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Breastfeeding Runners Are At Greater Risk For Bone Stress Injuries.
I know what you are thinking, “Great, just another thing us new mommas have to be worried about!”
The hormonal changes during pregnancy and breastfeeding combined with the new stress of motherhood, increased calorie demands of making milk and sleep deprivation put postpartum females at a higher risk for getting stress fractures. We must be mindful of these changes and allow our body to rest and recover the appropriate amount of time before returning to our prior level of activity. Our bodies are working really hard to recover and provide the nutrients to ourselves and the baby, let's not forget this.
Hormones are essential to creating changes and balancing our system. Estrogen helps regulate the breakdown of old bone and the growth of new bone. During pregnancy, the levels of estrogen rise and then once the baby is delivered there is a drop and that drop remains lowered during breastfeeding. Additionally, breastfeeding moms are now producing food for another human, the body must work hard to do this. Calories are key along with making sure you are not asking too much of yourself too soon (Running too soon after giving birth).
So, you’re probably thinking, well if I just take in more calcium wont it help? Or “I’ll just do more strength training to help with my bone health to prevent it.” Well, I hate to be the bearerof bad news but that won’t necessarily prevent you from getting a stress fracture at this postpartum stage. It is recommended that the amount of calcium a woman needs does not change when they are nursing or pregnant. Always consult with your doctor before you go making any crazy changes in supplements. Although there is a temporary bone density decrease during pregnancy and breastfeeding postpartum, it is not abnormal. Typically bone density will be restored after pregnancy and/or 12-18 months after the cessation of breastfeeding. But on the other hand, the good news is that even though we have a decrease in calcium with breastfeeding there is no correlation that it will lead to osteoporosis!
Another thing that you might be thinking (I was), “But what if I am not breastfeeding, am I still at a higher risk for getting a stress fracture?”. The answer is no. This is since you’re not providing nutrients to a tiny human anymore your body will return to its “normal” levels of calcium in the bones. Just be aware that it will take time for your body to get back to how it was prior to pregnancy so don’t go jump right back into running 5 miles. A return to running program is still very essential.
Postpartum return to running looks different for everybody, however most it is recommended to wait until around 12 weeks. (Look at some of our other blogs for more on Postpartum Return to Running). It is also important to go see a pelvic floor PT around 4-6 weeks postpartum and prior to returning to running to ensure that you are healed, and your body is ready to begin to take the loading and forces that come with running.
Check out the book “ Go Ahead Stop & Pee: Running During Pregnancy and PostPartum”, written by Precision's very own Dr. Kate Mihevc Edwards, DPT.
Additionally, The RUNSource app about to drop (May 2024) will have everything you need to know for your “return to running” postpartum journey. Including strength, running programs and information from pelvic health PTs and more! Keep your eyes open for it!
Thanks for reading!
Noelle O’Hara, PT DPT
Winter, E. M., Ireland, A., Butterfield, N. C., Haffner-Luntzer, M., Horcajada, M., Veldhuis-Vlug, A. G., Oei, L., Colaianni, G., & Bonnet, N. (2020). Pregnancy and lactation, a challenge for the skeleton. Endocrine Connections, 9(6), R143-R157. Retrieved May 1, 2024, from https://doi.org/10.1530/EC-20-0055