Return to Running Postpartum
Returning to running after having a baby is a milestone goal for many new mothers. Running can be an empowering way to improve aerobic fitness, mental health, and even social connection. However, it’s also one of the most challenging forms of exercise to return to after pregnancy because of its repetitive impact. Many women return too quickly, or before meeting key milestones. Doing so can increase the risk of both musculoskeletal injury and pelvic floor dysfunction, such as urinary leakage or prolapse.¹ In fact, higher-impact activities like running are associated with a 4.59× greater risk of pelvic floor dysfunction compared to low-impact exercise.²
The good news? Returning to running after pregnancy is absolutely possible, but meeting certain criteria is essential for avoiding negative symptoms.
#1: Prior Level of Function
The first factor to consider is your prior level of function and your current starting point. Were you running throughout your third trimester, or has it been over nine months since you last laced up your shoes? Someone who was able to continue running during pregnancy will begin at a very different level than someone who wasn’t.
And maybe you’re actually starting your running journey for the first time - congratulations! Just remember, you’ll need to take it slow rather than heading out for a few miles right away.
#2: Time
Although everyone’s recovery journey is unique and there’s no one-size-fits-all timeline, it’s important to respect tissue healing. Most women are told, “No exercise or sex for six weeks after baby,” as a blanket guideline. That timeframe reflects the initial healing of skin, muscles, and fascia. But as most mothers know, it takes much longer than six weeks to feel “back to normal.”
Running places significant impact and force on the body, including the pelvic floor (up to 2.5 times body weight at just a moderate pace!²). Given that the pelvic floor has just completed the incredible task of supporting pregnancy and birth, patience is key. While gentle movement and strength training can be introduced earlier, most research recommends waiting at least 12 weeks before beginning a structured return-to-run program.²
#3: Strength
Once your body has had time to heal and you’ve assessed your starting point, the next step is building strength. Running itself is not a strengthening exercise. All runners, especially postpartum, should incorporate strength training into their weekly routine.
Single-leg loading and core strength are the foundation for safely adding impact. In my clinic, I assess readiness for running with movements such as single-leg bridges, single-leg squats, calf raises, hip abduction strength, and core control.
And don’t forget: you have to jump before you can run. If jumping causes pain, leakage, or pressure, it’s not yet time to return to running. I’m a big believer in “test, don’t guess,” and a pelvic floor PT can help you test these key movements so you can start your program with confidence.
#4: Sleep and Nutrition
Two other major factors in postpartum return to running are sleep and nutrition. This is true for all athletes, but especially important for new moms.
Let’s be real, what new mom is getting eight hours of sleep a night? Research shows that sleeping fewer than seven hours per night is linked to a 1.7× greater risk of musculoskeletal injury.⁴ This doesn’t mean new moms shouldn’t exercise, but it does mean fatigue should be factored in, with rest breaks added when possible throughout the day.
Nutrition is just as important. The pressure to “get your pre-pregnancy body back” can sometimes lead to restrictive or unhealthy practices. But running requires substantial energy. Without adequate fuel, you risk energy deficiency, which can impair metabolism, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health.² Make sure you’re fueling your body properly as you ramp up activity.
Finally, don’t overlook the biopsychosocial factors. Ask yourself: How am I feeling mentally? Am I returning to running for healthy reasons? Running can be a powerful stress reliever and mental health tool, but if you’re already drained, it may increase your injury risk.
How to Do It
So, you’ve checked all the boxes and you’re ready to return to running! I usually start my postpartum runners on a walk/jog program to gradually reintroduce impact. I also recommend at least two days per week of resistance training to continue building strength.
As you progress, keep an eye out for warning signs that you may need to pause and check in with a pelvic floor PT:
Urinary leakage with running
Pelvic heaviness or pressure
Any pain
If you’re struggling to get back into running, you don’t have to do it alone—we can help!
If you want to work with Lavender Roots for pelvic floor PT, contact us or schedule an appointment today!
References
MacArthur C, Wilson D, Herbison P, et al. Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12-year longitudinal cohort study. BJSM. 2024;58(4):183-190. doi:10.1136/bjsports-2023-106700
Goom T, Donnelly G, Brockwell E. Returning to running postnatal–guideline for medical, health and fitness professionals managing this population. Australasian College of Sport and Exercise Physicians; 2019.
American Physical Therapy Association. Postpartum return to running program for the physical therapist. 2023. Available at: https://assets-002.noviams.com/novi-file-uploads/apta/2023_Postpartum_Return_to_Running_Program_for_the_Physical_Therapist__2023_April_-2a7e2b3f.pdf
Milewski MD, Skaggs DL, Bishop GA, et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. 2014;34(2):129-133. doi:10.1097/BPO.0000000000000151
