REF-569 · Deering, Donnelly, Brockwell et al., 2024 · British Journal of Sports Medicine, 2024 Feb;58 · Paper · PubMed
International Delphi consensus on designing a postpartum return-to-running training programme
Key Findings
Delphi of professionals working with postpartum runners: 118 → 107 → 95 participants over three rounds (response rates 90.6% and 80.5%); consensus = ≥75% agreement; reached on 42/47 (89%) statements.
Round I: open-ended questions on designing the plan, modifications based on biopsychosocial factors, key muscle groups to train, referral and payment sources; Rounds II-III: Likert voting.
Program design: begin with relative rest, then use a walk-run protocol as the starting point, building duration and intensity gradually and adding strength training — all on an individualised exercise prescription with targeted muscle strengthening.
Adjust training when there are concerns about sleep, mental health, lactation, energy availability, or musculoskeletal or pelvic symptoms.
Cost and access to experienced postpartum-running professionals = potential barriers to care.
Practical Application
Delphi consensus of 118 → 95 clinical and exercise professionals (42/47 statements at ≥75% agreement): a postpartum return to running should start with relative rest, then a walk-run protocol with gradual increases in duration and intensity, individualised, with strength training — modified for musculoskeletal or pelvic symptoms, sleep, mental health, lactation and energy availability.
Do not restart with continuous mileage — begin walk-run once cleared, and layer in targeted strength before load.The panel reached consensus that pelvic floor, abdominal, hip extensor/abductor/rotator, hamstring, quadriceps, gastrocnemius/soleus, intrinsic foot and back-extensor muscles and the diaphragm are key targets before and during run training, but also that every postpartum runner should have a full musculoskeletal assessment with impairments targeted (95.3%) and that specific muscle groups matter less than overall movement patterns (87.1%) (preprint full text, checked 2026-09-28: Table 7).
Build symptom gates: MSK pain or pelvic symptoms (leaking, heaviness/pressure/bulge) trigger regression + pelvic-health physio referral, not "push through" — the symptom examples are the base's own wording of "pelvic symptoms".
Titrate weekly against sleep, mood, lactation demand, energy availability — the explicit modifiers named by the panel.
Limitations
Consensus/expert opinion, low on the evidence hierarchy; no single universal return date; panel skewed to specialist clinicians. Readiness needs a pelvic-health assessment the coach cannot perform — a referral-and-structure tool, not clearance.
How this entry was checked and changed
Why this level
(consensus statement; underlying evidence is expert opinion)
Content correction 2026-09-27
Lead rewritten to the study's own result (panel size, 42/47 statements, the consensus recommendations) instead of house instructions.
Specific muscle groups (hip/pelvis/trunk, calf/foot) labelled as full text; the abstract says "key muscle groups" / "targeted muscle strengthening" only. Response rates added; cross-references given refIds; Sport line set to "running".
2026-09-28: lines labelled "full text; not checked" read against the open-access full text (shura.shu.ac.uk, accepted manuscript): 0 confirmed, 1 corrected (muscle list completed from Table 7; added the panel's "movement patterns over specific muscles" consensus), 0 removed.