How can we support women to return to running following childbirth?

Why is this study needed?

Women experience a multitude of physical and mental changes during pregnancy and childbirth. Supporting women to re-engage in active lives following childbirth is incredibly important, for two generations; mother and child. Supporting and empowering women through active rehabilitation can help them to regain physical and mental aspects, such as fitness, athletic identities and that all important me time. But little is known about how to rehabilitate women following childbirth and what factors influence return to running and running-related urinary incontinence. So, we decided to explore this in our recent study(1).

How did this study come about?

Gráinne co-authored the clinical guidelines for return-to-running, alongside Emma Brockwell and Tom Goom. A year later, this got Izzy’s attention – she was a bit slow to react! Then Gráinne, Emma and Izzy met for an hour, it was more like two… and the idea to understand what factors contribute to women returning to running and running-related urinary incontinence was born. More meetings followed, other members of the team joined and before we knew it we were launching the survey.

The response we had to the survey was overwhelming! A huge thank you goes out to all women that completed it for us. We really appreciate you taking the time to take part.

What did we find?

Key findings were:

• On average women returned to running at 12 weeks postpartum which is in keeping with recommendations outlined in the return-to-running guidelines.
• Including running during pregnancy increased the odds of returning to running following pregnancy.
• Heaviness in the vaginal area was a factor that may prevent women from returning to running. Much more so than perineal tears.
• In addition, we identified that current concepts established within other specialist populations, e.g. sports medicine, are relevant in the postpartum population too. For example, fear of movement.

What can expectant mothers do?

• Proactively engage with pelvic floor exercises
• Remain active, as long as there are no contraindications identified by your healthcare provider

What can mothers do following childbirth?

• Tell healthcare providers about any feelings of heaviness or exercise-related pain
• Progress activity slowly to build up tolerance to running
• Understand that exercise and sport can be resumed following childbirth
• Understand that running can resume following perineal tears, after allowing appropriate time for healing to have occurred. Perineal tears do not appear to be a barrier to high impact exercise

What can clinicians do?

• Encourage women to keep running during pregnancy, where is appropriate and safe to do so
• Address pelvic floor dysfunction early
• Consider assessing fear of movement following childbirth and considering ways to address any fear identified. Ensure that prenatal management of this population offers evidence informed and empowering information regarding running during and after pregnancy.
• Ask women about the sensation of vaginal heaviness and address any identified concerns.
• Ensure exercise-related pain is assessed and managed accordingly