Running Postnatal: How Soon is Too Soon?

99% of American women who deliver babies in the US are doing so in a hospital setting (1), typically under the care of an OB/GYN; as such, after baby is born, assuming you haven’t had any major complications, once you leave the hospital, the next time your own health will be assessed will be at your 6 week follow up.

Six weeks?

After ten months of carrying and growing a human inside?

And while books, websites, blogs and podcast on the topic of pregnancy expectations, concerns and questions abound, information on what happens after the magical moment when you welcome your baby into the world is mysteriously absent for the most part.

I’ve written before about my own learning on the importance of understanding the postpartum period (and I don’t mean postpartum depression; there are many other facets in this period to familiarize ourselves with) and one additional focal point I feel must be addressed is the healing of our bodies.

In detail.

Do a quick google search for postpartum and chances are high that most of the top results are to do with postpartum depression.

As a whole, we’re uncomfortable talking about this important topic, often so much so to the point of women feeling ashamed to mention that they’re having incontinence, painful sex or simply just not feeling right when they return to exercise after their OB gave them the ok to do so.

And we assume all we need to do are kegels, without even knowing if we’re doing them properly!

Subsequently, we settle for what the current health care model offers us, many times not asking questions and certainly not even talking about our concerns with friends or family.

One way in which this came to light for me personally was learning about, then experiencing working with a physical therapist who not only specializes in women’s health, but pre and post natal women’s health.

Heather Jeffcoat was referred to me by both my midwife and doula; fortunately I learned about her prior to my son being born so I was able to get a head start on learning about my own pelvic floor health, strength and stability.

Not only did seeing her prenatal afford me the ability to get a base line for which she could compare my recovery to postnatal, I was also able to get an assessment for how my labor might go, what exercises and stretches I might do in order to prepare for the big day.

An internal exam was performed and not only did I learn that I was not performing my kegel exercises properly, I learned about the anatomy of my own body.

How funny that I’d never even blinked an eye that female (or male) internal anatomy was not covered in any course I took at university – including anatomy, general physiology, exercise physiology or kinesiology!

As if muscles and ligaments such as the levator ani muscles, and the transcervical, pubocervical, and sacrocervical ligaments were somehow less important than Vastus lateralis, Vastus medialis and Vastus intermedius!

A thorough understanding of our own bodies and how each muscle and ligament works, particularly for the purposes of this post in pregnancy, is crucial to understanding how we can heal.

6 weeks post birth, I saw my midwife for my follow up exam and she agreed it was then time for me to return to PT for an internal assessment.

In my case, since my baby was low in my abdomen and pressure was concentrated primarily on the bladder, the corresponding ligaments became stretched and consequently, they need a bit more time to heal and return to normal length and elasticity.

Which, thanks to a healthy diet and proper exercise routine, they will and without the need for surgery or intervention.

So running can wait a bit longer – it’s simply not worth it. Long walks, hiking, yoga and swim ( as well as upright cycling to achieve a preferable pelvic angle for now) provide plenty of variety and time with my son to get my workout fix in each and every day.

While I’d planned on the NYC Marathon being my return to racing, if I need to defer to 2020, so be it.

But what about all the women who are unaware of all of this?

Other than a brief check of any incisions, in terms of organs and or connective tissue, other than the ovaries, uterus and cervix, chances are slim that anything else will be evaluated… unless the patient actually already has the information about what to ask and is also comfortable broaching the topic (2).

This poses a high risk, not just for you other mamas out there who are athletes, who build up running far too soon, ignoring that strange sensations you’re having that somethings not quite right ‘because your doctor said you were fine’, but for women who are simply trying to go about day to day life and feeling unsure if they’re properly healing ‘down there’ as too many of us refer to our own bodies.

There is not even any real research that shows exactly how long women should wait to exercise after giving birth. According to guidelines from the American College of Obstetricians and Gynecologists, physical activity can be “resumed as soon as physically and medically safe.” (3).

And this is being determined in the brief, 10-15 minute exam by a doctor who may or may not have any pelvic floor specialization.

In researching for this article, I came across one story for reference in which a woman who had started to experience debilitating, painful constipation and occasional incontinence that grew worse with time, which took five years from the birth of her second child before she was finally diagnosed with a rectocele (an injury in which the rectum bulges into the vagina, creating a pocket where stool can get trapped) (4).

Another woman spoke about having to rush to the hospital after feeling something was ‘falling out of her’ after hiking to discover she had a grade III prolapse of the bladder.

We owe it to ourselves to take the lead on learning about our bodies so that we can best prepare for being the best moms we can be (in this instance) ; no different from digging deep through all the nonsense that exists in terms of what we should be eating to support not only a healthy pregnancy but a healthy, optimal lifestyle from a health perspective.

No matter what stage you are in pregnancy, or if you’re not pregnant at all, don’t be shy about seeking out a practitioner near you who specializes in this field and can help you get all the information you need to have a complication free birth and recovery.

And don’t forget to tell the other women in your life about it, too!