Return to Running Postnatal - guideline for medical, health and fitness professionals managing this population

Purpose

There are currently no national/international guidelines to provide a framework to support health professionals working with women who wish to return to running postnatal.

Musculoskeletal pain, urinary incontinence, abdominal separation (Blyholder, Chumanov, Carr & Heiderscheit, 2016) and pelvic organ prolapse are prevalent conditions amongst postnatal runners and often create barriers to exercise (Nygaard et al., 2005). Engagement in regular physical activity is a public health priority due to its established health benefits.


Aim: To create an evidence-based guideline that offers a framework to support health professionals in providing appropriate advice to women following delivery and returning to running.

 

Approach

The guideline was based around current best evidence which was reviewed and evaluated by the authors using the Royal College of Obstetrician's and Gynaecologist's classification. It underwent 3 months of peer review and revision.

Outcomes

The evidence base specific to this population is limited. The combined skillset of musculoskeletal alongside pelvic health physiotherapists should be utilised to carry out a variety of tests to achieve a comprehensive evaluation of the postnatal woman. An individualised plan can then be devised to guide a woman back to running from 12 weeks postnatal if all tests are passed and the woman is symptom free.

This guideline will assist health professionals to guide women safely and effectively back to running postnatal. It provides the starting point for the development of professionally-accredited, standardised, research-informed guidelines.

Implications

A more holistic, considered and evidence based approach will be adopted when guiding women back to running.


Guidance will provide a framework which will allow more effective rehabilitation and potentially a reduction in pelvic floor dysfunction and musculoskeletal conditions.


Rehabilitation pre running is encouraged and thus the potential for a reduction in pelvic floor dysfunction achieved.


Women will be better educated in their return to exercise.


Evidence based guidance for Fitness professionals and running coaches. Both will be more aware of Signs and symptoms which indicate a referral to appropriate health care professional and a clearer pathway of referral made apparent.

Funding acknowledgements

Nil, all work has been voluntary.

Additional notes

This work was presented at Physiotherapy UK 2019