ElonRUNS Blog

Postpartum Running Fact Sheet

Postpartum Running Fact Sheet

●  Return to exercise will vary woman to woman and there is no specific set time of when you may safely return to activity. Only true marker to return to exercise is to be deemed physically and medically safe by your doctor.
●  The physiologic and morphologic effects of pregnancy on a woman’s body may persist for 4 to 6 weeks postpartum. Common suggestions are to wait to return to exercise 6-8 weeks after delivery.

Contraindications/Precautions
●  Contraindications have limited research
●  Ligamentous laxity from breastfeeding
○ Laxity persists until after breastfeeding cessation
●  Pelvic floor dysfunction (Goom et al, 2019)
○  Urinary and/or faecal incontinence
○  Urinary and/or faecal urgency that is difficult to defer
○  Heaviness/pressure/bulge/dragging in the pelvic area
○  Pain with intercourse
○  Obstructive defecation
○  Pendular abdomen, separated abdominal muscles and/or decreased abdominal
○  strength and function
○  Musculoskeletal lumbopelvic pain
●  Pre-existing hypermobility condition (Ehlers-Danlos) (Goom et al, 2019)
●  Obesity (Goom et al, 2019)
●  C-section (Goom et al, 2019)
●  Diastasis recti (Goom et al, 2019)

Risk Factors to Postpartum Pain

●  Length of labor
●  Ethnicity: non-white
●  Marital Status

Benefits

● Physical activity before, during and after pregnancy could prevent or reduce postpartum depression
○ Ensure that the physical activity is stress-relieving and not stress-provoking to attain these benefits

● Breastfeeding
○ May have increased production and better quality milk (no evidence that moderate-vigorous exercise
decreases milk production)
● Postnatal/Postpartum Depression
○ Exercise before, during and after pregnancy may reduce the risk of postpartum depression
■ Stress relieving NOT stress provoking physical activity
●  Reduces fatigue and increases vigor
●  Improves mood states,mental acuity and overall fitness
●  Promotes return to pre-pregnancy weight
●  Decreases the risk for developing future chronic health conditions

Suggestions

●  Obtain medical clearance from your provider before returning to exercise
●  Start slow and build up load over time
■ Individualized
■ Gradually introduce various resistance training and/or functional training activities.
● Breastfeeding before exercise
■ Decreases amount of acidity in milk compared to breastfeeding after exercise
● High-intensity exercise can increase lactate levels in milk.
■More comfortable, less of a chance of feeling “full” during exercise
■Consider breastfeeding or pumping just before exercising to both feel more comfortable when you are      exercising and avoid the increase in lactate associated with high-intensity workouts.
● Consider pelvic health physical therapy postpartum
■ Estimated that 50% of women have decreased pelvic support after vaginal delivery
● Prevalence of organ prolapse 3-6 months postpartum range from 18-56%■ Urinary incontinence rates range from 15-30% in postpartum population

○ Goom et al 2019
■Strong evidence for pelvic floor retraining for treatment of urinary incontinence in postpartum population
■Individualized assessment for “prevention and management of organ prolapse, urinary incontinence, and      improved sexual function” (Level 1+ evidence)

Resources:

Artal R. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. ​British Journal of Sports Medicine.​ 2003;37(1):6-12. doi:10.1136/bjsm.37.1.6.
Blyholder L, Chumanov E, Carr K, Heiderscheit B. Exercise Behaviors and Health Conditions of Runners After Childbirth.Sports Health: A Multidisciplinary Approach​. 2016;9(1):45-51. doi:10.1177/1941738116673605.
Tenforde AS, Toth KES, Langen E, Fredericson M, Sainani KL. Running Habits of Competitive Runners During Pregnancy and Breastfeeding. ​Sports Health: A Multidisciplinary Approach​. 2014;7(2):172-176. doi:10.1177/1941738114549542.
Bø K, Barakat R, Brown W, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3—exercise in the postpartum period. ​British Journal of Sports Medicine​. 2017:1-10.
Goom T, Donnelly G, Brockwell E. ​Returning to running postnatal- guidelines for medical, health and fitness professionals managing this population.​ March 2019.