fitness · Guest Post · health · illness · injury

Keeping Fit While Healing from Hysterectomy, Part 2 (The Lifting Edition)

It is now nearly 10 weeks after my complete, laparoscopic hysterectomy, and I figure it’s about time for an update on my progress! When I last wrote, it had been about a month, and I was working on following my own fitness plan. (If you haven’t read that post, you can find it here.) My goals at that time were to do what I could to maintain healthy habits and to preserve as much strength as I could without compromising healing. The plan was to do a bands-based resistance program and daily walking. Today, I’ll discuss some overall impressions and get into the weeds a bit about where I’m at with lifting. I’ll do a separate post about my ongoing efforts to return to running.

So, how did the plan go?

During that first month of exercises (post-op weeks 3-6), my strength and endurance varied quite a bit from day to day. Some days I felt great and had to force myself to keep things easy, other days, all I could handle was lifting up and washing the dishes in the sink. I did my best to honor the time I needed to rest. There was one week when I seemed tired all the time, and I wasn’t sure if that meant I’d been overdoing it or if it was something else going on. I rested a few days, and then I returned to my resistance bands and walking but with reduced volume. For several days there, I was tired before I got started but found that a little movement helped my mood and energized me, which reinforced that those were the right decisions.

For the most part, pain continued to not be a major concern. I had some discomfort for sure, but it was most often a generalized achiness, especially on the right side of my abdomen, rather than sharp pains. Bending over at the waist and pushing/pulling heavy objects were the most-limited movements, giving me the immediate feedback that I was still healing inside. Sometimes I thought some activity I’d done had exacerbated the aches, but plenty of times I couldn’t correlate the pain to any particular increase in activity.

The only time I had severe pain, it was while I was out wandering through a neighborhood garage sale with my husband. I hadn’t done anything strenuous in the previous 24 hours or so, and suddenly, every step resulted in a tearing feeling in my side. It completely stopped me in my tracks and brought tears to my eyes. We very gingerly walked home, with shallow, baby steps so I wouldn’t jostle my insides any further, and I laid down on the sofa for the rest of the day. This happened to be only a couple days before the 6-week post-op appointment with my surgeon, so I mentioned it to her at that time. Her hypothesis was that it was “scar tissue disease” that had formed and was being pulled and separated again, causing the tearing feeling I had. Her response to this surprised me–she advised me to stay as active as possible. She didn’t want scar tissue to limit my activities down the road, so the more I can prevent these tissues from sticking and forming together, the better off I’ll be long term.

Back to the gym
At that 6-week appointment, my doctor released me to “gradually return to regular activities.” She made it clear that she didn’t want me holding back too much, as that would slow down my progress. “You can’t hurt anything now,” she said after examining my vaginal sutures, which were apparently healing as expected. So, I left the appointment with her blessing to get back to the gym, to do all the stretching, twisting and bending that I felt ready to do.

I have been back to lifting for a little over 2 weeks now. I decided to go with a 4-day upper/lower split program that I’ve done before. I’ve modified the lifts to avoid undue abdominal pressure (no push-ups, planks, or similar poses). I wasn’t a great squatter before the surgery, but now I’ve gone back to light goblet squats just to parallel. I’m trying to feel out how my pelvic floor responds to the increased loading. As far as I can tell, it’s going ok, although honestly, there isn’t an obvious way to measure it.* My surgeon informed me that my pelvic floor was “more pliable than predicted,” given that I have never been pregnant. She did not know if this was due to my being a lifter or to my history of obesity. It’s not clear to me how careful I need to continue to be to protect my pelvic floor health going forward. And as discussed in the first post, there’s very few evidence-based resources out there to help people navigate this situation.

I’m lifting about 60% (in terms of both weight and volume) of what I was doing before surgery. My preferred programming is usually pretty high volume, and I hope to keep working on increasing it over the next few weeks. I started with 2-3 sets, and I plan on adding a set every couple of weeks until I’m back to doing 5 sets of the major lifts. Only after I get the volume up do I expect to progress the weights heavier again. I’ve dropped out almost all accessory lifts other than those I do to maintain mobility, and I’m focussing on the big, multijoint movements. Here’s how that looks:

Lower 1:
Goblet Squat, 1×6-8, lower weight by 10%, 2xAMRAP (as many reps as possible)
Leg Curl (Machine), 3×12-15
Offset Split Squat, 3×12-15
Monster Walks and lower body mobility work

Upper 1:
Upright Dumbbell Press, 1×6-8, lower weight by 10%, 2xAMRAP
Assisted Chin-up, 2×6-8, 1×10-12
Incline Dumbbell Bench Press, 3×12-15
Cable Row, 3×15-20
shoulder mobility work

