Returning to Running After Having a Baby: What the Guidelines Actually Say

"When can I run again?" is one of the most common questions new mums ask — and one of the most poorly answered. The advice ranges from "whenever you feel ready" to "wait until you've stopped breastfeeding", most of it offered with great confidence and no evidence.

In 2019, three UK physiotherapists — Tom Goom, Gráinne Donnelly and Emma Brockwell — published the first evidence-informed guidelines for returning to running postnatally. They have since become the international reference point for clinicians. Here's what they actually say, and why the details matter.

Running Is a High-Impact Activity — and That's the Point

Each running stride loads the body with roughly 1.6 to 2.5 times your bodyweight, repeated around 80 to 90 times per minute per leg. That load travels through tissues that have just spent nine months adapting to pregnancy and then been through birth — abdominal wall, pelvic floor, and the supporting structures of the pelvis.

This doesn't mean running is dangerous after birth. It means it's a genuine physical demand that the body needs to be rebuilt for — exactly like returning to sport after any other significant event. The mistake isn't running; it's sprinting the rebuild.

Why Not Just "Listen to Your Body"?

Because early postpartum, the signals are unreliable. Around one in three women experience urinary incontinence after birth, and pelvic organ prolapse symptoms often only appear once loading increases. Many women feel fine walking and lifting — then develop heaviness, leaking or pain weeks after returning to impact exercise, because the deficit was there all along but had never been tested against running-level load.

This is the same principle we apply to ACL rehab: how something feels is a poor predictor of what it can handle. The answer in both cases is the same — measure it.

The Criteria That Matter

The guidelines describe a battery of load and impact tests that should be manageable — without pain, heaviness or leaking — before progressive running begins. They include:

Before you run, you should be able to:

• Walk 30 minutes comfortably and stand on one leg for 10 seconds each side.
• Single-leg squat 10 repetitions each side with good control.
• Jog on the spot for 1 minute, and tolerate hopping and running-man movements on each leg.
• Strength-endurance basics: around 20 repetitions each of single-leg calf raises, single-leg bridges and single-leg sit-to-stands.
• Pelvic floor screening: assessment by a pelvic health physiotherapist, particularly if there is any leaking, heaviness, pressure or pain.

If any of those provoke symptoms, that's not a failure — it's information. It tells us exactly which capacity needs rebuilding before impact is reintroduced, and that work is very trainable.

What a Sensible Return Actually Looks Like

Once the criteria are met, the return itself is graded: walk-jog intervals first, building duration before speed, with symptoms reviewed along the way. Sleep deprivation, breastfeeding-related hormonal changes, and a relative energy deficit all affect tissue capacity too — so the plan has to fit real postpartum life, not an idealised training calendar.

The two extremes to avoid are the ones most commonly recommended: returning at six weeks because "you've been cleared" (the six-week check is a medical review, not a running assessment), and avoiding impact for a year "just in case" (deconditioning helps nobody, and exercise is protective for postnatal mental health).

What This Looks Like at House of Rehab

Our postpartum assessments follow this guideline framework: pelvic health screening, the strength and impact test battery, and a graded return-to-running plan with objective re-testing along the way. Same physio every visit, so the plan adapts as your recovery does.