For years, women were told they could return to exercise — including running — at six weeks postnatally. This advice was never based on evidence. It was a rough marker for when the uterus had involuted, not a meaningful assessment of whether the body was ready for high-impact activity.

In 2019, physiotherapists Goom, Donnelly and Brockwell published updated guidelines that changed the conversation. Their recommendation: most women should wait at least three months before returning to running, and even then, only if they can pass a series of readiness criteria.

Running is a high-impact activity. With every stride, ground reaction forces through the pelvic floor reach around 2 to 3 times your body weight. After pregnancy and birth — whether vaginal or caesarean — the pelvic floor, abdominal muscles and connective tissue need time and rehabilitation before they're ready for that load.

Returning too soon doesn't just risk short-term symptoms like leaking or pelvic heaviness. It can contribute to longer-term issues including prolapse and persistent pelvic floor dysfunction.

Before returning to running, you should be able to complete each of the following without leaking, heaviness, urgency or pain:

• Walk briskly for 30 minutes
• Single-leg balance for 10 seconds each side
• Single-leg squat x20 each side
• Single-leg calf raise x20 each side
• Jog on the spot for 1 minute
• Forward bounds x10
• Single-leg hops x10 each side

If any of these bring on symptoms, your body is telling you it needs more preparation first — and that's completely normal. A pelvic health physiotherapist can also assess your pelvic floor function directly as part of a full readiness check.

The three-month window isn't about doing nothing. It's about building the foundations:

• Pelvic floor rehabilitation — not just Kegels, but coordinated, functional pelvic floor work
• Core reconnection — learning to use your deep abdominal muscles effectively again
• Low-impact cardio — walking, swimming and cycling are all excellent in the early weeks
• Strength work — squats, lunges and hip strengthening prepare the body for the demands of running

If you're keen to get back to running and want to do it safely, a postnatal physiotherapy assessment can make a real difference. I'll assess your pelvic floor, core and movement patterns, and give you a clear, personalised plan for returning to the activities you love.

Book a return to exercise assessment at Physio On The Hill — home visits in the Surrey Hills and clinic appointments in Walton-on-Thames.