Physiological Changes that Impact Return to Running Postpartum

The postpartum period is a time filled with many emotions, challenges, and for some women can be incredibly daunting. While an exciting time, new mothers often experience fatigue and exhaustion, caused and exacerbated by the physiological changes that the body goes through to create life. These physical effects, as well as other lifestyle factors, can lead to difficulty for some women who wish to return to physical activity like running, which requires a higher level of exertion. Knowing and understanding some of these factors can help in alleviating pressure that women may feel, during the journey back to higher intensity physical activity.

Hormonal changes

• During pregnancy, high levels of estrogen and progesterone are produced in anticipation of childbirth. Following delivery, these hormone levels dramatically decrease (to allow for prolactin which induces milk production) and can lead to a range of symptoms like fatigue, mood swings, and depression. As these hormones are directly involved in the musculoskeletal system, your ability to recover from physical activity may be reduced, and can impact your return to running due to its higher energy requirement.

Breastfeeding

• For those who opt for breastfeeding, running capacity may be decreased as estrogen and progesterone levels are reduced for a longer period of time, compared to those who don’t. The discomfort that generally accompanies breastfeeding can also be exacerbated by the impact of running, which may require some women to seek extra support or alternative exercise options during this time.

  Lack of sleep

• Regardless of feeding type, decreased energy from interrupted sleep is generally a universal experience, particularly for mothers with newborns who require frequent feeding. Whether from feeding, settling, or just being in a different routine to usual, poor sleep quality can contribute to the difficulties of returning to running. Decreased energy and performance outcomes of physical activity are directly linked, with the increased likelihood of poor movement quality having adverse effects.

Pelvic floor dysfunction

•   This group of muscles support the uterus, bladder, and rectum, often becoming weak and sometimes injured during pregnancy and/or labour. When running, the pelvic floor is involved in force absorption during impact into the ground, however if they are not in optimal condition their ability to do this will be decreased, often leading to issues. This may involve leaking, pain, or instability, and is a frequent experience that deters many women from returning to running.

Diastasis recti

-          Diastasis of the Rectus Abdominus muscle, or “DRAM” is the usual physiological change that occurs with pregnancy, where the connective tissue along the abdominal wall is stretched and weakened to allow room for your baby to grow. For some women, this separation does not reduce as much postpartum, and when internal pressure is not managed, may cause discomfort/pain, pressure, bulging, and remains weak. Running prior to addressing this may potentially exacerbate the separation and accompanying symptoms.

So how can these factors and effects be managed? Seeking assistance from a Women’s Health Exercise Physiologist will allow you to receive support to safely and optimally return to running. Having an assessment allows us to discuss each of these factors, as well as assessing your biomechanics, to provide tailored advice and programming. Being examined for pelvic floor activity, movement and engagement is necessary, but just being able to contract (and relax!) this muscle group is leaps and bounds away from the work and endurance required to bear load during impact exercises like running.

The common experience for most women is to have their 6 week checkup, and be “cleared for all exercise”. However, any other rehabilitation process (done correctly) follows a gradual, phased approach to return to movement for optimal outcomes. So why would pregnancy- a time where every system of the body undergoes significant change, be any different?

With an exercise physiologist you can expect to undergo testing that observes your stability, mobility, strength, endurance, balance and coordination, throughout your whole body- as these are ALL required to run optimally, and reduce the risk of the adverse effects discussed. Your return to running program will be individualised based on your body, lifestyle, training history, and goals, as we believe movement should be appropriate and accessible for every women during this time.