Lauren Andrews

Behind the Cross Training: A Year Off Running During Pregnancy & Postpartum

I was off running from 16 weeks pregnant to almost five months post partum. (Since then I’ve also been off for a surgery). 

If someone had told me the realities of what I was up against, I may not have had the courage and faith to make the best decision I’ve ever made and had my son. As a dedicated athlete who had a good handle on overcoming past injuries, including a torn meniscus and quad tendon where I was once told I wouldn’t run again, this year off running challenged me in a new way: going through the greatest identity change of my life without my favourite coping mechanism, running. 

I’ve learned a lot from my past about unhealthy coping mechanisms: I haven’t drank alcohol for over twelve years. I know I can become reliant on anything that makes me feel better – not so much as in happier, more so as in less anxious. I quiver when I hear someone say “running is my therapy” as I fear how they will cope without running, when the times inevitably comes that they are injured. On the training front, I went into pregnancy strong and healthy overall – I did my strength, my core, my mobility.  I was going to pro actively see a pelvic floor therapist before I “needed” to. I had those instagram posts saved, you know the ones about pregnancy and running, and was working my way down the checklists! 

Unfortunately after a stressful first trimester (first trimester bleeding and finding out I was carrying a high risk type of twin pregnant only to lose one twin) I came into my second trimester feeling physically strong and was running well, helping pace friends in workouts or doing effort based work.

Then, one day, my pelvis felt like it was splitting in half. At first, I thought, “Okay, let’s start that pelvic floor PT I was going to start soon anyways, and we can take a couple weeks to let it die down then run easy runs for the rest of the pregnancy”. I had pubic synthesis dysfunction due to very high relaxin (heads up, this hormone actually peaks after the first trimester as it doesn’t just relax ligaments, it also helps dilate all our blood vessels to accommodate a 50% increase in blood volume!).  A couple weeks of pubic synthesis pain turns into five months: it didn’t go away until several weeks after delivery. 

At this point, I believe I handled it well emotionally. I knew this type of thing could happen and I immediately took to lower impact sports like Nordic skiing, swimming, and later uphill hiking (it felt a bit better by my third trimester so could uphill hike but the first couple months even walking up stairs was painful). I kept up my strength work in the gym under the guidance of a trainer and felt I was handling what I thought would be five to six months off fairly well. 

Then I gave birth. 

This was both the best day of my life and one of the worst days. I don’t want to go into too much detail but I genuinely thought I could die, and the pain was out of control. The medical staff told me it was not normal even for an unmedicated birth. I fought my way through to delivery and was given an emergency epidural which was traumatic in itself – four adults pinning me down as I screamed in pain in order to put the epidural in. This was so I could push my son out otherwise it would be a c section (which in hindsight, may have prevented my birthing injuries). 

Within a couple days after giving birth, I felt like there was something seriously wrong. I knew our pelvic floors would be very swollen, that many of us tear (myself included, and yes I did all the tips and tricks  they say to prevent that in the last few weeks pregnant), and that it would feel hard to control our bladders. But the sensations I had when I even tried to walk down a subtle hill was that things would fall out if I didn’t squeeze as hard as I could to keep it in. I was told this would improve shortly but it didn’t. Six weeks out I was told I had three types of  “moderate” prolapse and to start working with my PT again. At twelve weeks I was nowhere near being able to run again. It was somewhere between 4-12 weeks when the anger started to emerge. 

I didn’t tell many people how I really felt as I was simultaneously in love with my son; it’s an “in love” no romance song can find the words to. Maybe that’s why there are so few songs about how much a mother loves her child. It’s indescribable. But I felt like my body had made a deal with the devil, so to speak. I felt a burning anger at my situation and, admittedly, jealous of seemingly “everyone else” I knew and saw on social media who at the most waited twelve weeks to resume running. I felt like I had done everything as advised and still come out so unlucky. Yet then I would feel shame for these emotions, awareness that I was relatively healthy otherwise and that my son, thankfully, was healthy too. I knew of women who had experienced the indescribable such as stillbirth or serious health issues post birth with months in the NICU. I knew I was overall still very fortunate but I also felt so much anger. 

When I googled how to manage my diagnosis, it said to not lift weights and to not run. Yet women are generally encouraged to lift weights for bone density and I really didn’t want to become solely a swimmer or cyclist, at least not now!  Through this period, I was doing just that: a fair amount of cross training. Swims, cycles, including several mountain ascents and even a triple crown, and tons of hiking (uphill only) with Everett strapped to me most of the time. From the outside perhaps it seemed like I was almost thriving. I wasn’t. I was surviving, and for better or for worse the cross training was one tool that helped me both manage the identity change, decompress from the stress of feeling like there were now a million little things to do and remember, and most of all, even for a few endorphin fuelled minutes at the top of a mountain, make me forget about the constant discomfort I was living with. 

