How to Return to Running Postpartum | A Guide for New & Experienced Moms

A mother’s guide for returning to running after giving birth created by postpartum physical therapy expert, Dr. Sara Tanza PT, DPT.

Returning to running after having a baby can feel a lot like chasing a beautifully familiar sensation while being stuck in a body that feels so foreign. Recognizing a major lack of free training resources for new and experienced mothers, we asked Dr. Sara Tanza PT, DPT - a pelvic floor physical therapist, runner, and mother of two - to help us demystify the process of returning to running postpartum.

It’s important to note that while this guide is a valuable resource, every individual's return to running experience is unique. This content is not intended to be a substitute for professional medical advice and as always we recommend consulting your preferred physiotherapist for additional guidance.

Before You Lace Up: 

Regardless of how much you trained throughout your pregnancy, the act of having a baby - either through vaginal delivery or cesarean section - creates an enormous amount of stress on the body. Returning to running postpartum is a lot like returning to a sport after a major procedure. Take an ACL tear and reconstruction surgery for example. While an athlete may have maintained a high level of training and pre-hab before the injury, the trauma of the surgery coupled with the fragility of the surgical site calls for a slow and methodical post-surgery rehab process that can take up to a full year. Like returning from a surgery, getting moving again after giving birth doesn’t happen overnight. 

Many women, including myself, dream of their first run back postpartum, re-establishing their training routine, and crossing finish lines to hug their tiny babies. From an outsider's perspective, some women seem to “bounce back” to their pre-pregnancy bodies and athletic activities just weeks after giving birth, but remember comparing one journey to another won’t get you where you want to be any quicker.

Understanding Pelvic Floor Dysfunction: 

The pelvic floor is one of the most vulnerable structures in our bodies postpartum. If you give birth vaginally, the pelvic floor is stretched to over 300%. If you give birth via c-section, your abdominal muscles are literally cut and repaired! Additionally, the weight of the baby and placenta, stretches and distorts the length of your abdominal, pelvic floor, and hip muscles which leaves them unable to contract at their normal force. While the way the body adapts to grow a baby is truly astonishing, it’s needless to say that pregnancy puts a lot of stress on your ligaments, muscles, and tendons. This situation is also compounded by the fact that you’re likely not getting the kind of sleep that aids in recovery. 

Pelvic floor dysfunction also serves as a “warning sign” that your musculoskeletal system is more susceptible to injury. To put it simply, when part of your core isn’t working correctly that’s an indicator that the rest of our core may also not be functioning properly. This is key as our core muscles are the foundation for our stability as runners and I don’t know about you, but I want to build my house on the strongest foundation possible!

It is important to assess the current state of your pelvic floor and core before returning to running. Use the self-assessment below to evaluate if you’re experiencing symptoms of pelvic floor dysfunction: 
  1. Do you leak urine or stool when resting, coughing, sneezing, walking, running, or jumping?
  2. Do you have pain with sex?
  3. Do you have sensations of heaviness in your vagina or anus (ex: feeling like a tampon falling out)?
  4. Do you have pain in your pelvis or abdomen?
  5. Do you have “coning” or “bulging” between your abdominal muscles when you sit up?
If you answered YES to any of the questions, follow up with a pelvic floor physical therapist for more personalized guidance.

Return to Running Checklist:  

After confirming you don’t have major pelvic floor dysfunction, you can start walking towards returning to running - literally. Running generates double the amount of ground reaction force on your body compared to walking. So before you run, gradually increase the amount of time you walk until you’re walking twice the amount of the time you would typically run. For example, if your average run before pregnancy was 30 minutes, your goal should be to build up to 60 minutes of walking. 

The checklist below will help you evaluate your body’s readiness to run and identify any underlying weaknesses you should address before your comeback.

Return to Running Plan:  

Once you can complete all the activities in the above Postpartum Run Readiness Test with little to no pain, a run-walk program is a great way to start your next chapter of running. Below is a sample progression table. The purpose of this framework is to make a complex process a little more simple and be adjustable to your unique needs.

Let’s run! Download your FREE Postpartum Return to Running Guide, complete with our Run Readiness Test and Return to Running Progression Schedule. Enjoy and share with others!

Want to learn more about Dr. Sara Tanza? Learn more on her website or follow her on social media

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Dr. Sara Tanza
About Dr. Sara Tanza

Dr. Sara Tanza is the owner of Pelvic Potential Physical Therapy in Santa Cruz, California. Dr. Tanza discovered the world of physical therapy after suffering a running injury while competing for her college triathlon team. After earning her doctorate degree from UCSF, Dr. Tanza explored Functional Manual Therapy before opening her own practice to help athletic mothers like herself.