The way and timing of returning to running after giving birth has long been a prominent topic in the field of pelvic floor and sports physiotherapy, as well as in social media. During pregnancy and after giving birth, the female body goes through incredible changes, which can certainly have an impact on strength, neuromuscular (nerve-muscle) control, endurance, and the resistance of the lower limb joints, spine and pelvic floor muscles. Because of these effects, it takes time for the female body to adjust to the high-impact and repetitive nature of running.(Christopher, Shefali Mathur PT, 2022, April)

For greater physical activity, i.e. running, you need:

• relaxation and quality sleep
• adequate strength and coordinated functioning of the limbs, trunk muscles and pelvic floor muscles
• and a proper musculoskeletal condition

During pregnancy, progesterone and relaxin hormones play a role in softing the joints, tendons and ligaments of the pelvis, in order to facilitating natural childbirth. Their effect extends to the whole body, not just the pelvic girdle. After childbirth, relaxin does not disappear, it remains in the body and maintains the relaxed state of the joints, connective tissue and muscles for approx. for 4 months. Breastfeeding also relaxes the tissues, especially if you also go running next to it.A looser tissue condition and running can combine to increase the risk of maternal injury, including pelvic floor dysfunction and uterine prolapse. (Goom et al, 2019)

After a natural birth, the recovery of the pelvic floor (mainly the levator ani muscle and the connective tissues and nerves connected to it) takes 4-6 months.(Shek et al. 2010, Stær-Jensen et al. 2015). And after a caesarean section, ultrasound studies showed that the abdominal fascia regained only 51-59% of its original tensile strength 6 weeks and 73-93% of its original tensile strength 6-7 months after giving birth.(Ceydeli et al. 2005). So, even after a natural birth and caesarean section, the body must first of all be given time to regenerate.

According to several scientific protocols, you can start running from the 3rd month after giving birth. But this recommendation is basically not enough by itself. There will indeed be moms who can safely return to running after 3 months, but it is also very important for these moms to know what to pay attention to, what are the warning signs when you really need to stop running. It is important to point out that it is forbidden to start rebuilding movement after childbirth with running. The fact that scary symptoms (dripping urine, feeling of a foreign body in the vagina, weakness, etc.) do not appear does not mean that you are ready to run.

A safe return to running is preceded by a palpation examination of the pelvic floor in a lying and standing position, an examination of the rectus diastasis and a general musculoskeletal condition assessment, then I set up an individualized treatment plan and proceed according to a scientifically proven 4-phase movement program and we are working together to the mum will be able to safely, actively play sports and run again.

Stop running if:

• you experience involuntary urination
• a sudden, urgent urge to urinate occurs
• you can’t hold back urination and you have to stop
• you feel a vaginal foreign body
• you feel general weakness around your pelvis
• musculoskeletal complaints occur (e.g. knee pain, hip pain, lower back pain) during and after running