[bbarlin10]

I know the title is ridiculous but I think that is what has happened to me.  I am 65 and was carrying a fitness average of high 70’s-low 80’s on Training Peaks when I had a sudden serious medical problem.  Due to surgery I had to cease all activity for an extended period, no choice.  This was about 6 weeks ago.  When this issue occurred I got extremely stressed and had numerous massive anxiety attacks for the first two weeks after surgery that left me feeling like I had run back to back marathons.  At the same time I was being almost completely sedentary.

Good news is that one month after surgery I was trying to get back at it.  I started walking a 2 weeks ago, longer and faster each day.  After 7 days I tried my first run, low zone 2 and it was a disaster.  I could only run maybe 1/4 mile or less before I had to walk to keep my HR from jumping up into zone 3.   I told myself be smart for a change, I quit the workout at 5 miles and called it a day (that morning before my run, my HRV as measured by my Apple watch,  was normal for me and I felt fine).

I went to my doctor today and he did a cardiogram on me and it all looked good.

The only thing I can think of as to why I feel this way is that the massive continuous stress for two weeks combined with almost zero movement has put me in some kind of weird metabolic/detrained hole that I’m having a hard time climbing out of.  Am I crazy?  If not crazy, what is the recommend recovery?  My doctor just said “rest”.    Maybe continue zone 1 walking?  Stop all activity?  Guidelines for how long? One more piece of information, when running my energy system felt amazing, (5 miles in low zone 2 is usually super easy for me).  I was not energy constrained in the least.  Any thoughts would be appreciated.

[Scott Johnston]

Thanks for writing in with your question.

I’m not a doc, but I am 69 and have undergone many significant medical set back and surgeries, mostly orthopedic repairs for injuries.  All of them required a lot of sedentary recovery time with the concomitant loss of fitness.  The first of these took place at 26yrs and the last one at 65.  The most important observation is that the older I got, the harder the recovery became, the more fitness I lost and the slower I was to return to the same level as pre-surgery.

I do not know how the anxiety factors in other than to say: It sure didn’t help the physical stress side of things.  But on the physical side: The single biggest hit to fitness during bed rest is to aerobic metabolism.  Studies I put in the first book, Training for the New Alpinism, showed a 50% drop in the aerobic enzyme Cytochrome-C after five days of bed rest.  In both books, I recommend 1 day of easy aerobic work for every lost day of training due to illness or injury.  It takes a lot of energy to heal, and you’ve been through a major traumatic experience. Be patient, be consistent, be gentle, and your fitness will return.  The time frame will be months to years, not days to weeks. Four years after my second knee replacement, I am still seeing fitness/strength gains in that leg.

I hope this helps.
Scott

 

[Dr Andy Reed]

Hi there!

Scott is absolutely correct. Surgery, with bed rest, and the significant stress that comes along with this, are a huge hit to your aerobic fitness. This detraining effect that you describe, can certainly take place in the time lines you describe, but the good news is that by sensibly returning to easy aerobic efforts, you will be able to get back to your pre-surgery levels of fitness.

I would recommend keeping your efforts very easy at first and listen to how your body reacts, taking rest days as needed. Once you are able to consistently walk of jog for an hour, perform a HR drift test (described in our Knowledge section) to establish your Aerobic threshold HR. You will then need to spend time in zone 2 to rebuild your fitness. Everyone is different, and I don’t know the details of your surgery, but it can take months or even years to maximise your aerobic fitness. Err on the side of caution at first – don’t be tempted to do too much too soon. Be deliberate and consistent however, and your fitness will return.

If you wish to discuss things in more detail, I am happy to arrange a phone consult with you, and we can get more specific about your particular medical issue, if that would be beneficial.

Good luck.

[bbarlin10]

Thank you both.  I have been doing as recommended and just taking it easy with the training.  Starting to feel better but wow so slow to recover. Thank you.

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