Making a Comeback

And now, as a continuation to yesterday's post: a personal look at the physiology of my postpartum return to running. As was mentioned by me and so well addressed by Rana, there are two key physical weaknesses after birth: abdominal separation and weakened pelvic floor. The first condition makes complete sense; although some women (myself included) don't really think about it until they become pregnant. The second is less apparent. 

Like the legendary parting of the Red Sea, a woman's abs separate to make room for her growing uterus. Instead of running down the mid line of her belly, the muscles separate into two halves on her right and left sides. In most cases after baby is born, the two will slowly meet back in middle, but even then they won't fully come together for a while. In fact, you can usually detect the soft space between your abs if you lie on your back, with your knees bent, lifting your head slightly - you may even be able to see it. After seven weeks, mine has naturally come back to where there's a little less than one finger's width in between. But to get that last little bit closed up will require core strengthening work.

Now as for the more obscure pelvic floor - which is not only less visible than, say, a six pack, but also less known - we have another set of issues. These muscle fibers deserve just as much attention as the core gets because while strong abs keep you upright and rocking a sexy midriff, a healthy pelvic floor maintains continence. No, seriously. It supports the bladder, intestines, and uterus that, when weakened from pregnancy, can leak at the slightest. A cough, a sneeze, shoot, even a hearty laugh, will leave you with an embarrassing flashback to potty-training days. If we can all put vanity aside for a moment, I think there would be a unanimous agreement that we'd rather avoid a situation than have abs that resemble "The Situation". 

This is where a little education goes a long way. My husband and I took Bradley Method birth classes, which encourage mother's to trust their body and focus on diet and exercise throughout pregnancy to ensure natural birth and speedy recovery. The classes schooled us on these pregnancy weaknesses and we learned to train those muscles with Kegels, pelvic rocking, butterfly, squats. All this knowledge particularly appealed to me because I've had a history with physical weaknesses. See, I've never had a strong core and there's a slight tilt to my pelvis, which has caused mechanical issues in my running even before I was pregnant.

Once the bun was is in the oven, my ligaments started to stretch and pull, further aggravating the misalignment already present in my hips/low back. It may not have been so bad if I hadn't run the Chicago marathon eight weeks pregnant. I had no clue at the time, by the way. I thought I was exhausted from 70+ miles a week of running and that aversion to my favorite thing in the whole wide world - coffee - was because my body was so in tune to the need for pre-race hydration, not because of minor morning sickness. Ah, naivete... No wonder I felt like garbage during the race. Anyway, 26.2 miles of pounding resulted in a very fatigued and very sore groin. But as I've mentioned before, pregnancy can teach you to listen better to your body, so I back off the running and took to more gentle activities (because I'm a self-proclaimed teacher's pet and not only did my Bradley homework, but went for the extra credit by swimming, walking, or doing yoga) All that work won't let you coast through postpartum recovery though and now that I have the "green light", all systems are go. 

Today I read this article about pregnancy and running which drove all points home. Below is one particularly relevant quote: 

"Pregnancy and labor stretch the muscles and connective tissues in the abdomen," which allows the slightly unmoored pelvis to tilt and sway. Unless a woman strengthens the affected muscles after pregnancy, the tissues remain stretched.

Relying on that gym standby, crunches, won’t do the trick, though, Dr. Heiderscheit says. They don’t activate the small muscles deep within the abdomen. Instead, he suggests pulling the belly up and in multiple times and also “imagining that you’re trying to cut off the flow of urine.”

Using those techniques, together with traditional abdominal exercises like squats, planks and bridges (instructions for these can be found on The Journal of Orthopaedic & Sports Physical Therapy’s Web site), can help stabilize the pelvic area.

So as you can see, my motivation comes less from aesthetics and more from mechanics. And since I already have a weak pelvis to begin with, you can bet that as I start building back into a running regimen, I'm going to make sure the rest of my body is strong first. Look out plank, I've got your number. Bridge... you're a bit more challenging and I'll probably have to use yoga blocks for support, but you better be scared too.