It was six weeks after my son was born and I was at my check-up appointment with the doctor. I had plenty of questions, the most pressing of which was whether it was okay for me to start running postpartum. After a brief examination, the midwife told me I was good to go, but to take it easy.
I left the hospital elated—and later that day, headed out on my first run after childbirth.
Being out there again felt great, but everything else felt, well, not so great. My lower back ached, I gasped for breath, and I was so parched I guzzled about a gallon of water afterward. On subsequent runs, a dull, new-to-me pain nagged in my pelvic area.
As is the case with so much else about first-time parenting, I had no idea about any of these challenges of running postpartum until I faced them. Furthermore, I discovered a surprising lack of information and resources for postpartum women trying to get back into shape.
So, here are 10 things no one tells you about getting back to running postpartum—and how you can cope.
Tips for a Better Return to Running Postpartum
1. Your pelvic floor needs lots of attention
You may not hear about it in your post-birth doctor’s appointment, but your pelvic floor—the group of muscles, tissues, and ligaments that act as a sling holding up the uterus, bowels, and other organs—plays a critical role in returning to exercise. Wellness professionals like yoga teachers, Pilates instructors, and physical therapists put a primary focus on healing and strengthening the pelvic floor, which becomes stretched out and weakened during pregnancy and that can lead to a range of problems.
“Without taking the time to rehabilitate your pelvic floor properly, you’re going to have potential injury, muscle pain, and incontinence issues, especially for women who are runners,” says Laura Arndt, a certified personal trainer and Pilates instructor in Fairfax, Virginia.
To help strengthen the pelvic floor, Arndt recommends starting with exercises like pelvic tilts, which involve lying on your back and lifting your pelvis, and incorporating squats into your routine a couple of months post-delivery. Kegels are also a good exercise for most women, which you can start doing after childbirth, working up to two sets of 10 reps, holding for a few seconds, every day. Postpartum yoga classes also bring a focus to the pelvic floor.
Working with a pelvic floor therapist is also a smart option for all new moms, but especially those experiencing pain or those not sure exactly how to do kegels (or if they’re right for you). “A pelvic floor physical therapist can help identify how your muscles are working for you, so that you can manage whatever pressures you need to put on your body without leaking,” says Julie Westing-Spencer, physical therapist who specializes in the pelvic floor and co-founder of The Restoration Space in Bethlehem, Pennsylvania.
2. You’ll be seriously thirsty postpartum
As any breastfeeding mother knows, making milk makes you crazy thirsty. And when you’re running postpartum, that thirst can kick up to stratospheric levels.
“The rule of thumb is to have your regular eight glasses of water daily, and every time you breastfeed that’s another eight ounces, and every time after you exercise, drink another two or three glasses,” says Crystal Widmann, a fitness trainer and owner of Y2B Fit, a Philadelphia-based company that specializes in helping women gain postnatal fitness. “If you’re running and cardio training, you’re looking at three times the water intake of your pre-baby self.”
3. Expect aches and pains in new places
On my first few runs postpartum (read: 15-minute-mile slogs), I’d come home with aches in my pelvic area, the likes of which I’d never experienced before. It hurt deep in my bones, like someone had put a vice on my pelvis.
The likely culprits, according to Widmann: The aforementioned weakened core and pelvic floor muscles, as well as my pelvis’s anterior tilt from pregnancy still shifting back into its normal, neutral position.
“Usually, by about six months postpartum, the pelvis is back into a neutral position,” she says. “But if you didn’t run through your whole pregnancy, starting to run again too soon, with those tight hip flexor muscles, can aggravate it and make it worse.”
Also, relaxin, a hormone that develops in pregnancy to soften joints and ligaments and prepare the body for birth, can be present for up to a year postpartum, says Alexandra Sowa, M.D., an internist and obesity medicine specialist at SoWell Health in New York City. As a result, many mothers experience exacerbated joint pain—often in the knees and ankles, but also in the hands and wrists—while exercising in the first few months after having a baby.
4. Your posture may be screwy for a while, too
“Everyone thinks about our posture changing when you have this big belly, but as soon as the baby comes out, it doesn’t all go away,” says Sowa, who’s also a mom of two. “When you’re hunched over breastfeeding or picking up your baby, there’s a lot of forward flexion and rolling of the shoulders, which weakens your core and can lead to a lot of neck tension and back problems.”
To combat those challenges, experts recommend incorporating strength training and stretching into your running routine, as well as focusing on strengthening the core muscles.
In addition, at the first sign of pain during a run, stop and walk—that’s your body telling you you’re pushing it too hard.
5. It can take a lot longer than you think to bounce back
While some moms can snap back into their regular running routine in a few months, many need up to a year—or more—to start feeling normal.
However, “take it slow” is something that many runners don’t relish hearing.
“I always tell my clients: give yourself a year. After a year, 95 percent of women say they’re starting to feel like themselves again,” says Widmann. “If you get back to it before that, great, but if you have the mindset that it can take a year, it will be much easier on you mentally.”
