Sure babies are cute, but they do some ugly things to our runner bodies. As I explained in my intro post, I didn’t train for a marathon until after I had my second child. Like many eager new running moms, I fell victim to “too much, too fast, too soon” after giving birth. I thought at seven months postpartum I was well past any potential injury related to labor and delivery, but I was wrong.
The bright side? I gained an increased awareness and understanding about what my body needed to stay strong and support a heavy training load. I especially learned a lot about my core and pelvic floor, which were perhaps the parts of my body most impacted by pregnancy and childbirth and, perhaps worse, the parts I most neglected.
The End of the World Injury
When my doctor gave me the green light at my four week postpartum check-up, I felt confident returning to running. After all, I ran through 90% of my pregnancy, had a 45 minute labour, and had already successfully returned to running after my son was born in 2012. Days, weeks, and months went by and I felt stronger all the time. By the time my daughter was five months old, I felt good enough to start training for that first marathon!
In March 2016, I was only seven weeks into an 18 week marathon training plan, seven months postpartum and still breastfeeding. Part way through my 21 mile long run, I hopped off an unusually high curb and felt my left side drop. I kept running, but something didn’t feel right. Then my left hip and lower back completely seized up. I went home, stretched, soaked in the tub and then went back outside to finish my run — NOT a smart move.
The next morning I woke up and I couldn’t walk. The panic started setting in. My chiropractor was on vacation so I booked an appointment with a different one and went in for an adjustment that morning. She discovered my pelvis was locked in a forward tilt and there was a lot of swelling. That week I alternated between massage and chiropractic care each day.
I noticed small improvements in my mobility, but still didn’t know exactly what was wrong with me. Another week of chiropractic care and massage, and I decided to look for a physiotherapist. That first physiotherapy appointment opened my eyes to what I was going through, and thankfully she didn’t think I was crazy for still thinking I could run a marathon in two months.
The diagnosis? I had sprained my sacroiliac (SI) joint. The impact of the curb jolted my pelvis and locked it forward as my ligaments were still very loose from giving birth and breastfeeding. My pelvic floor was incredibly weak, and my core wasn’t much better.
If I could go back in time, what nuggets of wisdom would I impart to myself to have a healthier postpartum return to training?
Rebuild Your Pelvic Floor and Core
Do not ignore your core or pelvic floor! Your pelvic floor muscles do a lot of heavy lifting during pregnancy, and especially during a vaginal delivery. It is not uncommon for there to be dysfunction with these muscles after giving birth. But the pelvic floor does so much more than keep us from peeing in our tights; these muscles are essential to maintaining hip stability. Likewise, pregnancy often does a number on our abdominal muscles too.
Postpartum pelvic floor and core strengthening are essential, and the two of them go hand in hand. The strengthening routine my physiotherapist gave me focused heavily on engaging my transversus abdominis (TVA). It’s the least sexy ab muscle in the human body, but probably the most important one. It’s key to maintaining spine and hip stability. By actively engaging this area, especially when running, I noticed a decrease in lower back pain and a more stable pelvis. I am now much more aware of this area and the role it plays in injury-free running.
If your OB or midwife checks you out and thinks you’re not suffering from a severe dysfunction of either your pelvic floor or your core, ease into a restrengthening routine. For the pelvic floor, consistent Kegels are the most recommended exercise for restrengthening the pelvic floor, although core exercises like bridge and plank also engage the pelvic floor. You can begin Kegels as soon as you can do them pain-free.
As for core, wait until you get the go-ahead from your doctor because you can make an ab separation, a common post-birth condition called diastasis recti, worse by doing conventional ab workouts like crunches and planks. Once you get the go-ahead ease back into core work slowly, consistently, and gently.
I assumed I didn’t have pelvic floor issues, as I wasn’t peeing my pants, but you know what they say about assuming, right? When returning to running after childbirth, I wish I had consulted with a physiotherapist or pelvic floor specialist sooner. If you can afford to see a postpartum specialist to assess your weaknesses and make a plan to regain strength and re-balance your body, it’s worth it.
But if you’re experiencing signs of pelvic floor or core dysfunction, like incontinence while running, pain in the pubic area, back pain, etc., seek help of a medical professional to get yourself back on track and ready to run like a boss again.
Until I got injured, I didn’t realize anything was wrong. Had the injury not happened when it did, I could have been sidelined with something even worse, further into my training, which could have resulted in missing the marathon. In my situation, I found that a combination of PT, chiropractic and massage helped me bring balance back to my muscles. Almost a year after this injury, I keep up this routine in order to remain strong and help to prevent injuries.
Did you have pelvic floor issues after returning to running after having a baby? How did you overcome them?
*The information above is based on my experience with an SI Joint sprain after giving birth. This is not medical advice and I am not a medical practitioner. Always consult a professional before returning to running after having a baby or experiencing an injury.