Running During Pregnancy

So my last blog was about running after pregnancy.  The questions that followed were more about running while pregnant. It seems that there are lots of women getting mixed messages about running while pregnant. Is it safe? The answer is, it depends.

Let me start with I am not an OB/Gyn specialist. I am a podiatrist who specializes in sports medicine. That being said, I am the mother of three girls; and ran a marathon 3 months pregnant with my daughter Caitlin (who is now almost 15). I ran during my first two pregnancies; but during my pregnancy with Sasha, my youngest, I had to stop due to complications. Age definitely was a factor, since I was approaching 40 at the time. Conclusion, talk with your doctor. I can only tell you about my experience and the experiences of many of my patients with running during pregnancy.

Alysia Montano, a former University of California star, ran the 800 meters at the US Track and Field Championships last summer, at the age of 28 and 34 weeks (8 months) pregnant. Her doctor cleared her to run and she ran a slower than her normal, at a steady even pace but finished with a respectable time. Her goal was just to compete.

I ran a marathon pregnant at the age of 31, and 14 weeks pregnant (3 months), but wore a heart rate monitor, and had a Sherpa on his bike checking on me along the course. His job was to make sure I didn’t get dehydrated or have any issues along the way. I finished in a respectable time; not my best, but not my worst!

So what are the recommendations about running while pregnant?

Running is actually good for the Mom and the baby, as long as you are not high risk AND it is part of your normal routine PRIOR to your pregnancy. It is not recommended to start a vigorous exercise program while pregnant.

During your first trimester, you should continue your normal routine; but be mindful of getting over heated. Make sure you stay hydrated and cool.

During your second trimester, time to talk with your doctor. Some women have to stop running because they have weakness in their cervix. This was why in my later pregnancy I had to stop. I was slowed down to a brisk walk. Kegal exercises are also important during the second trimester.

During your second trimester, it is also important to realize that you need to shorten your stride and watch your posture. Hunch back is not a good look; and it puts too much pressure on your knees and feet. This is also the time to change your shoes to at least a half size bigger. You may need wider as well. You may also need a more supportive shoe than what you normally wear. As you start to add bulk to your frame, your feet tend to swell and get a little longer, wider and a little flatter. (This does not change after you delivery – most women stay at least a half size larger in shoe size after pregnancy)

The third trimester is usually where many women stop running just because they are uncomfortable. There are bands that can help with the bulk of your belly; but you want to avoid anything that hampers fetal blood flow. Brisk walking and slow jogging can really be helpful to keep the swelling down in your legs and help in delivery. No studies have shown running is harmful to your baby.

After delivery, it is important to get back to your routine. This helps with your recovery and also can help avoid post-partum depression. See my last blogs for tips on getting back out there.

Bottom line: Pregnancy is not the time to start a new running program, but if you are a veteran runner and just happen to be pregnant; talk to your doctor about continuing to run. Other than woman with cervical weakness, most runners can continue as long as they are mindful of increasing heart rate, over heating and dehydration.

Update on the goal to run 2,015 miles in 2015: Art and I continue to churn out the miles. We are approaching 700 miles this weekend and will be in Chattanooga, Tennessee for the Ironman 70.3 Chattanooga this weekend. Full race report to follow next week.

Run Happy! Run Healthy!

Running After Pregnancy

So you are holding your new little bundle of joy, and after the first few weeks of sleepless nights and exhaustion are over, you start to think, “When can I get back to running? I feel FAT!”

You are not alone! After having my first daughter, Alex, I started a marathon training program to lose the weight and find myself again. Running makes Moms more sane (better than Prozac, ha ha). Seriously, a mother who feels better has happier children (ask mine - they send me running when I’m cranky).

So when is it OK to run again? And how should you approach it?

Most physicians will tell you that you need to wait at least 6 weeks before trying to resume exercise. Your body needs to heal. It is important to discuss this with your doctor and realize that with each subsequent pregnancy it may take longer. I couldn’t run effectively for 4 months after having my youngest daughter, Sasha, at the age of 40. Older Moms need more healing time. Talk to your doctor and listen to your body. If it hurts, wait a little longer.

It is fundamentally important to understand that new Moms experience several changes in their biomechanics due to post-partum gait changes. The greatest of these changes is a forward-tilting pelvis. This forward tilt of a typically stable area of the body can cause hip, lower back and leg pain due to compensation. Due to the strain of pregnancy and labor on the abdominal muscles, it is important to focus on strengthening them on your way to getting back to running.

