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Getting back to running after a baby

After having a baby, many mums are keen to get their fitness back—running is often a big goal. But, pregnancy and childbirth can take a serious toll on your body, so getting back to running takes time, patience, and a bit of preparation. While there’s plenty of advice and return-to-run programs available, how ready you are to run will depend on your individual recovery and meeting a few key milestones.

How Pregnancy and Birth Affect Your Body

Pregnancy puts a lot of pressure on your body. Your abdominal muscles stretch and separate, your pelvic floor gets stretched, and your joints become looser. As exercise intensity usually decreases during pregnancy, you may lose some strength and fitness, too.

After birth, estrogen levels drop, especially if you’re breastfeeding, which can weaken the pelvic floor further. This makes it harder for your pelvic floor to support organs like your bladder and uterus. Joint laxity can also stick around, making your hips, knees, and pelvis more vulnerable to strain or injury. That’s why it’s so important to focus on rebuilding strength and control in your muscles and joints before considering higher-impact activities like running.

Abdominal separation (where the muscles in your belly stretch apart) happens to all mums who carry to full term, and while it’s necessary for baby’s growth, it means less support in your abdominal wall after birth. Without this support, running or any impact activity can place extra stress on your pelvic floor and spine.

On top of all this, the general decrease in fitness during pregnancy and the demands of caring for a newborn (hello, sleep deprivation!) can make it even harder to get back on track.

What You Need to Consider Before Running Again

 

1. Rest and Recovery

Your body needs time to recover before jumping back into exercise. Pregnancy and childbirth cause a lot of changes, and it takes time for things to settle. For vaginal births, about a third of first-time mums experience perineal tearing, and there’s a risk of pelvic organ prolapse (when your pelvic organs drop down), especially if labour was long or complicated. While prolapse is common, most cases aren’t serious and often improve within a few months. That’s why it’s generally recommended to wait at least three months before returning to high-impact activities like running.

For C-sections, it’s important to remember that it’s major abdominal surgery. Recovery typically takes 6-8 weeks, during which time your body is healing. No lifting or strenuous activity during that time—wait until you’ve had enough healing before thinking about strength exercises or impact activities.

2. Abdominal Strength and Healing

The first few months postpartum are crucial for your abdominal recovery. Wearing compression garments can help your abdominal muscles heal by supporting them and reducing unnecessary pressure. Strengthening deep core muscles, like the transverse abdominis and pelvic floor, is key to rebuilding your abdominal wall. This will help prevent unnecessary strain during impact activities like running.

If you notice your belly “doming” (bulging in the middle) or experience bladder leakage during activities, it’s a sign your core isn’t ready for high-impact exercises yet. Focus on deep core strengthening before progressing to more intense exercises.

 

3. Pelvic Floor Strength

Your pelvic floor plays a huge role in supporting your bladder, bowel, uterus, and helps manage abdominal pressure during activities like running, jumping, or even coughing and sneezing. If your pelvic floor isn’t strong enough, you might experience incontinence, pelvic pain, or feelings of heaviness down below.

Before returning to running, your pelvic floor needs to be strong enough to cope with the impact. This means being able to perform pelvic floor contractions quickly and hold them for a reasonable amount of time. If you’re experiencing any pelvic floor symptoms, such as leaking, pain, or heaviness, it’s important to address those before considering running.

4. Lower Limb Strength and Control

To run without injury, your legs and joints need a baseline level of strength and control. There are a few basic tests to check if you’re ready for running, such as:

  • Walking for 30 minutes
  • Balancing on one leg for 10 seconds
  • 10 single-leg squats
  • Jogging on the spot for 1 minute
  • 10 forward bounds or 
  • 10 single-leg hops
  • 10 Running mans

If you’re able to do these without issues, you’re on the right track. But don’t rush it—gradually build up strength and control before adding the impact of running.

 

5. Gradual Build-Up and Structured Program

When you’re ready to start running again, it’s important to ease into it with a structured program. Start with short, easy runs and gradually increase the distance and intensity. This helps your body adjust to the demands of running without risking injury. Patience is key here—don’t rush the process.

 

6. Supportive Gear

Wearing supportive underwear and a good sports bra can help protect your pelvic floor while you run. Research shows these can reduce strain on the pelvic floor and lower the risk of dysfunction. There are also compression garments designed specifically for postpartum recovery that can provide extra support, especially for the pelvic region.

