RUNNING POST-PARTUM
COMMON RUNNING INJURIES
One commonly asked question by patients who have just delivered a baby is “When can I get back to running?” A good guideline is to perform low impact exercises for the first 3 months post-partum. Then, in the 3-6 month timeframe, a return to run program may begin.One important factor in return to run assessment is pelvic floor stability. The pelvic floor is a group of muscles and tissue in the lower part of the pelvis. Its function is to support the pelvic organs. After delivery, the pelvic floor is likely weak and injured, and the patient may need instruction on how to perform a proper pelvic floor contraction. It is important to properly facilitate the pelvic floor during running, as it is responsible for cushioning impact. Thus, return to run in the postnatal period will be determined on an individual basis depending on muscle strength and control. At Excellcare Physical Therapy, we look at several things to support our return to run recommendation. Some examples are: • Can you walk without any symptoms produced for 30 minutes? • Can you perform 10 single leg squats with good leg position? • Can you hop in place 10 times with good leg position? Another important factor is if there is a separation of the rectus abdominis, which can cause stability problems. Once the separation is rehabbed and functionally stable, the patient can safely return to running. One thing to be aware of is that running with a stroller leads to changes in trunk, pelvis, and hip movements, and can be considered 6-9 months post partum. A strengthening program for the hips is advised for moms who would like to take baby on their runs with them. Return to run in the post partum period should be carefully assessed. The take home is that the mom should be screened to ensure that the pelvic floor will adequately support the demands of running.
Let’s talk about how running injuries happen. A leading cause of injury to runners is training error. Large changes in running volume or speed can contribute to these injuries. A runner’s training program should be consistent, slowly building up intensity. Poor strength of legs, and lack of good coordination leads to improper form and may result in injury. Iliotibial Band Friction Syndrome Iliotibial Band Friction Syndrome is a condition seen in runners commonly, and a main cause of lateral knee pain. The main cause of ITBS is weak hip abductors, which causes abnormal hip and foot mechanics, and may lead to tightening of the iliotibial tract. Here at Excellcare Physical Therapy, we will focus on mobilizing the tight soft tissue, and properly facilitating the weak hip abductors. We will then begin a return to run program on a flat surface. Hamstring tendinopathy Another common running injury is Hamstring tendinopathy. The pain may be reported to be in the buttock or posterior thigh. Again, this injury can be a result of improper training and muscular imbalances. In order to take the strain off of the hamstring, treatment will focus on trunk and pelvic stabilization exercises. We also offer dry needling to the hamstring, which will break up adhesions in the muscle. There may also be changes recommended after a gait analysis, such as instruction to not over stride. Sacroiliac dysfunction Sacroiliac dysfunction may be reported by a patient as low back pain, but also may refer pain to gluteal region, groin, or thigh. Hip extensor and abductor weakness contributes to SI dysfunction, so treatment will focus on facilitating the weak muscles. The SI joint may be hypomobile, or “stiff”, so we can optimize mobility through muscle energy techniques. If you feel that you have an injury due to running, go to excellcare.net, or call 773.779.1111 for an evaluation.
Patient Success Spotlight
“Everyone is great and so sweet and helpful.”
“I recieved excellent care here the staff is great My hip pain is gone. I highly recomend this place. I have recieved treatments here several times. Everyone is great and so sweet and helpful.” -L.B.
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