The 6 Week Green Light

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Many thanks to the knowledgeable staff at Fitness Matters for providing this content.

It has been 6 weeks since you had your baby. You have waited patiently for this day, the day you get the all clear and the green light to return to running. You strap on your running shoes, walk out the door, start your run…. but wait, your body feels so exhausted, maybe unstable, maybe you are experiencing pain, maybe you pee yourself… maybe even find you are losing stool. Perhaps you have absolutely no idea what you are experiencing, you just feel different and lost.

What Has Happened to My Body?

Now you are thinking, “what has happened to my body?” Well, let’s dive into this a little. If you had a vaginal delivery, your baby had to pass through a group of muscles generally referred to as the pelvic floor. The pelvic floor is a bowl of muscle that sits between your hip bones and it moves and contracts just like any other muscle in your body. The pelvic floor is the foundation of your house, it supports the organs of your body and helps to maintain continence. The pelvic floor undergoes remarkable changes, such as stretching of the muscle, to allow the baby to pass. Sometimes, this can cause injury, weakness – or it can lead to in-coordination of this grouping of muscles.

If you have a cesarean delivery, there are multiple layers the surgeon must go through in order to reach your baby. The layers include your skin, subcutaneous tissue, fascia, muscle, three layers of the uterus, and potentially the amniotic sac. This is not to scare you, this is to inform you and help you to understand the healing that must then occur. Just as with any other orthopedic surgery or injury – there is the science of healing that needs to be respected. At 6 weeks, your pelvic floor or the incision from the surgery, are not completely healed so to expect to return to dynamic activity at that time, may not be the best advice.

What to Do and Who Do I Turn To?

It is not recommended to return to running until 3 months postpartum to allow for improved healing of the muscle and tissue. It is also not recommended to return to a running program if you are experiencing any leakage of urine or fecal matter, urgency of urine or fecal matter, heaviness, pressure bulging in the pelvic area, pain with intercourse, feeling of obstruction when you are attempting to defecate, or general pain. If you do experience any of these symptoms, it is recommended you see a pelvic health physical therapist. Pelvic health physical therapists can guide you through an individualized program to assist you in returning to what you love. Simplifying clinical decisions by creating blanket rules is tempting, but usually unhelpful to each individual. Everyone’s birth experience and current life situation are unique to them.

How Do I Get Back to What I Love?

If returning to running is your main goal, Fitness Matters offers a Run Right Coaching program to assist you into returning to run. It would be best to start with an evaluation from a pelvic health physical therapist after the 6-week checkup with your OBGYN in order to start to prepare you and your body for the progression into a personalized running program. The Run Right Coaching program offers a Gold and Silver Package, both of which are 12-weeks long and start with an initial evaluation looking at your running gait, mobility screen, and a discussion of your goals. The Gold Package takes it a step further and re-evaluates you in person around the 4- and 8-week mark. Throughout both packages you will stay in communication with your running coach. The most important thing is that you remember what you have just done. You have just spent 9 months growing another life and bringing that life into this world. A lot has changed for you and it is important to be gracious with yourself and to celebrate the small successes you achieve. The goal with the Run Right Coaching program isn’t to make you an athlete for a year, the goal is to give you the tools and support you need in order to help make you an athlete for life.

References:

Ashton-Miller JA, Delancey JO. On the biomechanics of vaginal birth and common sequelae.
Annu Rev Biomed Eng. 2009;11:163‐176. doi:10.1146/annurev-bioeng-061008-124823

Goom T, Donnelly G, Brockwell E. Returning to running postnatal – guidelines for medical,
health and fitness professionals managing this population. March 2019.
https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-
_guidelines_for_medical_health_and_fitness_professionals_managing_this_population.

Sung S, Mahdy H. Cesarean Section. [Updated 2020 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK546707/

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