Start super slow, and not before two months after having a baby UNLESS you have been super consistent with activating your TA and PF. If you are a hard core runner you have a little more grace in that you can start running 6 weeks post a vaginal delivery (given your doctor agrees).
Once postnatal…you are always postnatal. So this applies to every mama!
Starting running too soon can wreak havoc on your pelvic floor, PF. Its primary job is to keep that baby in and then afterwards to keep your insides… well… in. Think of it as a hammock that holds your bladder and reproductive organs in and attaches to the front and back of your pelvis. These muscles work all day long. 24/7. They work in conjunction with the TA to stabilize the core. Any insufficiencies in these muscles can cause pain, incontinence and altered movement. A study by Poświata in 2014, found that 45.54% of the 112 elite female endurance athletes (runners and cross-country skiers) polled, suffered from incontinence. It is so common ladies! You are not alone!
You never want to subtract to add i.e. don’t put your pelvic floor at risk to start adding miles. If you have good core strength and stabilization you can progress through the following recommendation more rapidly, otherwise spend 2-3 weeks at each stage. Make sure you properly warm up (walking) and cool (walking and stretching).
Timed I: aim for 20 minutes of run 1 minute/walk 1 minute, repeat
Timed II: aim for 20 minutes of run 2 minutes/walk 1 minute, repeat
Timed III: aim for 20 minutes of run 3 minutes/walk 1 minute, repeat
Mileage I: aim for 2-3 miles of run 3 minutes/walk 1 minute, repeat
Mileage II: aim for running 1 mile, walk 2-3 minutes, aim for running 1-2 more miles
Mileage III: aim for running 2 miles, walk 2-3 minutes, aim for running 1-2 more miles
Incorporate daily PF exercises. Read at the end of this section for your pelvic floor exercises. As always, it’s important to incorporate strength and flexibility into any running routine. If you are 5-6+ months postpartum, I recommend Moms Into Fitness Ignite your Inner Athlete. Running happens in one plane of motion, so it’s a must that you strengthen your core and all the muscles that move in the lateral direction i.e. glteus medius. This will keep your body healthy!
“Should I run with diastasis recti?”
Megan Hoover, DPT, answered this question for us during the Moms Into Fitness Instructor Training.
This is a question I often get asked by ladies after having their babies. In my idealistic physical therapy world, the answer would be no. Now, before you completely write me off… please keep reading.
While my easy answer is no, I understand that runners are a unique and wonderful group and are very driven to return to their sport. I also know that most runners are going to return to running regardless. Trust me, I know… I am one of you. My hope is that we can help you run with less impact on your DR and help you understand why running may slow your progress of reducing your diastasis and can impact your pelvic floor. Regardless of if you had your baby/babies via vaginal delivery or C-section, your pelvic floor was impacted. For 10 months (seriously… whoever said pregnancy was 9 months obviously never was pregnant 😉), your pelvic floor kept that baby in and supported you both… That is a ton of work. Taking time to re-educated and strengthen your pelvic floor before you return to running and while you are running is so very important. It is not normal for you to pee every time you laugh, cough, sneeze, jump… Moms, you are incredibly selfless and put your kiddos’ needs before your own! Please do not put your pelvic floor and core in the back seat, mommas! You do not have to put up with pelvic pain and incontinence. If you read on you will find a list of exercises to help you activate your deeper core muscles to help combat your diastasis recti as well as strengthen your core and pelvic floor.
(Make sure you check out the PF exercises below and use the Daily Core Exercises that are safe for Diastasis Recti).
Diastasis recti abdominis (DR) is a condition in which the rectus abdominis muscle separates or thins along the middle of the muscle at the linea alba. It can be mild to severe. DR dramatically impacts the stability and integrity of your core muscles. The linea alba is made up of tissue known as fascia. Think of fascia as the saran wrap of the body. It covers our entire body, gives muscles their shape and is integral in any movement of the body. Now, think about your core as a bridge. The fascia, specifically the linea alba, is the rope along the sides of the bridge that you hold onto to cross and is what provides tension in the bridge. If you lose that tension, well, you’re probably not going to want to cross the Grand Canyon using a floppy bridge.
Let’s talk about the deeper abdominals or the Transverse Abdominis (TA). Pay attention my running mommas. This is where we talk about you successfully returning to running without making your DR worse. On either side of your floppy bridge are winches, otherwise known as your TA. Your TA fibers run horizontally and act as the corset of your core. As your TA gets stronger, those winches crank on your bridge and you get that tension back.
Next in…your pelvic floor, just as we discussed above. Your core/trunk is a transfer station for everything that goes on in the body. Running dramatically increases the amount of force through the core, pelvic floor and legs. If you have DR, your structural integrity is already compromised. When running with DR, you are likely compensating, which can lead to other structural issues including, knee pain, IT band pain, plantar fasciitis, low back pain and hip flexor issues, just to name a few. Not to mention increased strain through your pelvic floor. We need to address your compensations to insure you can run with proper alignment, so you can successfully return to one of your loves. It can be very difficult to know how you are compensating. Getting the help of a physical therapist or a personal trainer who is educated in working with post-partum mommas will be so helpful, if not essential to your success.
These TA exercises that are safe for diastasis recti can be found in our Core Restore program. Core stability and strength take time and consistency. I find that it takes about 4-6 weeks of performing these exercises about 4-5 times/week to see a measurable change. Most of you will be running in conjunction with these exercises. If you are going to continue to run with a DR, please do these exercises!
Please also avoid sprinting. When you sprint, you increase the force and rotation through your trunk muscles, which can really strain the linea alba and surrounding muscles and fascia.
If you are not seeing a significant improvement in your DR after consistently doing the exercises, please get in touch with a Women’s Health physical therapist. Your core may not be firing correctly. A Women’s Health PT will be able to get your brain re-connected to the rest of you!
Pelvic Floor Exercises:
- Hold Em’s
- Squeeze and lift the pelvic floor muscles by thinking of pulling on both ends of that hammock I talked about. You can also think about using the muscles that you use to stop the flow of urine or hold in gas.
- Hold for 5-10 seconds (you should be able to talk while you do these so you don’t hold your breath). And relax for 10 seconds. It is just as important to learn how to relax these muscles as it is to turn them on, so don’t skip that step!
- Do 10 contractions. Try to get in about 4-5 sessions of these puppies a day.
- Quick Squeezes
- Now contract those same muscles quickly 5 times. Don’t hold. We’re training motor control here… fancy term for retraining that brain to turn them on/off quickly. Relax for 10 seconds after your 5th quick contract.
- Repeat 10 times.
If you do not know whether or not you have diastasis recti please check out Lindsay’s video on her blog at https://www.momsintofitness.com/blog-diastasis-recti/.
Duvall, S. (Accessed October 26,2017). Can I Run with a Diastasis? Retrieved from http://www.coreexercisesolutions.com/can-i-run-with-a-diastasis/
Lee, D. (Accessed October 26, 2017). Diastasis rectus abdominis & postpartum health consideration for exercise training. Retrieved from http://dianelee.ca/articles/Diastasis-rectus-abd.pdf
Nixon, J., Goom, T. (Accessed October 26, 2017). Running, incontinence and pelvic floor exercises. http://www.running-physio.com/pelvic-floor/
Poswiata, A., Socha, T., Opara, J.(2014). Prevalence of Stress Urinary Incontinence in Elite Female Endurance Athletes. Journal of Human Kinetics, 44, 91-96.