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Running during the “fourth trimester”

New research is providing guidance for women who are trying to return to running after pregnancy

Getting back to running is important for many new mothers and postpartum women, but there is often very little guidance for how to do so safely. Most of the information that does exist is focused on the musculoskeletal factors that determine a woman’s readiness to return to running, but there is a lot more to it than that. Recently, a team of researchers came up with some guidelines for women in this situation, recommending a whole-systems approach to returning to running safely.

The fourth trimester

The fourth trimester, of course, isn’t truly a trimester, but describes those first few months after childbirth when a woman’s body is recovering from the effects of pregnancy and the birthing experience. For many women, getting back into a regular running routine is an important way to maintain her physical and mental well-being while adjusting to her new life taking care of a child.

The goal of this paper, published in The Journal of Women’s Health Physical Therapy, was to address “how to evaluate and manage postpartum return-to-running in a systematic order by discussing relevant whole-systems considerations beyond the musculoskeletal system.” The authors also wanted to highlight how different considerations interact with each other and how that will affect each woman differently.

The authors recommend physical therapists who are working with postpartum women should consider the following factors when evaluating an individual’s readiness to return to running:

  • physical deconditioning
  • changes to body mass
  • sleeping patterns
  • breastfeeding
  • relative energy deficiency in sport
  • postpartum fatigue and thyroid autoimmunity
  • fear of movement
  • psychological well-being
  • socioeconomic considerations

Each of these factors, the authors suggest, should be considered alongside a musculoskeletal evaluation and a graded exercise progression.

Postpartum running: an infographic

The authors created this handy infographic to summarize their guidelines for assessing a woman’s readiness to return to running. While it is meant to help physiotherapists and other healthcare professionals guide their patients, runners can use it to an extent to guide themselves. (Note MSK stands for musculoskeletal).

Photo Rita Deering PhD and Amanda Olson, DPT, PRPC

Returning to running safely

The information in this paper highlights that generalized guidelines are ineffective when helping a woman return to running postpartum. Every single woman is different, and pregnancy and childbirth will affect each woman in different ways and to varying intensities.

If you’re trying to return to running after pregnancy, the best thing you can do is to see a physiotherapist or other health professional who can assess your readiness to start running again and evaluate your progress as time goes on to reduce your risk for injuries or other complications.

Finally, it’s important to listen to your body and not rush yourself back to a regular running routine. It will take time for your body to bounce back, especially when those first few months can be a shock to your system. Remember to go easy on yourself. Running, especially during this busy and exciting time in your life, should reduce your stress, not add to it.