Safety Status:
Trying to Conceive: SafePregnancy: Limited
Postpartum: Limited
What We Know: Running is a high-impact, weight-bearing exercise that provides significant cardiovascular benefits but places greater stress on joints and the pelvic floor than lower-impact activities.
For individuals trying to conceive, running is generally considered safe for those already adapted to this exercise mode. The American Society for Reproductive Medicine notes that moderate exercise supports fertility, though they caution that very high volume or intensity training (such as marathon preparation) might temporarily affect menstrual regularity and ovulation in some individuals. A 2017 systematic review in Sports Medicine found no negative impact of moderate running on fertility parameters, though extreme training volumes were associated with potential reproductive disruptions in some studies.
During pregnancy, running receives a “Limited” classification due to its high-impact nature and the physiological changes of pregnancy. ACOG advises that individuals who were regular runners before pregnancy can often continue running with modifications, particularly in early pregnancy. However, as pregnancy progresses, the increased joint laxity, altered center of gravity, and additional weight can increase injury risk and pelvic floor strain. A 2018 consensus statement from the International Olympic Committee recommends that pregnant athletes monitor intensity using the talk test (being able to maintain conversation) rather than heart rate, and consider switching to lower-impact activities in the second and third trimesters.
For postpartum individuals, running also receives a “Limited” classification, with timing of safe return highly individualized. The 2019 guidelines from the Association of Chartered Physiotherapists in Women’s Health recommend waiting at least 3-6 months before returning to running, with specific milestones to achieve first. Multiple studies, including a 2021 review in the Journal of Physiotherapy, indicate that returning to running too early (before 12 weeks postpartum) is associated with increased risk of pelvic floor dysfunction, regardless of delivery method.
Key pelvic floor considerations for postpartum running include:
- Evidence from pelvic floor ultrasound studies shows that the pelvic floor undergoes significant remodeling for at least 4-6 months after delivery
- A clinical assessment by a pelvic floor physical therapist is recommended before return to running
- According to the 2019 “Return to Running Postnatal Guidelines,” individuals should be able to complete 30 minutes of brisk walking, single-leg balance exercises, and single-leg squats without pain or leakage before attempting running
- Gradual progression using walk-run intervals is recommended when returning to running
- Any symptoms of heaviness, pressure, leakage, or pain should prompt evaluation and modification of activity
For cesarean deliveries, additional considerations include complete healing of the incision and restoration of core function, which typically requires at least 12 weeks of recovery according to the American Physical Therapy Association’s Section on Women’s Health.
Sources: American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No. 804, Physical Activity and Exercise During Pregnancy and the Postpartum Period; Association of Chartered Physiotherapists in Women’s Health “Return to Running Postnatal Guidelines”; Journal of Physiotherapy, “When Can I Run After Having a Baby?”; International Olympic Committee Consensus Statement on Exercise in Pregnancy; American Physical Therapy Association Section on Women’s Health Clinical Practice Guidelines