Lower 2:
Deadlift, 2×5-6, 1×8-10
Goblet Squat, 3×15-20
Pallof Press, 2×12-15
Alternating Reverse Lunge, 2×15-20
Monster walks and lower body mobility work

Upper 2:
Bench Press, 1×6-8, lower weight by 10%, 2xAMRAP
1-arm Dumbbell Row, 2×8-10, 1×12-15
Arnold Press, 3×15
Palms Down Cable Pulldown, 3×15
Dumbbell Lat Raise, 2xAMRAP (up to 20)
Dumbbell Reverse Fly, 2xAMRAP (up to 25)
shoulder mobility work

The mobility work is feeling especially important right now, as it seems like I’m stiff any time I’m not warmed up. I’m hoping that feeling will decrease as I get back to the rest of my usual routines and is not a new normal. I’m aware that I’m recovering from this surgery in my forties, and older lifters are frequently discussing the increased need for mobility work to keep lifting. I’ve never been sure how true that would be for me, since these folks are usually lifelong athletes, and I’m a relative noob. I have neither the benefit of a foundation of strength, nor the detriment of a lifetime of activity-related aches and pains.

So as far as the lifting part of my recovery plan goes, I’m feeling pretty good about it. The old advice to “lift nothing over 10 pounds,” clearly wasn’t the right advice for me. I was able to do more than that after the first two weeks of total rest, and I didn’t injure myself or create problems for my healing. Even still, my muscles are acting like I haven’t lifted in two months, and I was especially sore with lactic acid burn the first week back. It’s a bit disappointing to be so stiff and sore, given I was continuing to train in some fashion for most of the last couple months. However, I’m pleased that I kept it part of my routine, so that it usually does not feel hard to get myself to the gym–that moment of “ugh, do I really have the energy to do this?!” is less common than it might have been. It’s too early to know how the hysterectomy might impact my lifting options long term. I’m considering going back to the physical therapist to have her evaluate where I’m at, to see if there’s anything I’m missing as I continue to recover. Regardless, it’s clear to me from my experience that the typical lifting advice is more conservative than necessary, at least for some of us.

*Fun fact–in research, apparently they measure internal abdominal pressure by inserting a balloon up the rectum of test subjects. Then, when they do particular lifts, researchers can measure changes in the pressure upon the balloon. For the record, I will not be signing up for this, even in the interest of science!

Marjorie Hundtoft is a middle school science and health teacher. She can be found picking up heavy things and putting them down again in Portland, Oregon.

aging · fit at mid-life · injury · motivation · running

I Recommitted To Running, But There’s Been A Bump

I want to renew my running vows. I want me and Running to hold hands and skip through a flurry of confetti in great outfits; the way we did back at the beginning of our relationship 25-years ago. 

As some of you know, I did a half-marathon in April (The Half Marathon I’m Dreading). I was not proud of my time. I self-sabotaged. My training was not exemplary. My head was not in the right place. Not the first time. The run made me realize—I love you, running, but I’ve let our relationship go stale. I love you more when we spend quality time together. When I pay more attention. When I push, even a little. When I commit. I have let the inevitable slowdown of age interfere with our joyful communion. Time to do something. 

Early in May, a friend invited me to join her Hood to Coast team. Hood to Coast is a 199-mile (36-leg) relay with teams of between 6-12 members. My partner has done it four times. But with a men’s team. I prevaricated. I said I needed the weekend to decide. I went hiking in Joshua Tree National Park with my partner. Side note: the Mojave Desert is spectacular. I hemmed and hawed. I decided, no. Wednesday, I hit reply to my friend’s invite. Started to type, “I’ve thought about it and I’m not going to join.” Instead I typed, “Sure. Sign me up.” 

What? Where did that come from? I’m a writer. My fingers often come up with words all on their own. But my fingers don’t usually take over decision-making. Sunday night, a few days after I signed up, I told a friend I was upping my game. The strategy of public commitment. My goal: To find the enthusiasm and focus of my years-past beginner’s mind. And at the same time, be mindful of not burdening that focus with performance pressure.   

Monday, I went for the first run with my new Warrior Queen headspace. My IT band hurt so much. I had to abandon my run. 

Aaargh. 

If you run and you have never had IT issues, you are extremely lucky. The iliotibial band is a big tendon running down the side of the leg from pelvic bone, over the hip to the knee. Pain usually manifest on the outside of the knee. In my case, pain is around the hip bone.   

