Running rebound: New research sheds light on how pregnancy can impact women runners

A team that included Elon faculty members Shefali Christopher and Srikant Vallabhajosula examined differences between postpartum women runners and women runners who had not given birth.

New research from a team including Assistant Professor Shefali Christopher and Associate Professor Srikant Vallabhajosula from the Elon University Department of Physical Therapy Education is shedding new light on how pregnancy can affect women runners and how those changes could increase the likelihood of injury.

Assistant Professor of Physical Therapy Education Shefali Christopher

Recently published in the Journal of Women’s Health Physical Therapy, the research conducted by Christopher and Vallabhajosula with colleagues from the University of Newcastle in Australia and the University of Oxford in England gathered extensive data about how postpartum women run compared to women who have not given birth. The hope is that a fuller understanding of how pregnancy and childbirth impact women runners can help inform new guidelines as they return to running.

The Elon University News Bureau recently talked with Christopher about the team’s research and what it could mean for women runners.

Why is it important to understand how changes during pregnancy can impact postpartum running?

Women are running after childbirth and up to 80 percent are reporting pain. There has been very little published on the topic and therefore women can find it intimidating or overwhelming to return to sport or running after childbirth. During pregnancy, women experience changes to the physiological system (hormones and cardiovascular function) and musculoskeletal system (Walking, change in balance, changes to abdominal muscles etc.).

The act of childbirth itself can be akin to any other major injury or surgery. While these bodily changes are well-documented, there’s little guidance for women about how it could impact their return to running and what they can do to reduce the chance of injury.

What pregnancy-related body changes can women see during pregnancy that might impact their running?

During the postpartum period, the body is returning to its pre-pregnancy state. Recovery from postural changes occurring during pregnancy (such as sway back and the pelvis tilting forward), walking-related changes (such as widening of step width, decreased single leg support time, and increase hip and knee movements and physiological changes (cardiovascular, thermoregulatory, etc.) are taking place. The body is also recovering from injuries or surgeries that may have occurred during delivery. Recovery from childbirth can be an important factor depending on delivery

Our research focused on running biomechanics (3D motion and forces on landing and take off ), muscle strength, flexibility and range of motion to see what differences were present in women after childbirth compared to women who had not delivered a child.

What stood out to you and your fellow researchers about how postpartum runners differ from women runners who have not given birth?

Through our research, we gathered 3D biomechanical data from runners on both a treadmill as well as over the ground. With more 30 markers on their body, we were able to gather plenty of data about their mechanics and how hard their feet were hitting the ground. Additionally, we measured their strength and flexibility, with a particular eye on their hamstrings and hip strength.

In our small pilot study, We found that the postpartum runners in our study landed with more force and had weakness in their hips, as well as decreased hamstring flexibility compared to those runners who had not given birth.

Hip strength could be affected due to the pelvic girdle changing and widening, and also women may not be exercising at the level they were before. There could be a number of pregnancy-related reasons for that weakness. While some might have expected hamstrings in postpartum runners to be looser, we actually found that they were tighter, perhaps because the runners were trying to stabilize themselves. We’re concerned about flexibility and motion — do they have a lot of extraneous motions due to the presence of birth hormones? That’s where the 3D biomechanical analysis is so helpful.

How can your findings impact the guidance postpartum runners receive before resuming running after giving birth?

Before I began teaching at Elon, I was a clinician, and I developed a niche practice treating runners. I saw a lot of postpartum women come in with pain and wanted to know more about what’s happening and they are having these injuries.

Our goal is to prevent these women from being sidelined by injuries at some point as they resume running after giving birth. Postpartum runners are often forgotten about, and there are not many guidelines for how they can safely begin running again and reduce the risk of injury. We hope our research will help produce guidelines for women who want to get back into a high-impact sport like running after pregnancy.

We recommend that postpartum runners work with health care professionals trained in gait analysis to evaluate their running as well as add strength to their return to running plan.

Next steps for your research?

We have more than doubled the number of markers used in the 3D biomechanical analysis to gain an even clearer picture of the body movements of postpartum runners, and are expanding the number of participants in our study. Our future studies will also follow a person through pregnancy and into the postpartum period to gain a better sense of how their body and running changes over a period of time.