Muscle Imbalance in Pregnancy and Postpartum Return to Run
In part 1, we addressed the 2 early foundational pieces of pre and postnatal health: breathing & posture. Assuming we have good control and awareness over those, we can move on to the stability, strength and resilience needed for healthy running while pregnant and postnatal return to run
Running demands strength from the body before pregnancy. You need strong hips, feet, calves and a solid core. You need to be able to have strength and control in single leg movement and the capacity to efficiently absorb impact and control your body while doing so. This is hard for many runners pre-pregnancy but changes in your body will make it even more challenging in the pre and postnatal phase.
Pregnancy & Muscular Changes
The psoas inserts on the lumbar spine and can become tight if unstable
Changes during pregnancy will affect both the hardware and software of your body needed to support healthy activity. Here's how:
S T A B I L I T Y & C O N T R O L
The psoas inserts on the lumbar spine and can become tight if unstable
Female runners already tend to be more hypermobile and require more strength and stability. Relaxin hormone will surge in pregnancy to relax soft tissue and prepare for birth. It can also means increased challenge to stabilize your lumbopelvic spine and hips which can be a source of pain especially around the SI joint and pubic symphysis. Muscles being loaded in different and more demanding ways can affect how they are recruited. This can lead to overactivation of muscles like the hip flexors and adductors in an effort to stabilize the pelvis if deeper stabilizers aren't firing correctly. Over-tightening (or hypertonicity of the pelvic floor) can also occur which can lead to pain, leaking and other maternal diagnoses. Inhibition of muscles like the glutes can lead to injury or delay proper healing especially as you look to return to running and training.
S T R E N G T H
No matter how strong and well-trained you are before and during pregnancy, you will deal with weakness in the postpartum period. You've just spent 9 months having your abdominal wall and musculature stretched out to accommodate your growing baby. Then you've either sustained trauma to your pelvic floor with a vaginal delivery or further weakening of your abdominals by cutting into them for a C-section. You won't be the first one to escape what it is inevitable, but we can work on building strength and resilience during and after pregnancy to try and minimize it.
I M B A L A N C E
Your back, chest and neck will get tight with carrying an breastfeeding. You are likely to be dealing with weakness and/or tightness of your pelvic floor after birth regardless of type of delivery. 9 months of changes magnify pre-existing weaknesses and can create responsive tightening all around your hip and pelvis. Side to side asymmetries are common and so is limited rib mobility and back expansion which further affect breathing and pressure management. All of this, including aforementioned inhibition and overactivation of some certain muscles, demand a deeper assessment of the individual postpartum woman to work on addressing smaller asymmetries before loading with strength and running.
How We Fix It & Get You Back to Running
Software First
It's important that we establish the software or the stability and control first before we start loading it with heavier weight or higher intensity activity. We will begin establishing this awareness and control in tandem with our work on posture and breathing and it will carry through into more challenging tasks. Addressing the software will include getting you back in touch with your body and your ability to control it as we address and lingering muscle imbalances.
What we'll prioritize :
- Reducing hypertonicity of the pelvic floor if it is tight
- Working on being able to feel your pelvic floor engage, especially at the right times including with exertion and timing it with breathing strategies
- Reducing any bearing down or overa-ctivation of global muscles trying to work too hard for simple tasks
- Recognizing your individual tendencies for postural breakdown with increasingly difficult tasks and how the relate to any lingering diagnoses
- Regain good lumbopelvic control in simple positions before advancing and loading
- Add strength and stability around muscles being overused such as the hip flexor and adductors
Add the Hardware
At The Run Rx we believe in getting strong and building the hardware and resilience needed to be an active mom. This goes beyond simple bodyweight exercises that don't challenge you enough to really push your body to add strength on top of the control we've worked on.
What we'll prioritize :
- Safe progressions back into functional movement patterns like the squat, hip hinge, single leg strengthening and upper body strength
- Working on properly loading and strengthening hips and the multiple layers of abdominal muscles without bearing down, compensating or worsening maternal diagnoses like diastasis, prolapse, leaking or pain.
- Loading the fascia appropriately to promote healing of the soft tissue and prevent complications with progressing demand
- Coordinating breathing and avoidance of Valsalva with heavier exercise
Make it Specific to the Runner
Let's be honest, if you wanted to just become a couch potato after birth, this would be a lot easier. But if you're hoping to continue being active as a mom, we have to make it specific and customized to the demands of a runner and your personal goals
What we'll prioritize :
- The whole kinetic chain - we need to address the whole runner and not just an isolated area. This is true of any running injury but especially true in the postpartum female where diagnoses are often related to dysfunction of the relationships between your entire system. This means we will address foot and upper body strength and mobility as indicated to make sure you are ready from head to toe.
- Single leg - running occurs one leg at a time so it's vital we strengthen that way! Check out our Return to Run Ebook for our checklist to determine if you're ready to run.
- Plyometrics - the impact of running adds more demand to the body and potentially vulnerable areas related to your pregnancy. We will incorporate progressive plyometrics to mimic the demands of running, train you to breath correctly with impact and improve your ability to efficiently shock absorb and protect your body.
- Safe progression - we will ensure you have a safe return to run plan in place to make sure you get your mileage back safely and as quickly as is safe!
What's the takeway? You are super strong and despite all your body has gone through, you can absolutely get back to being active by taking the right steps to take care of your body. There is no one size fits all steps to getting back to running. Getting a proper assessment by a physical therapist and running specialist certified in pre and postnatal care assures you are working with someone who gets you as both a runner and a pregnant or postpartum female.
Are you seeking to return to run after having your baby? Or looking to take the preventative steps while pregnant to reduce your risk postpartum? Whether you're expecting, newly postpartum or years postpartum - our For the Moms options have the programs for you!
Check out our free Ebooks for healthy pre and postnatal running or schedule a discovery call today!
