Muscoskeletal Pain in Postpartum Runners

Musculoskeletal pain is commonly experienced in postpartum runners. 

A recent study by Shefali examined postpartum runners and identified common characteristics of their musculoskeletal deficits.

 

This study analyzed strength, range of motion (ROM), alignment, flexibility, and risk factors associated with impairments of postpartum runners.

 

The results from the study associated with each category are listed below:

Muscle weakness: abdominals, hips, pelvic floor 

ROM: restricted hip extension, increased anterior pelvic tilt, overall hypermobility

Alignment: Trendelenburg, dynamic knee valgus, lumbar lordosis, over-pronation, thoracic kyphosis

Flexibility: abdominal wall laxity and tightness in hip flexors, lumbar extensors, IT Band, and hamstrings

Risk factors: muscular imbalance, decreased lumbopelvic control, too steep of an increase in training too soon, life stressors, pain during pregnancy, pelvic floor trauma

 

How does these findings affect runners?

Muscle weakness of the abdominals, hips and pelvic floor, in combination with the joint hypermobility, found in postpartum runners, can lead to altered alignment and lack of postural control. If this is not correctly counterbalanced with improved strength, then additional stress is added to areas of the body that cannot tolerate the load and translate into injury. 

As womens’ hips widen throughout the course of pregnancy, the angle between their femur and tibia is altered. This presents as knee valgus which applies additional stress to the medial side of the knee and when loaded during running the stress is amplified. This can lead to pain and biomechanical changes as they walk, run, and move throughout the day.

 

How can PT help women who experience pain with running after pregnancy?

PTs are experts in addressing strength, ROM and alignment deficits. They can find the driver of your pain and limitations, address it, and direct you in methods to address it in order to help you reach your goals and relieve your pain.

 

Here are some exercises to increase core, hip, and pelvic floor strength:

Core: TA marching

https://www.youtube.com/watch?v=KekFeccvZSo

Hip: Side plank series 

https://www.youtube.com/watch?v=Bx11hANgkg0

Pelvic floor: Bridge 

https://www.youtube.com/watch?v=aGJajj0zsTo

 

Reference: Christopher, S. M., Trepte, A., Snodgrass, S., & Cook, C. E. (2020, February). Common Musculoskeletal Impairments in Postpartum Runners with Pain: An International Delphi Study. In 2020 Combined Sections Meeting (CSM). APTA.

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