Return to Running After Pregnancy.
Running after having a baby — getting it right
Returning to running after pregnancy is one of the most common questions women ask their physiotherapist — and one of the most consistently mismanaged areas of postnatal recovery. The standard advice of "wait six weeks and get clearance from your GP" does not address whether your body is actually ready to run. The six-week check assesses wound healing and general recovery — it does not assess pelvic floor function, abdominal wall recovery or the specific physical capacity required for running.
Running is a high-impact activity that places significant repeated loading on the pelvic floor and abdominal wall with every stride. Returning to running before these structures have recovered sufficient strength and coordination is one of the most consistent causes of long-term pelvic floor dysfunction, prolapse symptoms, diastasis recti persistence and chronic pelvic pain — problems that are significantly harder to manage once established than they are to prevent with appropriate graduated return.
At Articulate Physiotherapy in Tarragindi, return to running assessment and programming for postnatal women is a specific clinical interest of Mauricio Bara — Principal Physiotherapist, APA Sports Physiotherapist and endurance runner who has completed the Sydney Marathon and Noosa Half Marathon. This combination of clinical expertise and personal running experience gives him a specific understanding of both the physiological demands of running and the postnatal recovery process that is unusual in a single clinician.
When is it safe to return to running?
The evidence-based framework for postnatal return to running — based on the 2019 systematic review by Groom, Donnelly and Brockwell that has become the standard of care in physiotherapy — recommends waiting until at least 12 weeks postpartum before returning to running. This recommendation applies to uncomplicated vaginal births. Following caesarean section, additional time is typically required to allow adequate healing of the abdominal wall layers before impact loading is appropriate.
The 12-week timeframe is a minimum, not a clearance. Meeting the time point does not mean you are ready to run — it means you may be ready, subject to passing specific functional criteria. The criteria that indicate readiness for running include:
What is a return to running assessment?
A postnatal return to running assessment at Articulate is a comprehensive clinical assessment that evaluates your readiness for running across the specific physical domains that running demands.
The assessment includes a detailed postnatal history — birth type, birth complications, current activity levels, symptoms and your running goals — alongside clinical assessment of pelvic floor and abdominal wall function, diastasis recti assessment using real time ultrasound, lower limb strength testing using our AxIT objective measurement system, single-leg functional testing, and running gait assessment where indicated.
Real time ultrasound is a particularly valuable tool in this assessment — directly visualising transversus abdominis activation and monitoring the functional response of the abdominal wall to loading in a way that clinical palpation alone cannot achieve. It provides objective information about functional abdominal recovery that guides the return to running timeline precisely.
The assessment concludes with a clear, specific recommendation — either clearance to begin a graduated return to running program, or a targeted rehabilitation program to address the specific deficits identified before return to running begins.
The graduated return to running program
A graduated return to running program builds running exposure progressively — beginning with walk-run intervals and advancing systematically toward continuous running — while monitoring for symptoms at each stage. The rate of progression is determined by the individual's functional capacity and symptom response, not by a fixed time schedule.
The program addresses not just running volume and intensity but the specific strength, flexibility and movement pattern factors that influence running biomechanics and pelvic floor loading during running. Hip abductor and gluteal strengthening, running cadence optimisation, trunk control during running and breathing mechanics are all components of a comprehensive return to running program.
For women who develop symptoms during the return to running program — leaking, heaviness or pelvic pain — the program is modified and the underlying contributors addressed before progression continues. Symptoms are information, not a reason to stop entirely.
What about caesarean section?
Return to running after caesarean section requires specific consideration of the abdominal wall recovery alongside the pelvic floor. The caesarean scar involves cutting through multiple layers of abdominal tissue — including the uterus, peritoneum, fascial layers and muscle — and the deeper layers take significantly longer to recover full tensile strength than the skin closure suggests.
Scar mobilisation from six weeks — once the wound has fully closed — addresses the fascial adhesions that can restrict abdominal wall mobility and affect running mechanics. Specific abdominal wall retraining addresses the neuromuscular recovery of the deep stabilisers that the surgery disrupts. The return to running timeline after caesarean section is typically longer than after vaginal birth — a minimum of 12 weeks but often 16 weeks or more depending on the nature of the surgical recovery.
What about breastfeeding?
