What happens during a Return to Running screen?
To do a full assessment, pelvic floor examination is strongly recommended. I complete a full assessment including bladder and bowel function, sexual dysfunction, previous injuries, pregnancy and birth history followed by a pelvic floor examination (if consent is given) to check for signs of dysfunction, weak/over active muscles, tummy muscle separation and teach you all about your core and pelvic floor. If there are any issues, we will make a plan to tackle those first and get them under control. This does not mean you have to stop exercising – we might have to just modify what you are doing/how you are doing it.
If there are no issues, we can then progress to the strength and impact screen. The body has to be strong enough to cope with impact so checking muscle strength is the next step. If there are any weaknesses this will be your homework for a few weeks to build strength.
Next step is the impact screen. This is designed to check how your body and especially pelvic floor will respond to an increase in load and pressure going down through it. It will highlight if there are any loading issues for example pain, leaking, pressure/heaviness – do you need to relax the pelvic floor more? Change your landing technique? Strengthen your pelvic floor more? If there are any issues then we work on these too.
Emily (from EmPowerMe Fitness) and I are working on a 6-8 week Return to running course….stay tuned for more info!!
Once you are symptom free, strong enough and your body has shown you are ready for impact….lets go! You can gradually ease back into whatever you would like to train for. For example:
Running – perhaps start a couch to 5km 8 week plan
Netball – preseason like drills to ease back into impact
Cross fit – low reps of jumping and landing (body weight only) and increase reps, speed, height, distance as you are able
Often return to impact will show up problems that women didn’t realise they had. I will often see them after 6-12 months when they have tried running but have developed issues. If this happens don’t panic – we just need to figure out what is going on and get a plan in place.
If you are ready to get back into running and impact exercise…you know who to call!
Risk factors for potential issues returning to running
Less than 3 months post natal
Pre-existing hypermobility conditions
Breastfeeding
Pre-existing pelvic floor dysfunction or lumbopelvic dysfunction
Psychological issues which may predispose a post-natal mother to inappropriate intensity and/or duration of running as a coping strategy
Obesity
Caesarian section or perineal scarring
RED-S (Relative Energy Deficiency in Sport)
Signs and symptoms of pelvic floor and/or abdominal wall dysfunction
Urinary and/or faecal incontinence
Urinary and/or faecal urgency that is difficult to defer
Heaviness/pressure/bulge/dragging in the pelvic area
Pain with intercourse
Obstructive defecation (e.g. constipation, staining to empty bowels)
Pendular abdomen, separated abdominal muscles and/or decreased abdominal strength and function
Lumbar/pelvic pain
Reference: Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. Tom Goom, Gráinne Donnelly and Emma Brockwell Published – March 2019