Ease back into exercise after illness and injury

Leslie Barker / The Dallas Morning News /

Published Mar 7, 2013 at 04:00AM

DALLAS — Megan O’Laughlin works hard to maintain her weight loss and fitness level. She’s diligent about portion control. She runs regularly and takes aerobics and weight-training classes.

So when she fell while running December’s Rock ‘n’ Roll half marathon in Las Vegas and broke her elbow, she had a big question for her doctor: “How soon can I start running again?”

“I used to be morbidly obese,” said the Dallas attorney, who ran the last nine miles of the race without knowing the extent of her injury. “I lost more than half my body weight. When you go through that, one fear is gaining weight back.”

Another was losing the level of fitness she’d worked so hard to attain. The injury was, she said, “like having the rug pulled out from under me. For someone who is addicted to exercise as mental therapy, it’s really hard to be sidelined.”

Luckily, avid exercisers can find ways to ease back into a routine during recovery from injury or illness — if they’re careful about it. Meanwhile, being injured, getting sick or having surgery can send diehard exercisers’ spirits into a sedentary tailspin.

“For people who exercise regularly, exercise becomes part of them,” said Bill Borowski, director for athletic training services at Baylor Institute for Rehabilitation in Texas. “It’s part of their social network, stress relief, everything else.”

O’Laughlin has spent almost every Tuesday, Thursday and Saturday for the last six years running with groups from Luke’s Locker.

The line between taking it too easy and rushing recovery is a narrow one, said Dr. Damond Blueitt, a sports medicine physician on the medical staff of Texas Health Fort Worth.

“With prolonged bed rest, you lose muscle mass, you lose strength,” he said. “Prolonged bed rest can decrease bone calcium.” It can also increase the risk of blood clots because the blood is static, he said.

But trying to speed your recovery can be dangerous, too.

“Say you had a surgery where you were repairing something,” he said. “You have a lot of blood vessels in that area. The tissue gets altered. Any time you do an exercise where you get your heart rate up, more blood is going to that area. One of the consequences is that it may produce more swelling, more scarring.”

Just as frightening is the potential for infection if you’re sweating and the wound gets dirty, he said.

“If someone has surgery and stitches, don’t get your heart rate up high for four or five days,” he said. “Let the tissue heal some.”

Most important, ask your doctor, and listen to the answer.

“You have to be specific,” he said. “If the doctor says, ‘I want you to rest for two weeks,’ ask what that means. ‘Does that mean I can’t go for a slow walk? Does it mean I can’t go light on the exercise bike or do light resistance training?’”

A stationary bike is often a go-to recommendation for Borowski, who tailors clients’ workouts based on what their doctors advise.

“It’s nonimpact in general, so you’re not getting a pounding like when you’re running,” he said. “You’re still using quads and hamstrings. It’s just a little different.”

Advised Blueitt: “There’s usually always something you can do to get your blood flowing and your heart rate up so you don’t have such a tough time recovering. You get better results after surgery if you can get that person moving again, but you want to make sure they’re not doing things to affect the area that needs rest.”

Is it safe?

How to know whether it’s OK to resume your workout:

• Listen to your body: “It’s telling you something, no matter what it is,” said Bill Borowski of the Baylor Institute for Rehabilitation. If your foot hurts, stop working out for a little while. Otherwise, it could get worse and you could end up having to stay off your feet for much longer.

“I know a lot of people who won’t stop and slow down,” he said. “Then instead of a little tendonitis, they’re dealing with stress fractures and have to sit out for eight weeks.”

• Let your neck be your guide: If your illness is from the neck up, like a head cold, and you feel like working out, go ahead. But, cautioned sports medicine physician Dr. Damond Blueitt, “once you have a chest problem, be careful.”

Said Borowski: “Once it’s into your lungs, you’re taking an already irritated organ because of inflammation or mucus — something inflamed — and making it work harder by increasing the heart rate.”

• Ease back into your routine: It’s going to take some time to get back to where you were before you eased off on your workouts. So be patient. If you get tired walking to the end of the block, back off a little the next day.

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