Great question! In 2019, three Pelvic Floor therapists developed return to running guidelines and established certain benchmarks for post-partum women. While research is still lacking in this area, these guidelines and benchmarks are a collection of the best practice information we have at the moment. ..
A few take-away’s:
Running is a high-impact activity is associated with a sudden rise in intra-abdominal pressure and; therefore, a lot of that pressure and forces are transmitted through the pelvic floor. It highlights the importance of having a strong pelvic floor musculature and to be able to address the increased load on the muscles of the pelvis.
- Return to running is not advisable if any of the following subjective issues are identified during screening: Urinary or fecal leakage prior to or while running, pressure/bulge/dragging of the vagina prior to and/or during running, ongoing vaginal bleeding not related to menstrual cycle during or after attempted low impact or high impact exercise, or other musculoskeletal pain (i.e. pelvic pain prior to or during the commencement of running.
- Aim to return to running between 3-6 months part-partum provided that you can pass the criteria listed below for both:1. load and impact management and 2. strength testing.
- Load and impact management assessment:
In order to successfully complete this assessment, you should be able to complete the following without pain, heaviness, dragging, or urinary leakage (incontinence):
- Walking for 30 minutes
- Single leg balance for 10 seconds
- Single leg squat 10 repetitions each side
- Jog on the spot for 1 minute
- Forward bounds 10 repetitions
- Hop in place 10 repetitions each leg
- Single leg “running man”: opposite arm and hip flexion/extension (bent knee) for 10 repetitions each side
In order to ensure key muscle groups are prepared for running, each of the following movements should be performed with the number of repetitions counted to fatigue. Aim for 20 repetitions for each test:
- Single leg calf raise
- Single leg bridge
- Single leg sit to stand
- Side lying hip abduction
CAUTION! If you can do these exercises for number of repetitions and with good form, however, running is still not feeling “good” to you, then, there may be other factors preventing you from reaching your goal. These guidelines also suggest being assessed by a pelvic floor PT and strength training your full body and pelvic floor for a minimum of 6-12 weeks after your 6 week post-partum follow up with your doctor.
While these guidelines are helpful, don’t forget that if you are experiencing pain, leakage, or need some guidance, Pelvic Floor Physical Therapy can help!
If you need assistance getting back to your activity or the sport that you enjoy, call us today!
Lisa Pan, PT, DPT
Staff Physical Therapist
Pelvic Therapy Your Way