Everything you need to know about how to get back into running after pregnancy. When you can safely start running after baby, how to start, and more.
Medically Reviewed By: Dr. Carrie Pagliano (PT), Dr. Lauren Levko (DPT), and Melanie Connell (PT, CHC). Fact-Checked By: Chelsea Plummer, Health Editor
This post was originally written on February 20, 2021. It was updated on December 21, 2023.
The starting line
Though many mother runners can be antsy to get back to their pre-pregnancy selves, it is important to give your body adequate time to recover, heal, and let your body rest after such a monumental activity as growing and birthing a baby.
Whether you birthed vaginally or with a c-section, many musculoskeletal changes have happened in your body that are worth giving your attention to before you get back out pounding the pavement (source). Though previous wisdom – and many OBGYNs – recommend getting back to exercise after 6 weeks, it may be more nuanced and personalized than that.
Read on to learn all about considerations to make when returning to running after having a baby, how to know when you are ready to get back to run, and how to make the transition safely and healthfully.
Disclaimer
This guide was written based on evidence-based studies, current scientific research, consultation with pelvic floor experts and physical therapists, and my experience as a VDOT-O2 certified running coach and a mother runner of two kids.
Before getting back to exercise postpartum it is always important to get cleared with your doctor and see a pelvic floor therapist when possible. The postpartum period before exercising can vary depending on the individual, pregnancy, pre-existing conditions, and more, so a personalized evaluation and re-introduction to running plan is very important to return to running healthfully.
These tips are not a substitute for professional medical advice, diagnosis, or treatment. Never disregard or delay in seeking professional medical advice because of something you read on this website.
Table of contents
- The starting line
- Can you safely return to running postpartum?
- When can I start running postpartum?
- Signs you should see a doctor or physical therapist when resuming running after baby
- How to strengthen your core and pelvic floor for running postpartum
- How to start running postpartum
- Can you run while breastfeeding?
- More postpartum running tips
- Summary
Can you safely return to running postpartum?
Yes, it is safe to return to running after giving birth. But, you should always consult your OBGYN, doctor, or pelvic floor therapist before doing so and should begin with low-impact exercise before higher-impact exercise such as running.
For postpartum mothers who had pregnancies without complications and vaginal deliveries, the general recommendations are to return to low-impact exercise as soon as a few days after delivery (source). C-section recovery can take longer and varies from person to person, so always consult your physician before returning to even low-impact exercise. Recovery time before returning to low-impact exercise may also be increased if you had a complicated vaginal delivery or a complicated pregnancy.
These recommendations to return to exercise, however, are for light low-impact exercise such as walking and for core rehabilitation exercises (more on that below!). The turn to high-impact exercises such as running is contingent on many other factors, so the process of returning to that takes much longer.
When can I start running postpartum?
Originally, general recommendations were to return to running after your OBGYN or midwife gave clearance to do so, often around 4-6 weeks, but there was variance in these recommendations from professional to professional since not much research was conducted on the topic (source).
Medical professionals are now working to fill the information and research gap around postpartum health. Physical therapists worldwide are sharing that postpartum women are returning to running too soon, resulting in a host of issues related to pelvic floor health and running injuries.
These physical therapists want to bring awareness and education to mother runners about our pelvic floor, core, and factors to consider when timing out and planning a return to running with injury prevention in mind.
In 2019, UK researcher Tom Goom and his colleagues published research backing a recommendation that postpartum women do not return to running until at least 12 weeks after giving birth (source). As shared previously, many factors are at play in the postpartum weeks and the transition to high-impact activities, so the exact amount of time needed to recover can depend on pelvic floor health, core strength and core health, muscle strength, ability to complete load bearing activities, scar tissue healing, and more (source).
The researchers explain what happens on a musculoskeletal level that needs to reverse before we hit the pavement or trails and that recovery is often months, not weeks: for example, “The levator hiatus widens during pregnancy and increases significantly during vaginal birth. Recovery time for the tissues is understood to be between 4-6 months, well beyond the traditional concept of full recovery by the 6-week postnatal check,” states the study. “If we consider cesarean section deliveries, we understand that abdominal fascia has only regained just over 50% of original tensile strength by 6 weeks post abdominal surgery and 73%-93% of original tensile strength by 6-7 months.”
The researchers also note that pelvic health physiotherapists around the world are passionate about raising awareness of the extended recovery period that is needed. Indeed, soft tissue is only about 75% healed at 6 weeks.
Given the nuance and individuality of recovering from pregnancy and birth, the best way to know when you should return to running is to consult with a pelvic floor physical therapist if possible. They are trained in these areas and will know how to evaluate you to determine if your body is ready to return to high-impact exercise and guide you through the transition from low-impact to higher-impact exercises as needed.
