Physical therapists have in depth and extensive knowledge about the muscles, nerves and bones, typical development from birth to old age , normal and abnormal movement and the injury process. They have knowledge in how to prevent injuries before they
Running and Pregnancy Articles (Running and Pregnancy Series): Running Research: Running and Nursing (Totalrunningperformance.com) Belly Support during Pregnancy (Totalrunningperformance.com) Items to get you through running pregnant (Totalrunningperformance.com) Returning to running after pregnancy guide (Totalrunningperformance.com) Is baby ready to move to
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Contemplating the return to running may be a distant hope those first few weeks or a definite need for you to squelch baby blues, provide much needed alone time and lose the extra weight and strengthen your body for parenthood. How do you return safely? Here are some phases to keep in mind to allow you to return safely and return stronger without a higher risk for injury.
There are no specific time limits in the phases as some may be at phase five by week 8 and some by month 6. You should progress based on how your own body responds and as cleared by your doctor and medical professional.
1. Phase 1: Healing and Holding:
This phase is all about healing your body and the transition to motherhood. Your body has undergone significant changes for the last 9-10 months and is healing from the trauma of birth. No two pregnancies and no two births are the same and it is important in this phase to understand that. There is no reason to compare but only to figure out and understand what your own body needs. This may be a first pregnancy that you breezed through easily and your body will adapt quickly or it may be your third, in which you’ve likely had a few more aches and pains and need more time to rebuild. You may have been able to run up until birth or maybe had to be placed on bed rest early on. Learning to listen to your own body and own situation is one of the most important things in this phase. Check with your doctor to obtain clearance through all phases, but especially here.
Your goal here should be to adapt to physically recovering and what your role as mom entails with a new little one in your household. Physically, the focus should be on getting sleep as able, balancing gentle moving with pain management, and eating high quality meals for optimal healing. If you are nursing, there is an additional large tax on the demands of your body physically and possibly emotionally. Whether parenthood is a new challenge or not, it brings large demands.
During the initial days, some things to focus on are: learning to use good body mechanics in getting in and out of bed and while lifting baby and other items (your core muscles will be weak and need to be protected until you can restart the connections and work back to strengthening), pain management as instructed by your doctor and how to alleviate it (pain inhibits muscles from working correctly), and gentle moving vs. staying immobile which in the long run will make you feel better. You can start gentle transverse and pelvic floor exercises as tolerated when cleared by your doctor. You’ll want to learn gentle abdominal splinting techniques, as approved by medical professionals and begin a return to basic deep breathing exercises. As you get towards that visit to be cleared for exercise by doctor, generally around 6-8 wks, you can add in more movement. Your doctor may allow gentle walking. Take a 5 min walk to tolerance and see how your body handles it. Add on 2 minutes every other day you can return pain free. If there is any pain or increased bleeding, undue fatigue or tiredness, take more days off in between and give your body time to heal and adapt.
This is not a race with anyone else, only yourself to make sure you get to the return of running as strong as possible in the long run. A hasty return could definitely leave you sidelined for long after you have your baby and you may not realize the damage done from returning too quickly until after your return post-marathon or even into the next pregnancy. Pelvic floor problems may not make themselves known until years down the line, so exercise caution.
2. Phase 2: Return to Movement. This phase begins when you are able to begin moving well in your new daily activities. Gentle walking, restorative strengthening program begins. Many runners are eager to jump into the running phase but an important thing to consider in this phase what needs healing and the speed at which the body heals. If you ran or exercised during pregnancy, it is likely that your aerobic fitness and leg muscles are much stronger than your hip muscles, core and pelvic floor. Many runners choose to ignore this and unfortunately it can cause many problems down the road. Overall, your core and pelvic floor (this includes the hips as well) need more time to heal and be strengthened. If you had a vaginal birth, you will likely be up and moving quicker and in less pain than if you had a c-section-major surgery. Pain in any of these areas can inhibit muscles and prevent them from working properly. Overall, it is important to engage in a sport specific program to get these areas healing and back in shape.
You will need to start specific core exercises strengthening the transverse abdominals and pelvic floor, preparing your body for the impact of running in later phases. This also includes specific exercises to strengthen arch of feet as arch ligaments may have weakened and will remain lax for a while, especially if you are breastfeeding.
3. Phase 3, the Walk/Run Phase: You should return to an overall strengthening program for the core and floor, advancing the exercises in this area. When ready, you should start a walk to run program. You can continue core exercises and add on dynamic movement with hips, two and one legged stance. Before resuming the run, walk program, you should test out some light plyometrics before running to see how your core and pelvic floor react. Any leaking or heaviness is a sign that you should return back to phase 2 exercises and may need a visit to see a Pelvic floor physical therapist. If you are good to go, build up slowly in the walk to run program and take days in between as needed to allow for recovery.
4. Phase 4: Return to Running: This phase is about returning to consistent regular running pain free up to 5k. You should be continuing dynamic core exercises adding in core exercises with running drills (light plyometrics) to continue to challenge the pelvic floor. You can consider cross training if needed here so that you are running every other day to allow your pelvic floor muscles some recovery time. Build up to running every day as able.
5. Phase 5: Building and Racing: Here, your core and floor should be well strengthened and you can consider the return your usual running and racing. Here, you’ll be completing dynamic core exercises with plyometrics and advanced to very advanced core exercises. Basic Pilates type exercises can be considered as long as the core is healed. You should be having no problems with incontinence and the core should be stable. You should consider waiting a new week or two to let your body adapt before adding in each of the three basic running workouts (tempo, intervals/hills, long run) and building up. Once you are there, the sky is the limit!
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This journal article article was an interesting read and caught my eye because, as a former heptathlete, I engaged in both sprint training and distance training at the same time. The study was completed in a group of thirty untrained