Abstract
BackgroundPostpartum runners report musculoskeletal pain with running. Because of inadequate research, little is known about the origin and pain-related classification. Through expert consensus, this study is the first attempt to understand the musculoskeletal impairments that these runners present with. The objective of this survey was to gather expert consensus on characteristics of reported impairments in postpartum runners that have musculoskeletal pain.MethodsA web-based Delphi survey was conducted and was composed of five categories: strength, range of motion, alignment and flexibility impairments, as well as risk factors for pain in postpartum runners.ResultsA total of 117 experts were invited. Forty-five experts completed round I and forty-one completed rounds II and III. The strength impairments that reached consensus were abdominal, hip and pelvic floor muscle weakness. The range of motion impairments that reached consensus were hip extension restriction, anterior pelvic tilt and general hypermobility. The alignment impairments that reached consensus were a Trendelenburg sign, dynamic knee valgus, lumbar lordosis, over-pronation and thoracic kyphosis. The flexibility impairments that reached consensus were abdominal wall laxity, and tightness in hip flexors, lumbar extensors, iliotibial band and hamstrings. The risk factors for pain in postpartum runners were muscular imbalance, poor lumbopelvic control, too much too soon, life stressors, pain during pregnancy and pelvic floor trauma.ConclusionThis study presents a framework for clinicians to understand pain in postpartum runners and that can be investigated in future cohort studies.Level of evidence5
Highlights
In 2019, USA running reported that 17.6 million people registered for road races with 61% of those registered identifying as female [1]
Musculoskeletal pain and dysfunction is prevalent in postpartum runners, lumbopelvic pain in most commonly reported [3]
90.24 diastasis recti, increased Q angle, too much too soon, trauma to the pelvic floor, altered running mechanics, and global laxity in the risk factor category. The purpose of this Delphi study was to identify impairments that contribute to pain with running in the postpartum population
Summary
In 2019, USA running reported that 17.6 million people registered for road races with 61% of those registered identifying as female [1]. Of those women 49% were between the ages of 25-44 years, prime childbearing age [1]. Among women who returned to running, 35% reported postpartum musculoskeletal pain upon returning to running, with 91% of pain complaints related to the lower back, pelvis and/or hips (lumbopelvic) [3]. Lumbopelvic pain is common during pregnancy and postpartum periods and is reported to affect 50% of pregnant women [4, 5]. The objective of this survey was to gather expert consensus on characteristics of reported impairments in postpartum runners that have musculoskeletal pain
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