I haven’t always loved to run. It wasn’t until I was in college that I really got into running “competitively”. I love the competition against myself and the challenge of trying to be better than I was the race before or even the day before. Running has become a wonderful outlet for me. It is my time to be alone with my thoughts or to escape my thoughts.
I have now run many races and logged many, many miles.
Last year, I completed my first full marathon here in Toledo, and in January 2020, I ran the Dopey Challenge in Disney World. This consists of a 5k, 10k, half marathon and full marathon on consecutive days for a whopping total of 48.6 miles in 4 days. To say I felt accomplished is an understatement.
One of the biggest challenges I’ve had in my running career has been becoming a Mom.
I got to meet both of my babies via c-section. Never would I have thought that I would not be able to bounce back to running. My core was weakened and my whole center of gravity felt off. I was cleared to start exercising after my first was born at my 6-week follow up and was chomping at the bit to start running again, and yet, I was set up for failure.
My OBGYN didn’t give me much guidance. I went out too hard at first, craving the runs I was so accustomed to. It was beyond frustrating and I felt even more out of control. Eventually, I got back to my “normal” and things were good again, but I struggled to run normally again for about the first 6-9 months.
With my daughter, almost two years later, I was not able to run past 16 weeks without pain. This was different from my first, where I ran up to the 30-week mark. This pregnancy was also different in that I had a different OBGYN. She is amazing and very into evidence-based practice instead of just doing things how they’ve always been done. She appreciated the fact that running was an important part of my life and worked with me to make sure I kept active and that running would be a much easier transition to make postpartum than my past experience. She suggested I go to pelvic floor physical therapy and said that it would change my life.
Boy did it!
I scoffed at first, thinking, “I’m young and in shape. I don’t pee my pants when I cough or sneeze”. Oh, bless my dumb soul. I now do both. Karma’s a peach. At my first appointment, I was blown away by how much I did not know about my own body! We started with an evaluation that pointed out my weaknesses. Sounds like a real treat, doesn’t it?
Turns out, my glutes were not firing at all when I was doing anything remotely similar to running. My hamstrings were beyond weak and I had a pretty severe diastasis recti, which is where the abdominal muscles separate up the center of the abdomen after carrying a baby. After talking with my PT, I learned I was fighting an uphill battle trying to run with this new body. Pregnancy changed my pelvic floor and was making it very hard for me to run without pain and injury.
Therapy made SUCH a difference! Being able to pinpoint exactly what needs to be worked on and strengthened was huge for my running. I highly recommend seeing a pelvic floor PT if you are a runner or even if you are just looking to start or restart exercising postpartum.
Alisha Bruhl is an amazing, sweet fellow “mother runner” who specializes in pelvic floor rehab after pregnancy. She worked to get me back out running and I love her to pieces for it. I asked her a few questions since she is an expert on the issue of pelvic floor strength after baby.
How do people get in to see a pelvic floor PT?
“As of right now, you can only see a physical therapist with a prescription from a healthcare provider. She states that it’s generally covered by health insurance.”
What would you say is the most common problem for women who are returning to running after having a baby?
“Incontinence, prolapse (sensation of something falling out of the vagina) and pain (abdominal, hip, and/or pelvic). Most often, one of the biggest factors related to all of these problems is coordination or poor control of the pelvic floor and the abdominal muscles as well as your breath! Any strengthening for our pelvic floor and abdominal muscles is ineffective and sometimes harmful until you regain good coordination.”
What’s your number one recommendation for mamas who are returning to running after delivery?
“Take it slow and listen to your body. Both sound cliche, but are very relevant to postpartum running. Relaxin, the hormone that increases joint laxity for delivery remains elevated for up to several months. You need to allow time for abdominal wall and pelvic floor healing (both vaginal and c-section) for low back and pelvic stability.”
She also recommends scaling runs back, as well as utilizing run/walk intervals. If you’re used to longer distances, shorter runs will be your BFF for a while. If you’re having pain or any abnormal sensation, this may be a good indicator you could use some physical therapy!
For women who can’t get in to see you after having a baby, what are some preliminary things that they can do to help get themselves back out clocking miles or exercising in general?
“First, check your breathing. Breathing using your diaphragm is vital for low back pain and pelvic stability and pelvic floor function! Second, increasing cadence (number of steps per minute) is the easiest and best way to reduce the impact your body experiences while running. Count your steps for 10 seconds and multiply by 6 to calculate a quick estimate. The gold standard is 180 steps/minute to give you an idea of what to reach for. If you are in the 150’s and 160’s your cadence is too low!”
I urge you if you are a runner or are active and are going to have a baby soon, or have in the past, ask your OBGYN about a physical therapy consultation. I was amazed that this was a thing and that I had no idea about it my first go-around. What I learned from my time with Alisha is vital to me running comfortably and injury-free. It helped me to keep running a way for me to ground myself, treat myself and set a good example for my kiddos who are always watching!