Interview with Dr. Shefali Christopher of Elon University

Dr. Christopher is a board-certified clinical specialist in sports physical therapy, who joined the Elon faculty in June 2017. Dr. Christopher enjoys the pedagogical challenges the classroom brings, communicating concepts in a variety of ways to best fit a diverse set of learning styles. She enjoys mentoring students who want to pursue careers in sports. Her clinical passion lies in treating endurance athletes. She enjoys evaluating faulty swimming, biking, and running mechanics as well as performing bike fit evaluations. She has given numerous talks at local and national conferences on treating triathletes. Dr. Christopher ‘s research is focused on postpartum athletes return to their sport safely and is researching pain risk factors and characteristics in postpartum runners as her Ph.D. study plan.

Note: You should consult with your doctor or physical therapist for recommendations on treatment. The views and opinions expressed in this article are those of Dr. Christopher and do not necessarily reflect the official policy or position of

How did you become interested in researching how postpartum athletes can return to athletic activity safely?

I was a varsity swimmer for four years in college and after graduating from Denison University, I started participating in triathlons in physical therapy school. I did an Ironman in August 2010 and found out I was pregnant in March 2011. I was intrigued about the ability to keep exercising and keep my ‘Athletic Identity’ so I started researching exercising while being pregnant. Back in 2011 there was not much information out there. The same was true for returning to exercise after giving birth. I had to use my knowledge about tissue healing, recovering guidelines etc. to make my own plan. So when I got an opportunity to start a PhD, I decided to tackle this problem of lack of evidence by studying postpartum return to exercise. 

What are some of the most important things we have learned in this area in recent years?

There is a lot of information out there on return to exercise, however it is people’s personal opinions or hypothesized from studies on either postpartum populations or athletic populations. There are very few studies on postpartum athlete populations. Athletes may have very different responses to pregnancy and postpartum and we should not hypothesize until we actually study this population. 

What do postpartum runners need to keep in mind to stay injury free and prevent pain?

Each person is a unique individual. They need to see a physical therapist to evaluate them for risk factors that may contribute to injury during return to sport/running. For example, one runner may have been put on bed rest during pregnancy and another runner may have run a 5 mile run right before birth. Both of those women would have very different recoveries. Same with delivery and pelvic floor strength. 

They should also consider a team approach to recovery if financially possible. Their OBGYN, lactation consultant, physical therapist (pelvic health focus at first) and coach should all be contributing to decisions about return to running and what is best for this athlete, especially if they are elite! 

What are some of the risk factors for developing pain as a runner after having a child?

The body goes through a variety of changes during pregnancy. The body also goes through a major injury/surgery during birth. Recovery from these events will be very individualized. In general, gait changes, pelvic floor weakness, musculoskeletal weakness, hypermobility/laxity until they are done breastfeeding, transient osteopenia during lactation, etc. are all potential risk factors for injury. 

Are there challenges to getting women with this sort of pain or injury the physical therapy care that they need?

In the USA, postpartum women get one follow up appointment 6 weeks after their child is born. It is at that time where a new mother gets to ask all her questions about recovery and going back to sport. Due to the lack of touchpoints with the MD after this point, women are not getting referred to the providers they need to see. This is the biggest challenge. There is work being done on this by the MDs at UNC chapel hill. They have started the 4th Trimester Project to address these challenges. 

How can PTs best stay up to date on the evidence in this area?

There are more studies coming out on this topic. Stay tuned. Don’t get distracted by the blogs and Instagram posts that have personal opinions! 

What aspect of your research are you most proud of?

I am just really thankful that my PhD supervisors Suzanne Snodgrass and Chad Cook were okay with me researching this topic. I am proud to have Elon DPT students Lindsey Bauer, Rebba Maylone, Haley Barak, Erin Kane, Kim Colby and Hannah Jannsen who are as passionate as I am and have spent many hours in the lab collecting data!!

What advice do you have for future PT students?

Take advantage of every opportunity that comes your way!