If you do not have access to a local pelvic floor specialist, there are many at-home and remote options available. Dr. Carrie Pagliano, a physical therapist and pelvic floor specialist, just released a free at-home 10-step screen based on the new UK guidelines that help you self-assess whether you’re ready to return to running. The exercise test can help you pinpoint trouble spots to work on so that you’re using your time most productively. If you live in a remote area or area without any pelvic floor therapists, you can also look into providers in other areas who except patients via telehealth.
Signs you should see a doctor or physical therapist when resuming running after baby
If you have returned to running, some signs that it was too soon or that a further foundation of lower-impact exercise needs to be established before continuing include, but are not limited to:
- Urinary incontinence such as leaking when running or sneezing, coughing, or jumping (which is common among 15-30% of first-time moms),
- Have pressure in the pelvic area,
- Have low back pain or lumbar pelvic pain,
- Have pain during intercourse.
Even if you don’t experience one of these issues, it’s important to assess your pelvic floor health for hidden or underlying issues.
“How much you ran during pregnancy or how you delivered does not necessarily dictate your postpartum pelvic floor health,” shares Dr. Pagliano, who has helped hundreds of moms with postpartum rehabilitation. “I actually worry more about those that don’t have early symptoms. They push too early and end up falling backward fast sometimes…It’s harder physically because they didn’t take the time to build a foundation and mentally because they feel like the rug was pulled out from under them.”
A pelvic floor specialist like Dr. Pagliano can examine you for diastasis recti, a separation of the rectus abdominis, or “six-pack” muscles, which meet at the midline of your stomach. Diastasis recti is very common postpartum because the uterus stretches the muscles of your stomach as your baby grows.
How to strengthen your core and pelvic floor for running postpartum
Contrary to popular belief, the core and hips are responsible for absorbing the bulk of the impact when running, not the knees and ankles. It is for this reason that strengthening the core and pelvic floor muscles is of most importance when returning to running.
A pelvic floor specialist will give you exercises to address issues and restrengthen your core and pelvic floor muscles postpartum. “The muscles, ligaments, and tendons stretch out a bit during pregnancy,” explains Celeste Goodson, founder of ReCORE Fitness, who has helped many elite mother runners return to running after giving birth. “There are a lot of factors that contribute to this, including hormone levels, genetics, how much room the baby has, how big the baby is, carrying multiples, etc. This makes the muscles lose neural connection and strength.”
Doing a program like Get Mom Strong, ReCORE, or tapping into the ReCORE YouTube program will help you strengthen that core. (I recommend this program for my pregnant and postpartum athletes.) Specifically, look at videos that teach inner core basics (like the Ab Sets) and how to engage the core and pelvic floor.
Try some of these core-focused moves
- bird dogs
- planks
- side planks
- bicycles
- split tabletop
- bridges
A pelvic floor specialist or a program like ReCORE will also teach you good breathing mechanics, core control (not letting the belly bulge during an exercise), and rotational resistance exercises as well as exercises to continue doing and progressing through as you make the postpartum return to running.
Related: 6 Key Pregnancy Core Exercises
An important note about alignment
Many pregnant women have an anterior pelvic tilt. This tilt occurs when your pelvis is tipped forward and downward.
Dr. Lauren Levko, doctor of physical therapy and founder of PhysioLab PT, says this is common because during and after pregnancy the core stabilizers, primarily the transverse abdominus, are weakened and the pelvis has more laxity due to hormonal changes allowing for a forward tip of the pelvis and a C shape of the spine.
If present, this can lead to an increased risk of a hamstring strain, hip flexor tendinopathy, and gluteal tendinopathy, and could exacerbate diastasis recti.
You can tell if you have an anterior pelvic tilt if you have a protruding lower abdomen and tight back and hamstrings. Your pelvic floor specialist can also assess for this and give you exercises you can do at home.
An important note about breath
Diaphragmatic breathing is another key way to heal your core and pelvic floor. Diaphragmatic breathing is when you feel your breath coming from your stomach as opposed to your chest and ribs. This type of breathing aids in running while strengthening and healing your inner core and pelvic floor.
“Breathing is the secret sauce to energy efficiency,” explains Melanie Connell, the owner of Remedy Physical Therapy & Wellness. “You can learn simple breathing techniques like diaphragmatic breathing to regulate your breath during a run as well as downregulate your body during recovery.”
Diaphragmatic breathing strengthens the diaphragm, thereby decreasing oxygen demand, slowing your breath, and using less effort and energy to breathe. Melanie adds that “when you breathe well during running, you can trust that your pelvic floor will work alongside the breath pattern. It happens automatically but where some people make mistakes is when they try to kegel and tense up when they run.”
How to do diaphragmatic breathing
- Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage.
- Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.
- Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.
- Do this exercise for 5-10 minutes about 3-4 times per day.
How to start running postpartum
The key to returning to running after giving birth is to take it slow. Take the time to let your body recover, rebuild the core and pelvic floor muscles, and walk before you run.
