During both of my pregnancies I went to a pelvic floor PT starting around 30 weeks or so. I had a very different experience each time, the second being much better. I found it so helpful that I decided to go back again after having my baby and before I started running again. Pelvic floor PT for pregnant and postpartum runners can be really beneficial for a variety of reasons and can help set you up for success with your long-term running goals.
The Benefits of Pelvic Floor PT for Pregnant and Postpartum Runners
I know there are many challenges to being able to work one-on-one with a pelvic floor PT, such as cost, accessibility, and time. If it’s not an option you could also consider working with someone virtually or finding a program such as Expecting and Empowered to help you navigate this time. However, if you can find a good PFPT I highly recommend seeing someone in person! Even if you are not having any problems, it can help prevent issues and set you up for a successful delivery and return to running.
What is Pelvic Floor Physical Therapy?
Pelvic floor physical therapy (PFPT), is a conservative treatment for many pelvic floor disorders that may include muscle strengthening, relaxation, and coordination exercises by a trained physical therapist. It may also involve manual therapy, biofeedback or electrical stimulation, education, and a home exercise program. There is a great deal of evidence supporting PFPT as a minimally invasive option to treat pelvic floor dysfunction, including postpartum pelvic floor dysfunction and chronic pelvic pain.
How to find a PFPT for Runners
I found that it was challenging to find someone to work with who would help with my pregnancy but also help me as a runner who wanted to set myself up for long term success. Some ways to find a good PFPT include researching online, talking to other local runners, and calling places that offer pelvic floor PT to see if their therapists have experience working with runners. I came across my PT by searching in a Moms’ Facebook group in my area for recommendations.
What are the Benefits of Pelvic Floor PT for Pregnant Runners?
When I was pregnant I chose to go to pelvic floor PT mainly for prevention. I wanted to make sure I was staying strong through my pregnancy to set myself up to be able to run again successfully after delivery. I also hoped to continue to run throughout my pregnancy. During my second pregnancy I was hesitant to go because I didn’t find it super helpful the first time around. (Mostly because the PT gave me exercises I was already doing and I worked with an assistant throughout my sessions.)
When I was around 7 months pregnant the second time around I felt like I was having to pee all the time. I mentioned it to my OB and asked if PFPT could help. She said maybe, but that it was pretty much par for the course. I was also hoping to have a VBAC (vaginal birth after C-section) and thought maybe a PFPT could help me prepare for that. My experience with a new PFPT was much different. I worked one-on-one directly with my PT for the full sessions. We focused on my individual needs, like relaxing certain muscles, strengthening others, and helping me to prepare for a VBAC. My return to running plan helped me progress back to my full strength exercises.
Up to 34% of postpartum women report urinary incontinence, and while this was not an issue for me it may have been without PT. There are studies that show that PFPT can lower the risk for urinary incontinence in late pregnancy and postpartum. (So even if you’re not a runner, expecting women should consider PFPT for this reason).
How PFPT can Help Pregnant and Postpartum Runners
A PT can assess your individual situation and make recommendations to help you stay healthy or feel better during pregnancy, and can guide you in your return to running postpartum. This may include manual therapy and exercises. Many women have a weak or tight pelvic floor and need to learn how to control and manage it, especially leading into childbirth. You will likely also get exercises to ensure that other core muscles, such as the TVA (transverse abdominus) and glutes are working well.
A 2022 article in the International Journal of Sports Physical Therapy notes that “many women are anecdotally instructed to focus on repeated pelvic floor contractions in order to strengthen the pelvic floor muscles without being instructed on the need for relaxation of these muscles to encourage improved ease of delivery. Many athletes may suffer from the overactivity of their musculature both in pregnancy and postpartum, and symptoms can be made worse by performing repeated and regular muscle contractions at the pelvic floor when not indicated. The ability of a trained pelvic floor physical therapist to perform an internal muscle examination both during pregnancy and postpartum can ensure that the pelvic floor musculature is achieving appropriate range of motion and that contractions are being performed correctly.”
Returning to Running Postpartum
As you prepare for a return to running after giving birth a PFPT can guide you through the process. This may include exercises to do starting at just a few days postpartum, and then helping to assess if you are ready to run. My progression was closely aligned with the recommendations from the International Journal of Sports Physical Therapy, but it was tailored specifically to meet my individual needs. I had a healthy pregnancy without any complications during pregnancy or delivery, and was able to run up until 2 days before I delivered via VBAC. In the days following delivery I started walking and doing breathing exercises, and progressed very slowly from there. After starting up with my PT again at 8 weeks pp I was cleared to begin my return to running at 10 weeks pp.
When can Postpartum Women Return to Running?
In 2023 a consensus survey was used to gain international consensus from clinicians and exercise professionals on run-readiness postpartum. Professionals who work with postpartum runners participated in an online survey to answer open-ended questions about postpartum return-to-running topics. There was unanimous consensus that the timeline to return to running should be person specific. 55% recommended waiting until after 6 weeks and 20% recommended waiting until at least 12 weeks. 97% felt that any acute birth injuries should be completely healed before returning to running.
Final Notes about Pelvic Floor PT for Pregnant and Postpartum Runners
Pregnancy and the postpartum period can be a confusing time for runners. If you want to run during pregnancy and set yourself up for a successful return to running postpartum, a pelvic floor PT can guide you through the process. The research shows that the best approach to returning to running is individualized to address each runners’ specific needs based on their strengths, weaknesses, and any issues in pregnancy or delivery. Finding the right PFPT can help you transition from pregnancy, to postpartum, and back to running while adressing any setbacks along the way.
You may also like:
10 Important Steps to Starting Stroller Running for Postpartum Moms
How to Keep Breastfeeding Successfully While Running and Training for Races
My Top 10 Tips for Running During Pregnancy
Have you tried pelvic floor PT for pregnancy or postpartum running?
Sources:
Christopher SM, Donnelly G, Brockwell E, et al Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statementBritish Journal of Sports Medicine 2024;58:299-312.
Selman R, Early K, Battles B, Seidenburg M, Wendel E, Westerlund S. Maximizing Recovery in the Postpartum Period: A Timeline for Rehabilitation from Pregnancy through Return to Sport. Int J Sports Phys Ther. 2022 Oct 1;17(6):1170-1183. doi: 10.26603/001c.37863. PMID: 36237644; PMCID: PMC9528725.
Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019 Dec;31(6):485-493. doi: 10.1097/GCO.0000000000000584. PMID: 31609735.
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I feel that this so important for pregnant women. It should be affordable (or covered by insurance) so more women can have access. As far as I know it wasn’t available when I was having babies but I certainly would have tried it if it was.
I’ve seen this a bunch the last few years. It is nice to see that more PTs are trained in and giving help for pelvic floor rehab. I’m glad it helped you so much! This is also a common topic amongst our running group
This is such valuable information. I am so glad to see that people in the medical profession are helping women take back control of their bodies. These are very normal conditions, with actual solutions… I’m so glad you had this positive experience and were able to share it.