That was the question trainer, researcher, and kinesiology professor Kara Radzak, PhD, ACT, faced after she had her first child in 2018.
“I did what every clinician and researcher does: I went to PubMed to see what’s out there, to look for evidence-based guidance on how I could return to running safely,” Radzak says. “There was nothing.”
Since then, things have changed: In 2019, a group of physiotherapist researchers published guidelines in the British Medical Association’s journal, The BMJ, for how clinicians can help formerly pregnant people start running again to mitigate injury and promote successful outcomes in back to run programs.
Now, in addition to recommending more comprehensive pelvic floor examinations, there is a seven-move “load and impact management assessment” they advise people to put their joints, muscles, and core (including the pelvic floor) through before returning to high-impact activity.
Typically, people who have given birth are told to not engage in any exercise for six weeks after giving birth vaginally, or eight weeks in the case of a c-section. Then, an OB/GYN will assess you and give you the green light to return to exercise again if you are recovering normally. Tia chief clinical officer Jessica Horwitz, MPH FNP-C, a board certified family nurse practitioner and public health clinician, says getting this clearance means it is “medically safe” to start working out.
Your OB will likely advise you to start slow, but, in terms of the impact on your body—a body that is still feeling the effects of carrying and delivering a baby “well after that six-week postpartum visit,” according to Horwitz—that might be harder to put into practice with some forms of exercise than others.
In particular, running is a high-impact activity that exerts a lot of force on your joints, when your joints may be loosened and/or aligned differently than they were pre-pregnancy thanks to hormonal changes. It also recruits pretty much every muscle in your lower body and core—a tall order after spending months not running, and experiencing abdominal muscle separation.
What’s more, if your pelvic floor, the sling of muscles that holds up your organs and entire trunk, is not adequately recovered after getting stretched to oblivion while pregnant, you could experience incontinence and/or have inadequate support for the rest of your upper body as you bounce up and down on those muscles.
That could all lead to discomfort or injury, or cause gait irregularities, which may do the same down the line. So the running preparedness test assesses whether your joints and muscles can handle the force that comes with gleefully launching yourself, one leg at a time, down the street, track, treadmill, or trail.
Radzak sees the test as a tool to give people more information when, in general, she says postpartum recovery and activity guidelines are vastly under-researched. “There’s just so little known and there’s such a big need, and it’s been overlooked for so long,” Radzak says. “There’s not [otherwise] a whole lot of guidance if you’re wanting to be physically active.”
If you’re not passing the test with flying colors but you feel ready to run again, consider consulting further with your doctor or a running coach about how to ease in.
Horwitz agrees that the test for running after pregnancy might help this group proceed with more confidence, but stresses that an external test should not be the last word. If you’re not passing the test with flying colors after growing a whole darn human in you, but you feel ready to run again, consider consulting further with your doctor or a running coach about how to ease in. Conversely, if the test says you’re physically ready, but you are not emotionally or mentally ready to take on the challenge of running, by no means should you feel pressured to do so.
“I think it’s a data point to consider as part of the whole picture,” Horwitz says.
Postpartum test for running after pregnancy
To pass the “load and impact management assessment,” you’ll want to be able to do the following activities “without pain, heaviness, dragging or incontinence.”
- Walking, 30 minutes
- Single-leg balance, 10 seconds per side
- Single-leg squat, 10 repetitions per side
- Jog on the spot, 1 minute
- Forward bounds (a slow, exaggerated, leaping run), 10 repetitions
- Hop in place on one leg, 10 repetitions per side
- Single leg ‘running man’ (arm and opposite leg bend up and then back at the same time, a slowed down in place run), 10 repetitions per side
If you “pass” the test, remember to nevertheless take it slow. Consider starting by alternating walking and jogging, and slowly increasing time, distance and speed. You can also consult a postnatal return to running program for a step by step guide.
