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Running For Two: The Pregnant Body in Motion

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Pregnancy is often painted as a time of wonder – but it’s also a period of physical upheaval. Beneath the glow, the musculoskeletal system quietly reshapes itself in ways that are powerful and, at times, painful. From loosening ligaments to changes in posture and gait, the physical toll is extensive.

 

Yet despite these challenges, some women not only remain active during pregnancy, but even run marathons. How is this possible, and what does it reveal about the adaptability of the female body?

 

The Musculoskeletal Shifts of Pregnancy

During pregnancy, the body releases a hormone called relaxin, which is essential for childbirth preparation. Relaxin loosens the ligaments in the pelvis to allow for expansion and delivery – but its effects are not localised. It softens ligaments throughout the body, which can compromise joint stability, particularly around the pelvis, hips and lower back.

 

Weight gain and a growing uterus also shift a pregnant person’s centre of gravity forward. This often results in a swayback posture (also known as lumbar lordosis) as the lower spine curves to counterbalance the bump.

 

Muscles, tendons, and joints are all working overtime to maintain balance, especially as the pregnancy progresses. The arches of the feet may flatten, knees may begin to angle differently, and the pelvic floor experiences increasing pressure.

 

Symphysis Pubis Dysfunction

Then there's SPD, now more commonly referred to as Pregnancy-Related Pelvic Girdle Pain (PGP). This condition affects approximately one in five pregnant women, according to Tommy’s, a UK charity dedicated to pregnancy health.

 

SPD occurs when the joint at the front of the pelvis (the symphysis pubis) becomes too relaxed and unstable. The pain can be debilitating – radiating through the lower back, hips, and even into the thighs. Activities like walking, climbing stairs, or turning in bed can become agonising.

 

The Core Under Pressure

The abdominal muscles also undergo dramatic changes during pregnancy, not just from external pressure but also from internal, structural adaptation. As the uterus expands, the rectus abdominis (the ‘six-pack’ muscles) can separate along the midline, a condition known as diastasis recti.

This muscle separation occurs in up to 60% of pregnant women by the third trimester.

 

This separation can weaken the core, compromise posture, and reduce the ability to stabilise the trunk of the body. It also places added strain on the lower back and pelvis, increasing susceptibility to pain or imbalance. In severe cases, diastasis recti can persist postpartum and may require physiotherapy or targeted rehabilitation to restore full function.

 

Engaging the deep core muscles, particularly the transverse abdominis, become crucial during and after pregnancy. Many prenatal exercise specialists now focus on this inner core engagement as a foundation for safe movement and injury prevention.

 

So with all these changes going on, how can someone keep running?

 

Biomechanical Realities

Running during pregnancy can seem counterintuitive given the significant changes happening in the body. Beyond the loosening ligaments, breathing also becomes more laboured as lung capacity decreases and blood volume rises. Furthermore, the core muscles may not provide the same trunk stability, which in turn can affect running form and increase strain on the lower back and pelvis.


Yet, despite all these shifts, movement remains not just possible, but beneficial for many pregnant runners.

 

What the Experts Say

Exercise during pregnancy is broadly encouraged for those with uncomplicated pregnancies. The NHS advises that if you were active before pregnancy, continuing that activity in moderation is typically safe. The American College of Obstetricians and Gynaecologists echoes this, recommending 20–30 minutes of moderate exercise most days of the week.

 

Dr. Emma Ross, a physiologist and women’s health advocate, puts it plainly in Runner’s World UK:

“Pregnancy is not a disability. It’s a different physical state.”

 

That doesn’t mean all forms of exercise are appropriate for everybody. Running may not be suitable for those with severe pelvic girdle pain (PGP), high-risk pregnancies, or other complications.

 

But for experienced runners who feel comfortable, adapting their routine by slowing pace, shortening stride, and listening closely to their bodies can allow them to continue safely.

 

Key safety adaptations often include:

  • Running at conversational pace

  • Avoiding uneven terrain

  • Wearing supportive footwear and maternity belts

  • Prioritising hydration and temperature regulation

  • Shifting to walk-run intervals as needed

Image source: Runesai
Image source: Runesai

Pain, dizziness, shortness of breath, or reduced fetal movement are all signals to stop and seek medical advice.

 

Stories from the Track

Personal accounts offer a powerful counterpoint to the assumptions that pregnant people should be sedentary. One such story is that of Jenny Faull, who ran a marathon at 31 weeks pregnant.

 

Speaking to Metro, Faull shared that running helped her manage anxiety and brought a sense of calm during an otherwise unpredictable time.

She trained under medical guidance, adjusted her expectations, and prioritised how her body felt over performance.

 

These stories aren’t about pushing limits or proving points – they’re about tuning into your body. Running while pregnant requires adapting to a shifting centre of gravity, a softening core, and a heart that beats for two. But for many, it’s not just possible. It’s grounding and empowering.

 

Recovery and Running Post-Birth

The postnatal period is often referred to as the ‘fourth trimester’ - a time of healing, rebalancing, and recovery. While society often pushes for a rapid bounce back, the truth is that musculoskeletal and hormonal changes persist long after birth. The pelvis and abdominal wall need time to realign and regain strength.

 

The effects of relaxin can linger for up to five months postpartum, meaning joints remain slightly unstable. If diastasis recti is present, jumping back into running too soon can exacerbate the issue or lead to pelvic floor dysfunction.

 

Most physiotherapists recommend a return-to-running protocol that includes:

  • A six-week postnatal check-up, ideally with a women’s health physio.

  • Pelvic floor rehabilitation.

  • Core engagement training, focusing on the abdominis and breathing mechanics.

  • Gradual load progression, such as walking, light jogging and strength training before resuming distance running.


Recovery isn’t linear and for many, it’s not about returning to the same version of themselves but discovering new strength and resilience in the postpartum body.

 

Bone Health: A Quiet Factor in Postpartum Running

Pregnancy and especially breastfeeding can lead to temporary bone density loss, as the body draws calcium to support the growing baby and milk production. While this rarely causes problems for healthy women, it may slightly increase the risk of bone stress injuries (like shin splints or pelvic stress fractures) particularly during the postpartum return to running. Ensuring adequate calcium and vitamin D intake, along with a gradual training rebuild, helps protect skeletal health during this vulnerable window.

 

Redefining Strength

Pregnancy is not a time to test the limits of endurance, but it is a time to acknowledge and adapt to a different kind of strength. The ability of the musculoskeletal system to carry, protect, and ultimately birth another human is staggering. That some women can continue to run, mile after careful mile, while undergoing this transformation is a testament not to defiance, but to deep bodily intuition.

 

In a society that too often side-lines pregnant bodies as fragile or incapacitated, stories of women running during pregnancy reclaim the narrative. It’s not about proving anything. It’s about trust in the body’s capacity to shift, hold and move forward, even under radically new conditions.

 

 

 

 

References


American College of Obstetricians and Gynecologists . (2020, April). Physical Activity and Exercise During Pregnancy and the Postpartum Period. Acog.org.


Canter, L., & Smyth, D. (2022, December 12). Is it safe to run when pregnant? Runner’s World.




Johnston, T. E., Jakavick, A. E., Mancuso, C. A., McGee, K. C., Wei, L., Wright, M. L., Close, J., Shimada, A., & Leiby, B. E. (2021). Risk Factors for Stress Fractures in Female Runners: Results of a Survey. International Journal of Sports Physical Therapy, 16(1).



 

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