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What studies say about returning to running as postpartum exercise

Most of the therapists in our office are moms, and we intimately understand wanting to get back to exercise after delivery. Caution should be taken when returning to running postpartum - we see this clinically and research also shows postpartum movement strategy changes that can increase your risk of injury.

A recent pilot study by Provenzano et al., 2019 compared the biomechanical changes of runners pre-pregnancy (or <14 weeks gestation and postpartum). They found at six weeks postpartum subjects had decreased trunk and pelvic rotation, decreased running speed, with increased step width and stance time compared to pre pregnancy measurements. They also found decreased motion in the hips with increased motion at the knee as a compensation.

These findings are similar to several studies that have assessed walking in pregnancy. It is believed that these changes may help with stability and prevent falls. These changes may also be compensations to avoid pain in the back and/or hips.

Exercises that improve range of motion

What’s important about this article is that most women are cleared to return to running at six weeks postpartum when pregnancy related changes in the trunk and pelvis are still present. Further studies need to be done to determine how long these changes remain.

Pelvic stabilization may be an appropriate strategy to prevent these biomechanical changes during pregnancy. In another biomechanical study by Mens et al., sacroiliac joint mobility was measured in pregnant patients with a belt. They found decreased sacroiliac joint laxity and improved stability with movement through the pelvis while wearing a belt.

In a systematic review of twenty-three articles, pelvic stabilization exercises were beneficial at decreasing low back and pelvic girdle pain in pregnancy (Bogaert et al., 2018). A combination of using a pelvic belt and internal stabilization through exercises could possibly help decrease muscle overuse and allow for better range of motion through the pelvis, trunk and hips. A pelvic brace or belt is not always necessary but can help with pain management. Seeing a qualified physical therapist or pelvic floor therapist can help you determine if this is something you may need.

Contact us for a telehealth session in California (or virtual consultation worldwide) so you can improve your form and function with your postpartum return to running program.

 

Resources:

Bogaert, J., Stack, M., Partington, S., Marceca, J., & Tremback-Ball, A. (2018). The effects of stabilization exercise on low back pain and pelvic girdle pain in pregnant women. Annals of Physical and Rehabilitation Medicine, 61. doi:10.1016/j.rehab.2018.05.356

Mens, J. M., Damen, L., Snijders, C. J., & Stam, H. J. (2006). The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain. Clinical Biomechanics, 21(2), 122-127. doi:10.1016/j.clinbiomech.2005.08.016

Provenzano, S. G., Hafer, J. F., Peacock, J., Kempner, S., Zendler, J. D., & Agresta, C. E. (2019). Restriction in Pelvis and Trunk Motion in Postpartum Runners Compared With Pre-pregnancy. Journal of Womenʼs Health Physical Therapy, 43(3), 119-126. doi:10.1097/jwh

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Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

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Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

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Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

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Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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