A Physical Therapist's Guidelines to Running Postpartum

November 11, 2022

Are you thinking about running postpartum but wondering if your body is ready? If you already identify as a runner, running postpartum is one of those activities that can make you feel like yourself again. Whole, recovered, free, capable, strong. If you are not yet a runner (perhaps even a tad giddy and nervous about the prospect of becoming one), and yet you long for the convenience and efficiency of stepping out your door and into your workout without long transitions (think swimming) or commutes (think gym) or annoying instructors (think classes), you are not alone. Running can be a wonderful activity that is healthy and restorative for body, mind and soul - but it is really important to be intentional about how and when to begin running postpartum to ensure you enjoy all the benefits of running without the collateral damage of injury. Whether you are eager to return to running or to begin to run postpartum, this article presents evidence-based guidelines on how and when to safely begin running postpartum. 

How long after birth should I wait to run?

First, as a general recommendation, it is ideal to wait at least 12 weeks after birth before beginning an impact activity such as running. Situations may vary, so this time frame is a loose guideline. 

Is your body ready to run?

When judging readiness to run postpartum there are a few things to consider - how long it has been since giving birth, how you are feeling during daily activities, and finally, how your body is feeling with impact activity such as jumping or hopping. As many as 1 in 3 women experience postpartum urinary incontinence, with some estimates as high as 55% at 12 months postpartum. If you are still leaking urine or experiencing pelvic pressure, you are not alone. Thankfully there is an effective, non-invasive solution to address these lingering symptoms.

Can I perform activities of daily living without leaking or pelvic pressure?

Another thing to consider prior to beginning any impact activity, such as running or jumping, is being able to perform your typical daily activities, lifting and walking, for instance, without leaking urine or experiencing significant pelvic pressure. “Significant pelvic pressure” is subjective, so gauge it as pressure that might feel uncomfortable, painful or just “not right” to the level that it would stop you from doing an activity. 

Consider a core and pelvic floor routine first

If you are experiencing any significant pelvic floor pressure or leakage during your daily activities, consider engaging in a regular strengthening routine for your core and pelvic floor, like Every Mother’s EMbody Reclaim program, for at least six weeks before working on any impact activities. Why six weeks? Because physiologic strengthening, meaning actual muscle growth or hypertrophy, typically takes at least six weeks. So, performing a core and pelvic floor strengthening routine 3x/week for at least six weeks should put you in a better place to start impact training, which can include running. After you have been cleared by your medical practitioner to resume full activity AND you’ve strengthened your deep core and pelvic floor to the point that you’re no longer leaking when you cough, sneeze or laugh, you’re ready to begin impact training, which we will cover below.

Retrain your pelvic floor muscles for better control during a run

Running is a series of hops. So, being able to jump and hop without leaking or feeling pelvic pressure is also important prior to running. Once you feel ready, and have a good foundation of core and pelvic floor strength, it is beneficial to actually practice impact activity in a more controlled manner prior to running. Working on impact activities that coordinate a conscious pelvic floor contraction with the moment of impact – performing a Kegel while you land a hop, for instance –  can result in the neuromuscular retraining needed to remind your pelvic floor what it is supposed to do during running. Luckily, neuromuscular retraining is much quicker than strengthening, so just a few weeks of practice with jumping and hopping should result in better pelvic floor control during a run. That way, when you go on a run you don’t have to think about contracting your pelvic floor or engaging your core, it will happen automatically! Every Mother offers a 21-day “Get Ready to Run” training program that specifically retrains this neuromuscular pathway to coordinate effective activation of the deep core, the pelvic floor and the breath to safely manage the intra-abdominal pressure inherent in impact. This is an excellent, evidence-based preparation that prepares you to approach your first postpartum run with both strength and confidence.

I can’t stress enough that every body is different, and every postpartum recovery is different. So try not to hold yourself to rigid time frames. These are just suggestions. It is important to honor where your body is and what you need. If you feel that you are in a place to move quicker don’t let these guidelines hold you back! These suggestions can help guide you when you don’t have a professional by your side to assess you at each step of the way.

So now you can walk, lift, jump, and hop without any pelvic floor symptoms. Put on your shoes and run that 10k!? Nope!

Running Training Schedule: Graded Run/Walk Intervals

If you have never run before, where should you start? One approach would be a graded running program starting with intervals of runs and walks, then ramping up to continuous running. Even if running were your pre-pregnancy exercise, I highly recommend beginning with run/walk intervals. An example of that could look like this:

Phase 1: Walk 5 minutes - run 1 minute, 5 rounds for 30 minutes
Phase 2: Walk 4 minutes - run 2 minutes, 5 rounds for 30 minutes 
Phase 3: Walk 3 minutes - run 3 minutes, 5 rounds for 30 minutes
Phase 4: Walk 2 minutes - run 4 minutes, 5 rounds for 30 minutes
Phase 5: Walk 1 minute - run 5 minutes, 5 rounds for 30 minutes
Phase 6: Continuous running

To progress through the above phases safely, the general recommendation is to perform each phase until you can do so with no symptoms of leakage, vaginal heaviness or pelvic pressure during or after the run three times. Once you can complete a phase at least three times without experiencing symptoms, move on to the next phase. 

Run every other day, performing your core and pelvic floor strengthening routine on your in between days. 

Pre-Run Core Compressions Improve Performance

I also highly recommend performing 1-2 minutes of Core Compressions just prior to your run in order to “turn on” that nerve pathway between your brain and your pelvic floor and core. This can result in better core and pelvic floor activation during your run.

Adding speed and distance to your running routine

Once you are running continuously without symptoms of leakage, vaginal heaviness or pelvic pressure, you can then try working on speed and distance. It is recommended to work on EITHER speed, or endurance during your run - avoid progressing both variables at the same time. Three runs with no symptoms is typically a safe point to progress to the next phase.

For more tips on running techniques and questions you might have about running and core health, see our Running and Postpartum Core Health article. If you are interested in running during pregnancy, see our Running During Pregnancy article.

Last Reviewed by Whitney Rogers PT, DPT in November 2022