But I’m committed. The Internet of Things delivered recovery plans. There’s time. I dusted my exercise ball.  I can cycle to stay strong. I replaced the exercise band I apparently threw out in a fit of optimism. I’m having fun doing short bursts of strengthening exercises throughout the day. I work at home, which makes that easy.  

So far, I’ve done:

  • squats,
  • single leg squats (a serious balance challenge), 
  • wall sits, 
  • abductor and adductor exercises with the band and ball, 
  • foot and arch strengthening exercises, and
  • a hamstring exercise, which involves lying on the floor, putting my feet on the exercise ball, elevating my hips and then doing repeats of pulling the ball toward me with my heels and pushing it away. The ball is squirrely, so there’s a lot of readjustment in every set. 

I’m also rolling on a trigger point tube. I can feel a big, painful bloop, halfway between my knee and my hip, as I roll over the muscle just behind my IT band. Plus stretching, but lightly. Plus acupuncture. Plus a Traumeel injection.

Silver crown on white background. Ashton Mullins on Unsplash

Fingers crossed; I heal with time to train. Patience. If I don’t heal, I still have my new WQ headspace for other sports and life in general. I feel a particular need for mental-emotional strength, because my new book, Run Like A Girl 365 Days a Year, is coming out in a month (featuring interview material with Samantha and Kim of this fabulous blog!). In one of those poetic convergences of life strands, the book is about the transformative impact of sports in women’s lives, just as I am living many of its questions with this latest injury. So, while I aim at WQ mind, I also know that if I don’t heal in time, I’ll probably be pretty disappointed. It will test my re-commitment. For now, I will ride the wave of renewed intention.

What’s your experience with renewing vows with a sport or other life activity or habit? 

fitness · injury · rest · self care · traveling

Tracy is an osteopath convert

Last week I published about my back troubles that ensued a few days after Anita and I ran the Around the Bay 30K. Lots of people jumped in with sympathy, empathy, encouragement and suggestions. Thank you!

The best suggestion came from Susan and others who recommended I try an osteopath. I know some people have had good results with chiropractors, but I’m deathly afraid of the idea of a snap adjustment. And I was in so much pain there was just no way. So a week after the race I contacted an osteopath who a friend had recommended for my neck issues but I’d never gotten around to calling.

I knew Grace from yoga way back when I did Iyengar yoga and she was in my class. She used to be a nurse and she also taught Iyengar yoga, which is very precise. So o felt confident she had the right knowledge base that I could trust her with my back. By the time I went to see her a week ago, I was in excruciating pain by the end of every day. It usually felt a bit better in the mornings after I’d been lying down for the night. And then ramped up throughout the day until by the evenings it had me weeping and almost unable to move.

Grace got me at the end of the day and could see that I was moving in a hesitant manner by then. Hesitant in that way you move when a possible wrong move will result in searing pain that makes the legs go weak.

She had me stand and then slowly walk so she could size me up. Then she got me on her table…very carefully. And started doing very general manipulations of my body (the best being traction, when she pulled ever so lightly on my feet, which immediately released my back). I told Grace I’d been doing back exercises and stretching and yoga and had gone for a deep tissue massage. And in her view, those were all the wrong things, explaining why it was getting worse not better.

What was the right thing? Rest. Total rest. She showed me two lying down resting postures for releasing my back. They both gave me wonderful relief. She showed me how to get into and out of a lying down position without putting strain on my lower back. She recommended I not sit for more than 15 minutes at a time. If possible, she said, take a day or two off of work.

Things were kind of urgent because I was flying less than a week later (Sunday) for a short trip and then a week after that to China for work. When I saw Grace, the idea of sitting on a plane for any length of time seemed impossible.

So though I couldn’t take a day off until Friday, I did go into hyper rest mode as much as possible, lying on the floor with my legs up on a chair or in “constructive rest” with a heating pad and bolster on my lower abdomen to release the entire area and hopefully reduce the inflammation in my back. Grace suspected the inflammation was pushing up against a nerve and that’s why it hurt so much and get worse as the compression of the day’s sitting took hold.

Friday I went to see the nurse practitioner at my family doctor’s clinic. By then, after following Grace’s instructions for a couple of days I felt way better than I had. Thursday, hardly sitting (I even chaired a meeting at work standing up), I didn’t experience a single spasm. I told the nurse everything I was doing and she said “perfect!” So that was reassuring. Then I saw Grace one more time and she tweaked a few things and off I went. By Saturday I was feeling confident I could fly. Sunday came… no problem on my three and a half hour flight to the Bahamas.

