One of the common questions we get during our Post Natal MOTs is when can I go back to exercise and how do I know if I’m ready? A lot of clients come in searching for answers after getting mixed advice at their 6 week post natal follow up and reading varied opinions online.
Clinical evidence for return to running post natal is limited, however 3 expert clinicians in the UK, Tom Groom, Grainne Donnelly and Emma Brockwell, have recently put together new guidelines to provide the best available advice to help clients and clinicians.
When can I return to run?
At Four Sides London we suggest each client come in for a Post Natal MOT for an individualised assessment to ensure to you are ready to return to running and we use a similar assessment to the one outlined in the new guidelines. It is important that your body is strong enough to return to high impact exercise as returning too early can put you at risk for developing pelvic floor dysfunction.
The majority of information given by GPs suggests that you are safe to return to exercise at 6 weeks post natal however due to the high impact nature of running it is suggested that you wait a minimum of 12 weeks post natal and you should avoid running and seek treatment if you are experiencing any symptoms of urinary incontinence, fecal incontinence, heaviness/bulging/dragging in the vagina, or musculoskeletal pain as running may aggravate these symptoms or make them worse.
Waiting 12 weeks allows the body more time to heal from delivery and gives you time to strengthen your pelvic floor, core and leg muscles as well as decreases your risk for pelvic floor dysfunction.
How to assess readiness for return to running
When assessing you for readiness to run during a post natal MOT we will look at your pelvic floor strength and stability in a variety of ways and the new guidelines suggest you should be able to meet the following requirements:
Pelvic floor contractions in standing:
1) 10 quick pelvic floor contractions
2) 8-12 repetitions of 6-8 second hold of maximal pelvic floor contractions
3) 60 second hold of submaximal (50%) contraction of pelvic floor
Complete the following tasks without any pain, dragging, heaviness, or leaking
1) walk for 30 min
2) stand on one leg for 10 seconds
3) single leg squat 10 repetitions on each side
4) jog on spot for 1 min
5) 10 forward bounds
6) hop in place 10 repetitions on each leg
Complete 20 repetitions of the following strength tests without rest
1) single leg calf raises
2) single leg bridge
3) single leg sit to stand
4) side lying leg lifts
In addition to these physical tests it is also recommended scar mobility, abdominal muscle separation, sleep quality, post natal depression and whether or not you are breast feeding be taken into consideration for readiness to run.
How do I return to running?
Once it has been 12 weeks and you have the strength required to initiate a running program it is important to start with a slow and graded approach to give your body time to adjust. We suggest starting with 1-2 min bursts of running interspersed with walk breaks and increasing your total weekly running distance and time by no more than 10% each week. At Four Sides London we can help you put together a return to running program or the NHS couch to 5k program is a great and safe place to start.
If you are eager to get back to running and it hasn’t been 12 weeks since delivery or you don’t have adequate strength yet, do not worry as there is plenty of low impact exercise to keep you busy and help prepare you for running.
Our post natal Pilates classes and strength and conditioning classes for mums are a perfect place to start your strengthening and post natal recovery journey and at our post natal MOT assessment we can help you put together a plan to meet you goals for return to running and beyond.
Whilst these guidelines are written specifically for running, we can apply the same advice and strength criteria to returning to all high impact or high energy sports. Tennis and others ball sports, mountain biking, skiing and water sports are all examples of high load exercises. If this is your goal, test yourself with this checklist of strength criteria before you begin to avoid injury and ensure a strong return to your sport.