Multiple exercises that strengthen your abdominals can help: Squats, bridges, and planks are great examples. Couple this with shortening your stride and increasing your cadence to decrease impact. Some new Moms need pelvic floor exercises and even physical therapy to get back to normal; don’t hesitate to ask your doctor for a referral if you feel like you may need additional help getting those abs back to the new normal!

Important safety tips prior to walking outside to run!

1. If you are breast-feeding, feed your baby or pump yourself dry.

2. Buy a slap-them-to-your-chest running bra (4+ barbell strength at Titlenine.com).

3. Buy a new pair of running shoes and realize your shoe size usually increases at least half a size with each pregnancy. You may wear a larger size or even a wider size.

4.  Go pee, even if you don’t feel like you need to (New Moms tend to be leaky while running L)

5. If you are planning to run with a baby jogger, wait a few weeks because it takes more abdominal strength to push a jogger.

You have to walk before you run. Start with walking briskly for 10 minutes. Then run slowly for 5 minutes; walk for a minute. Repeat. Then walk a ten minute warm down. You’ve been out of the house for 32 minutes. Time to go home.

The next day, walk for 10 minutes to warm up; run 5 min: walk 1 min; repeat twice, then walk 10 minutes to warm down. You should notice a pattern. As long as you are feeling fine, increase by one interval each day. Do not run more than 6 times a week and drink lots and lots of water!

Running after pregnancy can be your only ME time! It’s important to have that time for your sanity. Let’s get back at it, but slowly and listen to your body! 

Returning to Running After Injury or Surgery

Returning to running after an injury or surgery is often frustrating to the runner, and also to their doctor! Most veteran runners start back too much, too soon and too fast. The opposite can also be true; newbie runners are often afraid to re-injure themselves so often are extremely cautious making themselves borderline paranoid in their return to sport. Which is better? Neither! Somewhere in between is the most prudent, and less frustrating way to return to activity; especially after surgery!

God’s basic rule of bone healing is that the average person takes at least 8 weeks to heal a fracture or a surgically cut bone. It is important to understand that it’s his rule, not mine - made up to torture my patients! It is also important to understand that age and extent of injury can make this 8 weeks longer! Yes, I said that bad word – age! Listen to your doctor and don’t try to run too soon, or you may cause yourself a set back laden with swelling and more pain!

So you’ve been cleared to return to running! Yea!!! But what does that really mean? Well, it depends. Great answer, I know J. The rate at which you can return to running is limited by your soft tissues ability to adapt to increasing stress. Gradual increase in running stress is paramount to this adaptation.

Here is a good basic plan to return to running after an injury or surgery:

Walk 5-7 minutes to warm up, run 5 minutes, walk one minute, run 5 minutes, and then walk 5-7 minutes to cool down. If you have no pain during this walking and running (Important tip! IF NO PAIN); then progress by one more interval each day. Day two would be walking 5-7 minutes, run 5 minutes, walk one minute, run 5 minutes, walk one minute, run 5 minutes, and finish with walk 5-7 minutes. You get the idea.

The next question is always, “When can I get rid of the walk breaks?” If you are under the age of 50 and a veteran runner, the walk breaks can be eliminated after you can walk:run with no pain for 45 minutes or so. In my opinion (and understand this is just my opinion), most newbie runners and those over the age of 50 should continue walk:run either forever (Yes, I love the Galloway method) or until they can comfortably walk:run for an hour.

Another good tip is also to start with a pace that is comfortable, even easy; then after you can walk:run for 45 min to an hour with no pain - then you can start increasing your pace. Long, slow distance is good for your adapting muscles, tendons and bones.

I know this seems very slow to many of my readers, but return from injury can be fraught with setbacks. This is a plan to continuously move forward in your fitness and avoid more time off! You will progress quickly through this algorithm if your body is healthy and sound - ready for the running challenge! Listen to your body and progress at your own pace!

Update on the Running 2,015 miles in 2015 Challenge: Art and I are still going strong! We reached 600 miles just before the end of April, and although we were slightly less than our target of 671; we are planning on doing quite a bit of racing this spring and summer, so I think we still can easily reach our goal! Next race is Ironman 70.3 Chattanooga next weekend! Full race report to follow!

Run Happy! Run Strong!