The Risks of Rushing Back into Running

It’s important to follow a proper return-to-run program to avoid long-term issues like pelvic organ prolapse, incontinence, or musculoskeletal injuries (such as tendinitis or stress fractures). Working with a physio can help ensure your return to running is safe and effective, based on your individual recovery and fitness level.

The key is to take your time, rebuild strength and control, and only progress to running when your body is truly ready. You’ve got this—just make sure to listen to your body and move at your own pace!

How to ‘heel’ your plantar fasciitis

What is plantar fasciitis?

The plantar fascia is the connective tissue that runs along the bottom of the foot from the heel to the toe bones. This makes up the arch of your foot. Plantar fasciitis is the overload of this tissue, and causes pain primarily at the base of your heel, however can occasionally be felt along the line of the plantar fascia.The plantar fascia is an extension of the fascia that connects your calf muscle to your foot. So often an overload or tightness in your calves will contribute to plantar fasciitis.

Common signs and symptoms

Pain in the plantar fascia is typically felt underneath the heel, especially during activities that put stress on the calves, such as walking or running. The discomfort often worsens after periods of rest, feeling more intense in the morning but improving with movement. In some cases, there may be tenderness when touching the base of the heel, and while the pain can vary from day to day, it usually diminishes as you move and the muscles warm up.

How does it happen?

Overload of the plantar fascia can occur in a number of ways, but when daily loads exceed the capacity of the plantar fascia, it will respond in pain.
Overload can occur suddenly, for example a person may jump off a step and feel immediate pain at the base of the heel. Or it can happen gradually over time, such as increasing running kilometers to prepare for a marathon. The accumulative load of progressively running longer distances can eventually exceed the foot’s ability to cope, leading to pain.

Overload can also occur indirectly. For example, if you’re limping because of an injury, you may put extra strain on your uninjured leg. This increased reliance can lead to overuse and ultimately result in pain in the plantar fascia.

Switching footwear can lead to increased strain on the calves, which may, in turn, overload the heel. This is often seen with high heels, where the foot is positioned in plantar flexion, causing the calves to work harder and putting extra stress on the fascia. Additionally, changing to sneakers that promote a more forefoot-striking pattern can also raise the load on both the calves and the plantar fascia.

Hormonal fluctuations can weaken tendons and raise their risk of overuse injuries. For instance, a decrease in estrogen around menopause leads to tendon stiffness, reducing their flexibility and making them more susceptible to injury. As a result, there is an increase in tendinopathies, including plantar fasciitis, among women aged 40 to 60 during the perimenopausal phase. 

Additionally, some medications can have a similar effect on tendons, causing degeneration over time without inflammation. This includes statins, which are often prescribed for cholesterol management, and long-term use of steroids to treat inflammation.

How to fix it


1. Pain management

Our initial goal in treating plantar fasciitis is to reduce the pain. There are a number of strategies Physio’s use to aid in pain management.
Firstly we recommend modifying the activities that cause pain. These will often be weight bearing activities such as walking or running, and although it may not be realistic or helpful to completely eliminate these activities from someone’s day, it may be as simple as opting for a lift to work instead of walking to and from the station, or reducing daily walks by half and taking a break from running temporarily.
Plantar fasciitis is typically worse after periods or rest and particularly with your feet resting in a plantar flexed (pointed) position. So a footrest at your desk chair, little exercises to perform at your desk or regularly getting up to move may help in controlling pain.

There are certain taping strategies we can use to better support the plantar fascia which may reduce loading and help with pain. The same goes for arch support in your shoes, or opting for more supportive shoes during the day.

Occasionally other interventions are used to more aggressively manage pain. These can include corticosteriod injections which allow a period of reduced pain, and when used in conjunction with activity modification, strength and mobility, can be a helpful contribution to the overall rehab journey.

2. Mobility

Mobility is an important factor in controlling plantar fasciitis, especially calf mobility. Massage, foam rolling and stretching are all strategies employed to help maintain calf length which can reduce pain, manage the injury and prevent its recurrence in the future.

3. Strength.

At the end of the day, the stronger your calves and feet are, and therefore your tendons and plantar fascia are, the more load they can tolerate and the less chance of them being overloaded. Strength is key in treating plantar fascia, however loading needs to be appropriate for the individual. Strengthening exercises shouldn’t cause pain, or overload the plantar fascia more than it already is. They should replicate and prepare the feet and calves for the type of activity the individual needs to get back to, and be maintained at a certain level to prevent overload occuring again in the future.

