Postpartum running plan: a step-by-step return to running

Here's the postpartum running plan the published guideline supports, minus the "bounce back" nonsense: low-impact work for the first 3 months, a readiness check, then a gradual return to running somewhere between 3 and 6 months after birth, at the earliest. Not 6 weeks. Not "when you feel ready". And not before your pelvic floor and abdominal wall are ready for the impact.

That timeline comes from "Returning to running postnatal", a 2019 guideline for medical, health and fitness professionals by physiotherapists Tom Goom, Gráinne Donnelly and Emma Brockwell. This post follows it closely. When you're ready for structure after that, you can get a plan built around your week, but the steps below come first.

The rule that matters most: check with your doctor, midwife or a pelvic health physiotherapist before you start running again. The guideline itself recommends that every woman, however she gave birth, gets a pelvic health assessment with a specialist physiotherapist. Nothing here is medical advice or a diagnosis.

What the postpartum running plan guideline says

The core recommendation, in the authors' words: "Return to running is not advisable prior to 3 months postnatal or beyond this if any symptoms of pelvic floor dysfunction are identified prior to, or after attempting, return to running" (Goom, Donnelly & Brockwell, 2019).

Two things worth knowing about that recommendation:

• ›It's expert opinion. The authors grade it as level 4 evidence, and they're upfront that research on returning to running after birth is limited. It's the best available framework, not settled science.
• ›It's a minimum, not a deadline. Three months is the earliest point. Symptoms, a caesarean birth, perineal scarring and other factors can push it later.

The reasoning: running is high impact, and the guideline cites ground reaction forces of 1.6 to 2.5 times body weight at a moderate running speed. The pelvic floor and abdominal wall need time to recover after birth before they can handle that repeatedly.

Running isn't the only thing to rebuild, either. The rest of the week matters in those first months, and a postpartum workout plan covers it. Lifting matters just as much for the months ahead, and if you were following a structured plan for women who lift before pregnancy, it comes back in stages too. The longer view of why strength matters across these decades is in strength training for women over 40 explained.

What official guidance says about the early weeks

The return-to-running guideline isn't the only source, and they agree on the direction.

• ›ACOG says exercise routines may be resumed gradually after pregnancy as soon as medically safe, depending on the mode of delivery and any medical or surgical complications, and that pelvic floor exercises can be started in the immediate postpartum period (ACOG, 2020).
• ›The NHS says that after a straightforward birth you can start gentle exercise such as walking, gentle stretches and pelvic floor exercises as soon as you feel up to it, and that it's usually a good idea to get advice at your 6-week postnatal check before starting high-impact exercise such as running. After a more complicated delivery or a caesarean, recovery takes longer, so talk to your midwife, health visitor or GP before anything strenuous (NHS).
• ›The WHO recommends regular physical activity throughout pregnancy and postpartum for women without contraindication, building toward at least 150 minutes of moderate-intensity activity a week (Bull et al., 2020).

The NHS describes the 6-week check as making sure you feel well and are recovering properly (NHS). Good moment to ask about exercise. Not, on its own, clearance to run.

Step 1: weeks 0–12, low impact

The guideline's Appendix 2 gives an example of exercise progression for the first 3 months. It's an example, and the authors say plans will vary depending on your birth experience and any issues.

Source: Appendix 2, Goom, Donnelly & Brockwell, 2019.

If you had a caesarean, the guideline notes that healing of the abdominal wall and uterine scar continues well beyond 6 weeks, which is one more reason the 3-month minimum isn't a target to beat.

Step 2: check you're ready

The guideline describes a load and impact assessment. The aim is to do all of the following without pain, heaviness, dragging or incontinence:

• ›Walking for 30 minutes
• ›Single-leg balance for 10 seconds
• ›Single-leg squat, 10 reps each side
• ›Jogging on the spot for 1 minute
• ›Forward bounds, 10 reps
• ›Hopping in place, 10 reps each leg
• ›Single-leg "running man" (opposite arm and hip flexion and extension, bent knee), 10 reps each side

It also suggests strength tests, aiming for 20 reps each of single-leg calf raises, single-leg bridges, single-leg sit-to-stands and side-lying leg raises (abduction). The authors note that weakness here shouldn't be a barrier to running, just a pointer to where strength work should go.

A pelvic health physiotherapist can run these properly, alongside the internal pelvic floor assessment the guideline recommends. The tests are a screen, not a pass mark you set for yourself on the living room floor.

