From the moment we stop running in prenatal, we are counting down the months, weeks, days and hours until we can resume our favourite sport.
After my second baby, I began running five weeks postpartum, adhering to what I considered to be a gentle conservative “return to running” program that I designed for myself. I ran a half marathon in 2:05:59 five months postpartum. Do I recommend this? No. Looking back I did my body no service, only my ego.
The core has taken a beating during pregnancy and delivery. The abdominal wall has stretched, the recti (six pack) have likely been displaced (diastasis recti) and the pelvic floor has supported the weight of a baby, stretched to 10 times its size in vaginal delivery or surgically impacted with a C-Section surgery. Pregnancy and delivery requires rehabilitation, which takes much longer than six weeks.
Once a diastasis is closed and/or functional, the core has strength and tension to support front loaded exercises. Sometimes cueing is still needed and we train to improve automation. The core needs to be further strengthened to create and sustain enough myofascial tension to support the impact of running. In addition, the timing of the core, specifically the anticipatory aspect of the core, must be improved before hitting the streets again. The core must be functionally rehabilitated before running is resumed. A targeted restorative program will prescribe you the exercises to achieve this. I estimate this time frame to be 9-12 months, longer if there have been multiple pregnancies and/or multiples. A restorative supplemental program should continue to focus on these aspects of core rehab and should run congruent to a well-designed postnatal running schedule.
An integral part of the comprehensive core is the pelvic floor muscle- a layered sling of muscles and connective tissue that supports your organs. Regardless of delivery method, it needs to be rehabilitated after pregnancy. No amount of involuntary leaking is acceptable- while coughing, sneezing, laughing, exercising, full bladder keys in the door, grocery bags in hand- not one drop. Rehabilitate your pelvic floor even if it is asymptomatic. Pelvic organ prolapse can be completely silent.
A rostered pelvic floor physiotherapist can help to assess your deep core function and clear you for impact exercise. This involves an internal assessment of the pelvic floor muscle itself and how it is being recruited through meaningful movements. I highly recommend that every mom book an assessment with a rostered pelvic floor physio to gain crucial insight into her core function and train accordingly!