It wasn’t like a type of running injury where maybe it only hurts while running – this was uncomfortable from the moment I stood out of bed to the moment I fell asleep. My own body felt like a purgatory. It felt almost worse than actual sports injuries I’d had in that while it wasn’t, thankfully, painful, it was such a deep sense of something being very broken, very wrong. It was also hard to verbalize how it felt to others, I still don’t have the right words to describe it. 

With the help of tons of physio and a pessary (like an ankle or knee brace for your pelvic floor), I was able to start a walk run at five months post partum and get a couple months of running in. Things improved to a point and plateaued.  I was referred to a specialist and put on the waitlist for repair surgery. This is normally up to a year wait in BC but a spot came up due to cancellation after only being on the waitlist for two months. I took it! I knew surgery is never perfect but my hope was it would help. It turns out my levator ligaments were almost fully avulsed from the bone – these ligaments are what the pelvic floor muscles attach to so, if you were like me, your muscle tone could have improved yet your symptoms would still be present. 

Having pelvic floor trauma repair surgery at nine months post partum was below my “worst possible outcome” (from an athletic perspective).  I didn’t even know this could happen less than a year prior. I went into surgery hoping that it would help but didn’t expect perfection. 

After waiting my prescribed five weeks post op, I tried to run again. I couldn’t run one minute without full stress incontinence. The surgery seemed to vastly improve the posterior symptoms and heaviness but in doing so, somehow exposed or altered something on the anterior side and it felt like I was Day Two post partum. Any drop of urine in me came out – my kidneys worked faster than I could empty my bladder. The first two weeks of runs post op were perhaps the hardest of all. I broke down one day as I realized I may not have any more options. It felt like running, in every form (not just competitive) was no longer in the cards. The day of this panic/anxiety attack, I felt so much anger I screamed. I fell asleep and woke up telling myself, “keep trying”.

So I went out there a couple days later and still peed myself. There was no “power of the mind” miracle. My pelvic floor was the same it was two days prior. But this time, I told myself to not give up. I added in extra sets of PT exercises, I experimented with a different pessary only to go back to the original one, I started to advocate for a bit of extra sleep and ate more frequently (I do believe some of this delayed healing could have been relayed to significant fatigue from months of sleep deprivation). 

The surgery was four months ago and I recently raced my first 10k in years without a watch and PB’d – and I experienced minimal symptoms! Most runs I don’t leak at all (unless an unfortunate run involving 10km of downhill mountain running, that is clearly my limit) or experience much heaviness, but I have noted symptoms are worse in evening runs. I am finally looking at some goals this fall and am back to lifting heavier weights. I continue my pelvic PT and know that it has been a combination of PT, surgery, time, and hormonal adjustments that have helped it improve. I know it will never be like pre birth and I’m beginning to accept this body. It’s been therapy, family, my son, and my friends who have helped me navigate emotionally. 

One last thought is the anger I felt when people, with the best of intentions, would tell me I didn’t even look like I’d had a baby. My cross training, if anything, was probably a bit TOO much for how little sleep I was getting. My body quickly looked similar to what I looked like pre pregnancy (I notice my lower abdomen still doesn’t have the musculature it had, but unlikely others notice). But on the inside, for much of the first year post partum, I felt so broken I couldn’t even demonstrate an A skip or walk down a hiking trail. Women’s bodies change on both the outside and the inside and it is not always parallel. 

Today, I can already see how this journey however awful in ways has been exactly what I needed to be the best mother and athlete I can be. If I can get through this, I can get through a marathon at paces I used to only dream of. Training and running in so many ways is a privilege. I am very aware of how much I advocated for myself and feel strongly receiving sufficient post partum rehab shouldn’t be only for those who can afford it or know about it. I am positive that if any male experienced what I felt for one day, they too would advocate to ensure post partum PT is included in public health care. 

If you are not ready to run again at twelve weeks post partum, know this: your body is recovering from something much harder than any sporting event you have done or will do. Wait, work with people you trust, advocate for yourself, and never stop believing that healing is possible. Cheer for the women who are more fortunate and get back at it, but cheer for yourself, too.   We may not be accomplishing anything much “only” (fill in the blank) time after having a baby, but what we are doing is equally incredible and your time, even if it’s years down the road, will come. 

– Lauren Andrews