Relaxin — the hormone that increases joint and ligament laxity during pregnancy — remains elevated during breastfeeding. This does not prevent running while breastfeeding, but it is a reason to be attentive to joint symptoms and to ensure the progressive loading of the return to running program does not outpace ligamentous recovery. A supportive sports bra is important both for comfort and for reducing the breast tissue loading that affects running comfort during breastfeeding.
Common symptoms that indicate the pelvic floor is not ready for running
Leaking urine during running or in the hours following — even small amounts — is not normal and not something to push through. Pelvic heaviness, pressure or a bulging sensation during or after running suggests pelvic organ prolapse and requires assessment before running continues. Pelvic pain or pelvic girdle pain during or after running requires assessment and targeted management before the running load is increased. Low back pain that develops or worsens with running warrants assessment of lumbopelvic stability and running mechanics.
Any of these symptoms during the return to running process is a prompt to reassess — not necessarily to stop running entirely, but to modify the program and address the underlying contributors.
How our postnatal Pilates and physiotherapy services support return to running
Building the pelvic floor, deep abdominal and gluteal strength needed for safe return to running is exactly what our Postnatal Mums and Bubs 8-week course and clinical exercise classes address. Many women use these classes in the 6 to 12 week period to build the strength foundation before commencing their return to running program — it is the most effective way to arrive at 12 weeks genuinely ready to run rather than simply at the time point.
Postnatal physiotherapy provides the clinical assessment of pelvic floor and abdominal wall recovery that underpins the return to running decision. Real time ultrasound is used routinely to assess deep stabiliser function. For women who have sustained a significant birth injury or who have symptoms of prolapse or pelvic floor dysfunction, referral to a specialist pelvic floor physiotherapist for internal assessment may be appropriate alongside our management.
Our physiotherapists Mauricio Bara, Bethany Kippen and Emma Cameron all have experience in postnatal physiotherapy and return to exercise management and are members of the Australian Physiotherapy Association.
To book a return to running assessment or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Returning to running after pregnancy is one of the most common questions women ask their physiotherapist — and one of the most consistently mismanaged areas of postnatal recovery. The standard advice of "wait six weeks and get clearance from your GP" does not address whether your body is actually ready to run. The six-week check assesses wound healing and general recovery — it does not assess pelvic floor function, abdominal wall recovery or the specific physical capacity required for running.
Running is a high-impact activity that places significant repeated loading on the pelvic floor and abdominal wall with every stride. Returning to running before these structures have recovered sufficient strength and coordination is one of the most consistent causes of long-term pelvic floor dysfunction, prolapse symptoms, diastasis recti persistence and chronic pelvic pain — problems that are significantly harder to manage once established than they are to prevent with appropriate graduated return.
At Articulate Physiotherapy in Tarragindi, return to running assessment and programming for postnatal women is a specific clinical interest of Mauricio Bara — Principal Physiotherapist, APA Sports Physiotherapist and endurance runner who has completed the Sydney Marathon and Noosa Half Marathon. This combination of clinical expertise and personal running experience gives him a specific understanding of both the physiological demands of running and the postnatal recovery process that is unusual in a single clinician.
When is it safe to return to running?
The evidence-based framework for postnatal return to running — based on the 2019 systematic review by Groom, Donnelly and Brockwell that has become the standard of care in physiotherapy — recommends waiting until at least 12 weeks postpartum before returning to running. This recommendation applies to uncomplicated vaginal births. Following caesarean section, additional time is typically required to allow adequate healing of the abdominal wall layers before impact loading is appropriate.
The 12-week timeframe is a minimum, not a clearance. Meeting the time point does not mean you are ready to run — it means you may be ready, subject to passing specific functional criteria. The criteria that indicate readiness for running include:
- Being able to walk briskly for 30 minutes without symptoms.
- Being able to perform 20 single-leg calf raises consecutively without symptoms.
- Demonstrating adequate single-leg balance and control.
- Performing a single-leg squat with good pelvic and trunk control.
- No symptoms of pelvic floor dysfunction — leaking, heaviness, pressure or pelvic pain — during or after low-impact activity.
What is a return to running assessment?
A postnatal return to running assessment at Articulate is a comprehensive clinical assessment that evaluates your readiness for running across the specific physical domains that running demands.