How to avoid it

Injuries like this can be challenging to avoid, especially if the triggering factor is something out of your control such as hormones fluctuations, rapid gain in weight similar to what happens in pregnancy, or an unaccounted increase in daily loads. But recognising the warning signs and addressing them immediately, sets you up better for a successful recovery.

Headaches – Can Physiotherapy Help?

Headaches can be challenging to manage due to their various causes and the different ways they manifest in individuals. Triggers can be physical such as an irritated joint or a tight muscle, psychological such as stress or anxiety, or related to lifestyle factors like dehydration, food intolerances, or lack of sleep. This variety is what often complicates effective management.

 

Identifying common factors associated with headaches can help you recognise their specific causes, allowing for more targeted management strategies.

Understanding the sources of headaches

Musculoskeletal headaches

Headaches can originate from musculoskeletal structures, such as joints or nerves in the spine. The upper three cervical joints (C1-3) refer to the head, so irritation at these levels can lead to headaches, nausea, or dizziness. 

Muscle tension is another common trigger for headaches. Certain muscles in the neck, jaw, and shoulders connect to the base of the skull, and if these muscles become tense or overactive, they can produce pain that manifests as a headache. 

Additionally, poor posture or physical overexertion can lead to muscle tension, contributing to this type of headache.

 

Preventing Tension-Related Headaches

Preventing these types of headaches often involves improving posture, especially in work-related settings where many people spend most of their day. An ergonomic assessment of your workplace can help identify poor habits that may be contributing to muscle tension and fatigue.

New mothers often experience neck and head pain from hours spent nursing or rocking their babies in awkward, repetitive positions. Various nursing pillows and chairs can provide support, along with changing feeding positions, incorporating muscle stretches and releases, and engaging in strength exercises to help manage discomfort.

For those who are active, reviewing your exercise routine may reveal movement patterns that place extra strain on the muscles at the base of your head. A physiotherapist can assist in identifying these issues and targeting specific muscles and movements to reduce the load on your head.

Migraines

Migraines are primarily a genetic neurological condition that can cause moderate to severe pain, often accompanied by nausea and sensitivity to light and sound. Typically, an aura precedes a migraine, which may result in visual disturbances like spots or stars, ringing in the ears, or escalating head pain. While migraines are usually one-sided, they can affect both sides of the head.

Because migraines stem from changes in blood flow and nerve sensitivity within the central nervous system, medication is often necessary for management. Keeping a headache diary can also help identify potential migraine triggers, such as hormonal fluctuations, specific foods, or exposure to light and sound.

Physiotherapy can assist in managing the musculoskeletal tension and pain associated with migraines, complimenting medication as part of treatment.

Lifestyle-related headaches

Dehydration can influence blood pressure, leading to headaches that are typically experienced as a diffuse pain across the whole head. To differentiate a blood pressure-related headache, it’s important to assess factors such as fluid intake, alcohol and caffeine consumption, medications, and exercise habits.

Mental health significantly contributes to the incidence of headaches. Increased cortisol levels during stressful periods can trigger headaches, while stress can also reduce pain tolerance and lead to muscle tension that radiates to the head. Similarly, lack of sleep decreases pain tolerance, often resulting in more intense headaches. Quality sleep is essential for the brain to rest and function properly; disruptions can lead to mood and hormonal imbalances that contribute to headaches.

In addition to stress management techniques, physiotherapy can help relieve tension in the neck and jaw, which may reduce the severity of stress-related headaches.

Certain medications and food intolerances can lead to headaches as a side effect. Your doctor may evaluate your medications to help manage these side effects, while a dietitian might suggest keeping a food and headache diary to pinpoint potential triggers. This approach can help you find suitable alternatives while still meeting your nutrition needs.

 

The most effective management of headaches involves a multidisciplinary team of healthcare professionals. Doctors play a crucial role in referring patients for scans, specialists, and prescribing medications to alleviate headache symptoms. Physiotherapists can address muscle tension related to headaches, assess posture and movement, and provide corrective exercises to reduce recurrence. Psychologists contribute by offering stress management strategies, which can help mitigate headache triggers. Meanwhile, dietitians can identify food-related triggers and recommend suitable alternatives to improve overall well-being.



All professionals involved have the expertise to identify headache triggers, manage symptoms within their area of expertise, and refer you to the appropriate healthcare provider for issues they cannot address. If you are experiencing recurrent headaches, please don’t hesitate to seek help.