Step 3: start running, small

At 3 months or more postnatal, with the screening passed, the guideline supports a graded return. Its suggestions:

• ›Start small. The authors suggest starting with around 1 to 2 minutes of running at an easy pace.
• ›Use walk breaks. A couch-to-5K style program can help, because it builds gradually with walk breaks. The guideline describes the NHS Couch to 5K as starting with 3 runs in week 1: a brisk 5-minute walk, then alternating 1 minute of running with 90 seconds of walking, for a total of 20 minutes.
• ›Easy pace. Slow enough to hold a conversation.
• ›Volume before intensity. Build running time or distance before adding speed.
• ›Around 10% a week. The authors' expert consensus (Goom, Donnelly & Brockwell, 2019) is that weekly running distance or time shouldn't rise by much more than around 10% a week, though they note that when you're starting from a few minutes, a 10% rule is impractically slow and a small absolute jump (1 minute to 2) is fine.
• ›Goals. Agree short-term and long-term goals, and for demanding performance goals, consider working with a running coach.

That's the plan. It's deliberately boring. Boring is how you're still running in a year.

Signs to back off or get help

The guideline says: "Heaviness, dragging, incontinence or moderate to severe pain may suggest excessive training distance or intensity." It describes mild musculoskeletal pain (0–3 out of 10) that settles quickly after a run, with no pain lasting into the next day, as often acceptable, while stressing that decisions should be individual.

Its guidance for patients lists signs that make a referral to a pelvic health physiotherapist especially important, before or after attempting a return to running, quoted from the guideline (Goom, Donnelly & Brockwell, 2019):

• ›"Heaviness/ dragging in the pelvic area (can be associated with prolapse)"
• ›"Leaking urine or inability to control bowel movements"
• ›"Pendular abdomen or noticeable gap along the midline of your abdominal wall"
• ›"Pelvic or lower back pain"
• ›"Ongoing or increased blood loss beyond 8 weeks postnatal that is not linked to your monthly cycle"

The guideline's foreword describes urinary incontinence, abdominal separation and prolapse as prevalent among postnatal runners, and calls them "common but not normal". Common enough that nobody should be embarrassed, not normal enough to ignore.

Other things the guideline asks you to consider

• ›Risk factors. It lists risk factors for problems returning to running, including being less than 3 months postnatal, breastfeeding, pre-existing pelvic floor or lumbopelvic dysfunction, hypermobility conditions, a caesarean or perineal scarring, obesity, relative energy deficiency in sport (RED-S), and psychological issues that might push someone into inappropriate running as a coping strategy. Having one doesn't rule you out; it means a more cautious start.
• ›Breastfeeding. ACOG says regular aerobic exercise while breastfeeding has been shown to improve cardiovascular fitness without affecting milk production, composition or infant growth, and suggests feeding or expressing before exercising to avoid discomfort (ACOG, 2020).
• ›Abdominal separation. The NHS says separation of the stomach muscles usually goes back to normal by 8 weeks after birth, and to contact your GP if the gap is still obvious then (NHS).
• ›Kit. The guideline recommends a properly fitted, supportive sports bra and checking your shoe size, which can change permanently with pregnancy.
• ›Running buggies. The authors recommend not running with a buggy until your baby is at least 6 to 9 months old, in line with manufacturers' guidance, using a buggy designed for running and starting with a two-handed technique.

Where this fits

If you ran through pregnancy, the earlier questions are covered under pregnant woman running, and how training changes each trimester covers the rest of that stretch. Further down the road, menopause exercise brings its own. The broader picture of exercise during pregnancy explained covers what came before this, and once your periods return, workout with menstruation explained is relevant again. Getting back under a barbell runs in parallel, and a guide to postpartum strength training is its own subject, as is conditioning in later decades, where there is more on hiit workouts for women over 50.

How exrsz handles this

exrsz builds a periodized plan from your goal, schedule, level and equipment, balances running and lifting in one plan, adapts each week to how you actually trained, and reshuffles missed sessions, which with a newborn is most of them. It doesn't assess your pelvic floor or give medical advice. Check with your doctor, midwife or a pelvic health physiotherapist first, then build from where they say you are.

FAQ

When can I start running after having a baby?

The 2019 return-to-running guideline says running is not advisable before 3 months postnatal, or later if you have any symptoms of pelvic floor dysfunction (Goom, Donnelly & Brockwell, 2019). It suggests returning between 3 and 6 months, at the earliest, after a pelvic health assessment.

What should a postpartum running plan look like?

The guideline suggests low-impact exercise for the first 3 months, then starting with around 1 to 2 minutes of easy running, using walk breaks such as a couch-to-5K program, and building volume before intensity (Goom, Donnelly & Brockwell, 2019).

Is leaking while running after birth normal?

It's common, but it's a sign to get help, not to push through. The return-to-running guideline lists leaking urine as a reason to see a pelvic health physiotherapist (Goom, Donnelly & Brockwell, 2019).

Does running affect breastfeeding?

ACOG says regular aerobic exercise while breastfeeding has been shown to improve fitness without affecting milk production, composition or infant growth, and suggests feeding or expressing before exercise (ACOG, 2020).

Is the 6-week check clearance to run?

Not on its own. The NHS suggests getting advice at your 6-week postnatal check before high-impact exercise like running (NHS), and the return-to-running guideline puts the earliest return at 3 months.