffer from weak or damaged pelvic floors and require physio or surgery to repair the damage. If you’re experiencing incontinence when running or feel a heaviness or dragging sensation in your pelvis, raise it with your GP as there may be extra support that they can offer you.
Remember if you continue to leak and run you are likely to make it worse.
What is diastasis recti?
It’s very common for the two muscles that run down the middle of your stomach to separate during pregnancy. This is called diastasis recti or divarication. Almost all women are affected by this in some way. It happens because your growing womb (uterus) pushes the muscles apart, making them longer and weaker and can result in a protruding belly – that a lot of women feel self-conscious about after birth.
The separation between your stomach muscles will usually go back to normal by the time your baby is eight weeks old. If the gap is still obvious eight weeks after the birth, contact the GP as you may be at risk of back problems. The GP can refer you to a physiotherapist, who will give you some specific exercises to do.
Regular pelvic floor and deep stomach muscle exercises can help to reduce the size of the separation between your stomach muscles. It's also important to stand up tall and be aware of your posture.
What exercise can I do before 12 weeks?
Just because running is off the cards, doesn’t mean you can’t do any exercise. If you’re feeling up to it, you can begin to do light exercise as soon as you feel well enough to these guidelines may help. They've been written by specialist physiotherapists to support women returning to running (Brockwell, Donnelly, Goome, Dr Rankin, Dr Mills and Dr Marlize De Vivo – full details can be found in the British Journal of Sports Medicine). If you feel uncertain or in pain, always consult your GP or a health visitor.
Start off with basic breathing and pelvic floor exercises. If you had a vaginal birth, then you can go for walks as soon as you feel comfortable. Pushing a pushchair is a good way to slowly build strength.
Between two and four weeks, you can try a few squats, lunges and bridge poses to build up your pelvic floor and core strength. You may want to join a postnatal yoga or pilates class if you want some extra guidance.
If you’re feeling well between weeks four and six, you could try some low-impact exercises, like time on the cross trainer or on an exercise bike, if it feels comfortable.
By week six you could up the pace of your walking and see how it feels. You could also try cycling – if you’re not sore, some gentle strength training, swimming or spinning.
If you’ve had a c-section, you’ll need to take things a little slower. NHS guidelines recommend that you don’t lift anything heavier than your baby for at least six weeks. That’s because you need to allow time for your scar to heal and your abdominal muscles to recover.
The key is to take it slow. Don’t push yourself, but instead listen to your body and take your time to build up strength.
If you ever feel a strain or pain while exercising, visit your GP or ask to see a postnatal physiotherapist.
When is running after birth not a good idea?
Some women may be advised that returning to running isn’t an option for them after birth. This might be due to previous health conditions or complications during labour.
If you experience any of the following symptoms during your run or shortly after, you should visit your GP or a pelvic health physiotherapist to ask for advice. You may need to do some more strength work before returning to high-impact exercise.
- Heaviness or dragging in the pelvic area (can be associated with prolapse)
- Leaking urine or inability to control bowel movements
- A noticeable gap along the midline of your abdominal wall, called the pendular abdomen. This may indicate diastasis rectus abdominis (DRA)
- Pelvic or lower back pain
- Ongoing or increased blood loss beyond eight weeks postnatal that is not linked to your monthly cycle
If I can’t run, what exercise should I do?
If you’ve been advised not to run, there are plenty of other exercise options available to you. Brisk walking can get the heart rate moving in the same way that running can, and swimming is a great option too as it's a good low-impact cardio workout. You could also try cycling or spin classes if that’s comfortable for you or, if you want to try exercising with your baby, you could try a BuggyFit class in your local area.
With a bit of research and trial and error, you should be able to find some sort of exercise that suits your body and your lifestyle. Don’t worry if you’re not feeling up to exercise yet – looking after a newborn baby is exhausting work. Just go at your own pace and your body will tell you when it’s ready.
What is Couch to 5K?
Couch to 5K (or C25K) is a programme that aims to get you comfortably running 5K. It works by gradually increasing the distance you run over nine weeks, at your own speed, so that it won't be so lung-burstingly painful you're put off for life.
For example, in week one, you start with a brisk five-minute walk, then alternate 60 seconds of running with 90 seconds of brisk walking for 20 minutes, three times a week.
During week two, after your warm-up, you alternate 90 seconds of running with two minutes of walking, and so on.
One of the most popular elements about C25K is that, apart from being ultra fuss-free, many runners notice an improvement in their stamina and strength from the get-go. As one Mumsnetter says: “It was really great, I couldn't believe how quickly I progressed from wanting to die as a beginner to running a fair distance.”
What are the best Couch to 5k apps?
There are lots of running programmes that will help you to set your pace and build up fitness slowly. Test out a few to see which one works for you.
Here are some apps that Mumsnet users recommend:
Couch to 5k
“I use the NHS Couch to 5k app (green logo) with Sarah Millican's voice. I like to think she's sympathetic with my cause!”
“I've got Sarah Millican saying ‘well done, flower’ as well. I couldn't face some Olympian who has clearly been running 5k since infancy”
“I like Sarah Millican and Jo Wiley best. Sarah is very encouraging, but Jo really believes I can do it, so I tend to stick with her now.”
“I use Zen. You can have it giving fulsome encouragement and halfway marker notes, just walk/run commands, or nothing at all (just vibrate for the next walk/run section). I opt for the just walk/run prompts version and listen to my own music/podcast.”
“I love this app. The main one is very manageable for beginners. I found it really good because I wanted to go out the next time to find out what happened next.”
Need some moral support? Join a Couch to 5k group on Mumsnet’s exercise forum.
When can I jog with a baby in a buggy?
You might like the idea of taking your baby on runs with you – it’s a great way to get fresh air and bond with your baby at the same time. To do this you’ll need a specialist jogging buggy, i.e. one that has a five-point harness for the baby, fixed front wheels, hand-operated brakes, rear-wheel suspension, pneumatic tyres, three wheels and a wrist strap.
You shouldn’t try jogging with your baby until they’re at least six months old and can hold their head up. Start slowly with two hands on the buggy to ensure that you’re not adding any extra strain on your hips, back or pelvis.
What Mumsnet users say:
“I started running with a proper running buggy when my son was about six months old. I had been running by myself maybe two or three times a week for two months, by then. It's a different running style, but you do get used to it.”
About Emma Brockwell
This article has been fact checked by pelvic health physiotherapist Emma Brockwell. Emma runs a pelvic health clinic at Body Logic Health in Battersea. She’s a member of the professional network Pelvic Obstetric and Gynaecological Physiotherapy (POGP), the Chartered Society of Physiotherapy (CSP) and a member of the Health and Care Professions Council (HCPC)
She’s currently undertaking further research on postpartum female runners with Cardiff Metropolitan University. You can take part by filling in this questionnaire.