Post-injury exercise puts patience first

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 at Cooper Aerobics Center.

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.

She misses the camaraderie, she said. But she knows if she doesn’t do what she’s supposed to do – including three hours of physical therapy every day – her recovery will be longer.

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 says. “Let the tissue heal some.”

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

“You have to be specific,” he says. “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.”

Pilates instructor Marilyn Levitt will work with injured clients only after they have a doctor’s release. Often, they come to her to learn how to modify their workouts while they heal.

“Engaging in different types of exercise is so important,” said Levitt, owner of Core Pilates Dallas. “It’s tough being told you can’t run for a while. But that time could be used to strengthen other areas of the body.

“You can always do something else,” she said. “People who want to will find something they can do.”

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.”

What he, Levitt and Borowski stress is the neck rule: If your illness is from the neck up, you’re probably OK to work out. “When I really won’t work with a client,” Levitt said, “is when they are sick with a fever or something in the chest.”

“Once you get a chest problem, be careful,” Blueitt said.

For people like O’Laughlin who work out regularly and worry about dropping their fitness level or gaining weight, he has encouraging words. First, if you’re in fairly good shape, “it will take a while to lose a substantial amount” of fitness and will be easier to get it back.

As far as weight, Blueitt said, yes, you may gain some. Once you start moving again, you’ll drop it.

Besides, he said, “Your body is working in overload to heal. So usually the caloric intake you don’t have to watch as much because you need those extra calories to help the body heal.”

O’Laughlin has been relieved to find that she didn’t gain weight. In fact, her post-surgery experience has had the opposite effect.

“It’s crazy because my first fear was that I’d start gaining weight,” she said. “Without even trying, I’ve lost about 3 pounds. I think even if I’m not getting my heart rate up with a cardio workout, I’m being so active with physical therapy that I’m burning more calories.

“I wouldn’t think sitting on my butt and moving my arm would burn calories, but apparently it does.”