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  • Clinical and exercise professional opinion on designing a postpartum return-to-running training programme: an international Delphi study and consensus statement

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Consensus statement
Clinical and exercise professional opinion on designing a postpartum return-to-running training programme: an international Delphi study and consensus statement
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  1. Rita E Deering1,2,
  2. Gráinne M. Donnelly3,
  3. Emma Brockwell4,
  4. Kari Bo5,6,
  5. Margie H Davenport7,
  6. Marlize De Vivo8,9,10,
  7. Sinead Dufour11,
  8. Lori Forner12,
  9. Hayley Mills10,
  10. Isabel S Moore3,
  11. Amanda Olson13,
  12. Shefali Mathur Christopher14,15
  1. 1 Department of Physical Therapy, Carroll University, Waukesha, Wisconsin, USA
  2. 2 Department of Orthopedics and Rehabilitation, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
  3. 3 Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
  4. 4 Private Practice, Physiomum, Surrey, England, UK
  5. 5 Department of Sport Medicine, Norwegian School of Sports Sciences, Oslo, Norway
  6. 6 Department of Obstetrics and Gynaecology, Akershus University Hospital, Lorenskog, Norway
  7. 7 Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
  8. 8 The Active Pregnancy Foundation, England, UK
  9. 9 Sheffield Hallam University, Sheffield, UK
  10. 10 Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, Kent, UK
  11. 11 McMaster University Faculty of Health Sciences, Hamilton, southeastern Ontario, Canada
  12. 12 University of Queensland, Brisbane, Queensland, Australia
  13. 13 Intimate Rose, LLC, Medford, Oregon, USA
  14. 14 Doctor of Physical Therapy Program, Tufts University, Seattle, Washington, USA
  15. 15 Elon University, Elon, North Carolina, USA
  1. Correspondence to Dr Rita E Deering, Physical Therapy, Carroll University, Waukesha, Wisconsin, USA; rdeering{at}carrollu.edu

Abstract

Returning to running postpartum presents challenges such as musculoskeletal pain and pelvic floor dysfunction for some females, but there is little guidance on developing and progressing postpartum training programmes. This study aims to establish expert consensus recommendations on designing and modifying a postpartum return-to-running training programme, highlight costs and access to qualified professionals as potential barriers and discuss clinical, research and sports policy implications.

A three-round Delphi survey of clinical and exercise professionals working with postpartum runners was conducted. Round I consisted of open-ended questions related to designing the training plan, modifications based on biopsychosocial factors, key muscle groups to train and referral and payment sources. Rounds II and III involved Likert-scale voting to identify consensus (≥75% agreement).

118 participants completed Round I, 107 completed Round II (response rate 90.6%) and 95 completed Round III (response rate 80.5%). Consensus was reached in 42/47 (89%) statements, including recommendations for a period of relative rest, gradual increases in duration and intensity, starting with a walk-run protocol and incorporating strength training. Training should be modified based on musculoskeletal or pelvic symptoms, sleep, mental health, lactation or energy availability concerns. Cost and access to experienced postpartum running professionals were identified as potential barriers for runners to receive care.

Consensus recommendations for a postpartum return-to-running programme include an individualised exercise prescription, gradual increases in physical activity, walk-run protocols and targeted muscle strengthening. Further research and improved access to clinical and exercise professionals are needed to inform and facilitate best practices.

  • Consensus
  • Female
  • Pelvic floor
  • Running
  • Women in sport

https://doi.org/10.1136/bjsports-2023-107490

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    Footnotes

    • Twitter @ritadeeringPhD, @ABSPhysio, @ExercisePreg, @marlizedv, @Drhbomb, @IzzyMoorePhD, @amandaolsondpt

    • Contributors SMC, RED, GD and EB convened the author group. All authors

      conceived the idea for this Delphi study. SMC, RED, SD and MHD performed the

      thematic coding and data analysis. SMC and RED wrote the initial draft of the

      manuscript. All authors contributed to reviewing and giving feedback on each

      iteration of the survey and manuscript drafts. All authors contributed to the literature review. All authors reviewed the final manuscript.

    • Competing interests IM is an Associate Editor of BJSM.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.