The assessment includes a detailed postnatal history — birth type, birth complications, current activity levels, symptoms and your running goals — alongside clinical assessment of pelvic floor and abdominal wall function, diastasis recti assessment using real time ultrasound, lower limb strength testing using our AxIT objective measurement system, single-leg functional testing, and running gait assessment where indicated.
Real time ultrasound is a particularly valuable tool in this assessment — directly visualising transversus abdominis activation and monitoring the functional response of the abdominal wall to loading in a way that clinical palpation alone cannot achieve. It provides objective information about functional abdominal recovery that guides the return to running timeline precisely.
The assessment concludes with a clear, specific recommendation — either clearance to begin a graduated return to running program, or a targeted rehabilitation program to address the specific deficits identified before return to running begins.
The graduated return to running program
A graduated return to running program builds running exposure progressively — beginning with walk-run intervals and advancing systematically toward continuous running — while monitoring for symptoms at each stage. The rate of progression is determined by the individual's functional capacity and symptom response, not by a fixed time schedule.
The program addresses not just running volume and intensity but the specific strength, flexibility and movement pattern factors that influence running biomechanics and pelvic floor loading during running. Hip abductor and gluteal strengthening, running cadence optimisation, trunk control during running and breathing mechanics are all components of a comprehensive return to running program.
For women who develop symptoms during the return to running program — leaking, heaviness or pelvic pain — the program is modified and the underlying contributors addressed before progression continues. Symptoms are information, not a reason to stop entirely.
What about caesarean section?
Return to running after caesarean section requires specific consideration of the abdominal wall recovery alongside the pelvic floor. The caesarean scar involves cutting through multiple layers of abdominal tissue — including the uterus, peritoneum, fascial layers and muscle — and the deeper layers take significantly longer to recover full tensile strength than the skin closure suggests.
Scar mobilisation from six weeks — once the wound has fully closed — addresses the fascial adhesions that can restrict abdominal wall mobility and affect running mechanics. Specific abdominal wall retraining addresses the neuromuscular recovery of the deep stabilisers that the surgery disrupts. The return to running timeline after caesarean section is typically longer than after vaginal birth — a minimum of 12 weeks but often 16 weeks or more depending on the nature of the surgical recovery.
What about breastfeeding?
Relaxin — the hormone that increases joint and ligament laxity during pregnancy — remains elevated during breastfeeding. This does not prevent running while breastfeeding, but it is a reason to be attentive to joint symptoms and to ensure the progressive loading of the return to running program does not outpace ligamentous recovery. A supportive sports bra is important both for comfort and for reducing the breast tissue loading that affects running comfort during breastfeeding.
Common symptoms that indicate the pelvic floor is not ready for running
Leaking urine during running or in the hours following — even small amounts — is not normal and not something to push through. Pelvic heaviness, pressure or a bulging sensation during or after running suggests pelvic organ prolapse and requires assessment before running continues. Pelvic pain or pelvic girdle pain during or after running requires assessment and targeted management before the running load is increased. Low back pain that develops or worsens with running warrants assessment of lumbopelvic stability and running mechanics.
Any of these symptoms during the return to running process is a prompt to reassess — not necessarily to stop running entirely, but to modify the program and address the underlying contributors.
How our postnatal Pilates and physiotherapy services support return to running
Building the pelvic floor, deep abdominal and gluteal strength needed for safe return to running is exactly what our Postnatal Mums and Bubs 8-week course and clinical exercise classes address. Many women use these classes in the 6 to 12 week period to build the strength foundation before commencing their return to running program — it is the most effective way to arrive at 12 weeks genuinely ready to run rather than simply at the time point.
Postnatal physiotherapy provides the clinical assessment of pelvic floor and abdominal wall recovery that underpins the return to running decision. Real time ultrasound is used routinely to assess deep stabiliser function. For women who have sustained a significant birth injury or who have symptoms of prolapse or pelvic floor dysfunction, referral to a specialist pelvic floor physiotherapist for internal assessment may be appropriate alongside our management.
Our physiotherapists Mauricio Bara, Bethany Kippen and Emma Cameron all have experience in postnatal physiotherapy and return to exercise management and are members of the Australian Physiotherapy Association.
To book a return to running assessment or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Who to book with:
If you are unsure about which appointment type is right for you, please don't hesitate to get in touch with our friendly reception staff by calling 07 3706 3407 or emailing [email protected].