“Walking postpartum is great,” says Dr. Pagliano. “There’s a huge difference between walking with a stroller versus walking with a baby carrier. Both are great but walking with a carrier will obviously be slower and have more pressure and weight. Watch for red flags such as pressure, pain, and leakage of urine, stool, or gas.”
Start walking postpartum with flat even surfaces. When that feels comfortable, progress to uneven surfaces, and hills. Hillwalking repeats are tremendous for restrengthening that core.
“Going uphill is easier on the pelvic floor than downhill. This gives a chance for the pelvic floor and leg and core muscles to get stronger and prep for impact,” explains Celeste. “Then do walk/running intervals, then running. This can be several weeks to a few months of gradual progression depending on the issues women are dealing with.”
General guidelines for this return to running period are:
- Aim to introduce a new variable or increase the distance every 2-3 weeks to allow for the soft tissue to become stronger from the new stimulus.
- You can increase distance 10-30% every 3 weeks, just as you would when rehabbing a running injury.
- Continue with pelvic floor, core, and strength exercises, as recommended by a pelvic floor therapist or strength routine.
For a complete and free postpartum running plan, check out this post.
Can you run while breastfeeding?
Yes, once you are cleared to run by your medical team, you most certainly can run while breastfeeding. Contrary to popular belief, if you fuel and hydrate appropriately, milk supply does not decrease while running (source).
Here are my best tips for breastfeeding while running:
- Shake up that protein. Breastfeeding moms also need to make sure they’re getting enough protein. After growing a baby for 9 months and then supplying it with protein-rich breast milk, it’s necessary to replenish your own. Aim for five to seven servings of quality protein every day.
- Stay hydrated. You need to stay hydrated but don’t gorge yourself on water. Drink what you would normally drink if not breastfeeding (which should be about 1/2 to 3/4 of an ounce of water per pound that you weigh – so 65 ounces for a 130-pound woman) and then more to thirst after that.
- Eat adequately. Your body burns anywhere from 500-700 calories extra/day when breastfeeding (source) – and that is before factoring in additional calories burned by also running! Keep your milk supply full and prevent injuries or RED-S by eating enough for your activity level and nursing.
- Drink that milk. Be sure to get enough calcium; breastfeeding requires extra calcium intake. The National Academy of Sciences recommends that women who breastfeed consume 1,000 milligrams of calcium each day. Ask your doctor if it’s a good idea to take a calcium supplement. Consider continuing to take your prenatal vitamins as well if you are still nursing.
- Time nursing or pumping with your runs. Be sure to nurse or pump before you head out the door to be more comfortable and bide more time being away from your baby.
Related: 8 Clever Tips for Running While Breastfeeding
More postpartum running tips
If you are back successfully and healthfully running, here are a few tips to make the most of your solo miles (or with the running stroller)!
Support your middle. ReCORE’s Post-Natal FITSplint supports your abdominal muscles without restricting movement or breathing. It keeps you from getting injured and allows you to safely work on strengthening stretched-out muscles.
Make sure the shoe fits. Ensure your running shoes fit your postpartum feet, which may have enlarged. If your shoes still fit, make sure your shoes don’t have too many miles on them and provide plenty of support. If the soles are worn around the sides and on the treads, it’s time to get new ones.
Related: The Best Belly Bands for Pregnant Runners
Get the right bra. Chances are your pre-pregnancy sports bra isn’t going to fit your postpartum chest. You need more support and room. Popular running bras with “mother runners” are the Motherhood Maternity racerback nursing bra and Lululemon’s Enlite bra for their support and comfort.
Related: The 4 Best Nursing Sports Bras for Runners
Change out of your bra after running. Leaving your bra on too long could lead to blockage or worse, warns The Mother Runners Co-coach Laura Norris: “The compression of sports bras can block milk ducts which can lead to mastitis,” she explains. “Only wear sports bras to run in. Change in and out of them quickly to avoid blockage.”
Up your iron. Cutting back calories while simultaneously upping mileage is a recipe for injury, says nutritionist Betsy Johnson. In order to be healthy and energized, new moms need to focus on eating the right foods, like those containing iron. In fact, one in five women is iron deficient. Focus on eating iron-rich foods like meats, fish, leafy greens, and chocolate.
Sleep as much as possible. Make sure you get as much sleep as you can. Your body and mind are working overtime. Sleep experts recommend an extra minute of sleep per weekly mileage. So, if you run 20 miles a week, you need an extra 20 minutes a night to repair from the stress of running. Throw in caring and feeding a baby, and that number goes up. If you have an opportunity to rest, take it. It will help your body recover much faster!
Summary
Though many of us are itching to get back to running as fast as possible, patience will pay off! It’s better to return slowly and healthfully than to be suddenly derailed by underlying injury months or years into your postpartum running journey.
Thankfully there are plenty of resources out there for you to rehab at home while spending time with your new love. Check out my postpartum running plan here and comment below with any additional questions or comments you may have – I respond to every message I receive!