What that meant for me: scrapping the idea of running a spring half marathon with my husband, and instead focusing on slowly building up my mileage while letting my body heal.
6. A jogging stroller takes some getting used to
Don’t get me wrong: I love taking my little ankle biter on runs, listening to his cooing instead of my usual music mix, as our secondhand Bob Gear Revolution SE glides along the asphalt. But after nearly three decades of running unencumbered, adding a 25-pound, decidedly non-streamlined contraption—not to mention a demanding little human—to the mix has taken some getting used to. Relatively flat, smooth pavement is a must, and I’m hyper-vigilant, constantly on the lookout for potholes, cars, or scary-looking dogs heading toward us.
New moms should also pay attention to proper form when running with a jogging stroller. Most importantly, says Eric Orton, a running coach, author, and father, is to try to maintain as normal of a gait and arm swing as possible.
To do this, he advises keeping your stride short and your feet under you, and not leaning on the stroller, instead keeping the handle closer to your body versus way out in front of you. “To help with this, experiment with pushing with one arm for a few minutes and then switching to the other, versus always holding the handle with both hands,” he says. “Allowing one hand to remain free to swing is better than none.”
7. Two words: diastasis recti
One of the least-discussed postpartum conditions is also one of the most common. The majority of pregnant and postpartum women have some degree of diastasis recti, which, in short, is a gap between the left and right abdominal muscles as a result of the growing uterus. For some women, it can be so prominent that they feel self-conscious about wearing workout gear, and it can also lead to abdominal and pelvic issues.
Many yoga and Pilates instructors and personal trainers who specialize in pregnancy can easily check for diastasis recti (it’s indicated roughly by a gap of more than two to three fingers’ width). Several specific programs focus on addressing it (MuTu and Y2B Fit, for example). Keep in mind that traditional crunches and sit-ups can make the problem worse.
8. You might have to bump up a shoe size
That extra pregnancy weight, along with the hormone relaxin, can do a number on your feet, causing arches to flatten and feet to widen. The result? Your favorite running shoes might not be a good fit anymore during your postpartum running journey.
As one study shows some changes in your foot like arch height and length of foot (even if only by a millimeter) may be permanent. If your shoes feel especially tight, it’s a good idea to head to a reputable running store, where staff can help you find a shoe that’s better suited to your post-baby foot.
9. Breastfeeding and running are a tricky balance
Remember those carefree days when you could just lace up your sneakers and head out for a run whenever you felt like it? Yep, they’re all but over now, especially in the early days when your little one needs to breastfeed.
For some women, running can trigger the letdown reflex, adding yet another complication to what used to be a convenient outing. Here’s how your runs may look for a while: Between feeding your baby, wrestling yourself into a sports bra, shoving some food and water into your mouth, and emptying your bladder one last time, you finally get out the door. Twenty minutes down the road, you find yourself leaking milk and starving again.
Defeated, you walk home, wipe the sweat off your boob (or not—I like to ask my little guy if he’s ready for a salty milkshake), and start feeding your baby (again). Don’t get discouraged by this. Postpartum running is just about listening to your body even more than you did before.
10. You might experience incontinence when you run
For many women, the delight in returning to running is replaced by dismay upon discovering that they’re leaking. According to a study in the International Urogynecology Journal, 31 percent of the more than 35,000 women included in the study experienced urinary incontinence after having a baby.
For many, incontinence is a relatively minor (yet embarrassing) inconvenience that eventually resolves itself, but for others, it’s a debilitating problem that can require surgery. “Incontinence postpartum is extremely common, but it is not normal,” Westing-Spencer says. The leaking is often caused by a number of issues like weakened or stretched pelvic floor muscles, inflammation, healing from episiotomies, or abdominal muscle weakness while healing from a c-section.
“[Incontinence] should gradually go away within the first few weeks postpartum. If it does not, it is a sign that there is something else going on, most likely a muscle imbalance somewhere in the body that is a result of pregnancy and/or delivery, that is causing the body to compensate for muscles that are either working too hard or not enough,” Westing-Spencer says.
After her first two children, Elizabeth Pagel-Hogan, a writer and editor in Pittsburgh, Pennsylvania, noticed that she leaked urine not only while running, but also while sneezing, laughing, and even standing. “I stopped having fun,” says Pagel-Hogan, who ran track and cross country at Salisbury University in Maryland. “I almost stopped running.”
But after the birth of her third child, and five years dealing with the problem, Pagel-Hogan decided to have surgery to correct what ended up being a displaced urethra. Four months later, she was on the starting line for a 10-mile race with her college teammates. “At the finish line I was only wet with sweat—not a drop leaked!” she says. “It was miraculous.”
Many women can combat urinary incontinence with exercises that strengthen the pelvic floor. But Sowa says when the problem is severe, women should seek out pelvic floor physical therapists and urogynecologists who have a variety of treatment strategies, all the way up to surgery. “The take-home point here is that there are specialists for this,” she says. “You don’t have to spend the rest of your life dealing with it.”