I write this on Monday, a day (with Anita) mixed with work, walking on the beach, swimming, constructive rest, and measured amounts of sitting. I’ve had quite a bit of work reading to do, and I have done most of it in a reclining position on my bed, legs bent at the knees. China doesn’t seem impossible anymore.

Image description: Tracy sitting on a balcony rail wearing ball cap, sunglasses, loose sleeveless top, boyshort swimsuit bottoms and bare legs, smiling, beach and ocean and blue sky in the background

And I’m a total convert to osteopathy after one round of appointments. Thanks, Grace!

Have you ever tried an osteopath?

fitness · injury · rest · running

Tracy’s turn for a sad story

“OUCH!” in red block letters written in marker on a white background.

As I write this I am in bed with a cold pack on my right lower back and just got a text message from a friend who used to be a nurse. It said, “do you think maybe you should see your doctor? It’s not getting better over time?” She was talking about my lower back.

Ever since a couple of days after my Around the Bay 30K two Sundays ago I’ve had almost no sustained relief from a pain in my lower back unless I’m lying down. And even then, to get into a lying down position is a slow and careful process that sometimes leaves me weeping. Getting up from it (or from a chair, or into / out of the car) is similarly difficult.

If I move wrong when sitting, standing, or lying down, I get a searing pain and my back and leg go weak, such that it feels as if they are about to give way. Needless to say, I have not run since Around the Bay. I also cancelled my personal training last week. I made it to one actual yoga class, and it felt good, but again I had to scale to my capacity, which meant forward bends and anything that involved getting up or lowering myself down required a modified approach.

I asked Sam whether I should blog about this because I was so pumped after Around the Bay and felt so strong in every way possible, that this back situation feels like an enormous disappointment. Quite the come down, actually. Sam said it’s real and an okay thing to blog about.

Damn right it’s real. I don’t think I’ve experienced physical pain this real in years. The kind that makes me cry. I’ve got great pain tolerance. I didn’t even cry when the dentist drilled into a raw unfrozen nerve during a root canal.

But I tend to be a bit private about pain. Not that I don’t share setbacks and difficulties with my friends. And not that I never blog about challenging times. And not that the people I work with aren’t aware of my delicate back situation this week (because otherwise they would be wondering why I’m walking so slowly and wincing from time to time for no apparent reason). I’m not one to suffer in silence. But it would never occur to me to tell my Facebook friends that I am in excruciating back pain this week. So blogging about it is a bit uncomfortable.

And yet as Sam said, it’s real. And we all have setbacks sometimes. Sam blogged about her much more serious difficulties just the other day. And Catherine talked about getting realistic in April. We all have things that come up, some temporary and others more permanent.

Truth be told, I’m not “rolling with it” particularly well. I mean, I thought and expected that it would resolve in time for me to go for an easy run on Sunday morning. But that was not realistic. I probably shouldn’t have walked home from work on Wednesday. And now, I just can’t even imagine running or walking any distance, or going to the weight room, or even doing a yoga class without taking it super slow and easy.

I’m seeing an osteopath after work today and I went for a massage focusing on that part of my back at the end of the day yesterday. And yes, I’m lying on an ice pack right now and I think I will pop a couple of ibuprofen caplets. I hope, as Susan said, that the osteopath will “gently wiggle” me “back to health.”

Meanwhile, I think this has helped me decide that perhaps, as much as I love running, distances like 30K are too taxing on my 54-year old body. When I do get back to running, I’m sticking with a 10K max for awhile (until Anita talks me into another half marathon or something).

How well do you cope with injuries that interfere with what you’d ideally like to be doing?

accessibility · Aikido · fitness · injury

Aikido Sundays

I recently blogged about my inability to just walk away from Aikido. I still love it. I miss it.  I found myself back on the mat Sunday morning when the opportunity presented itself. Of course, I logged it in the 219 in 2019 group. I wrote, “Most of an Aikido class including some partner techniques, not just basic movements. Still trying to figure out what I can and can’t do with my knee in this condition.”

It’s not like running. I’ll never run again. I can’t. Even if I got new knees, I couldn’t run.

Obviously, I can’t kneel and some of the breakfalls are off limits. But I found I was able to practice some of the falls which made me happy because with the stiff, sore knee I’ve been more worried than usual about falling on the ice this winter.

And the thing is if I met someone with a knee like mine, I would tell them that Aikido is worthwhile. All the things I love about Aikido remain the same as when I wrote about it in 2012.  I love how gentle it is. I love the rhythm and ritual. I love learning to fall. I love the age range and the diversity of the participants. I wish there were a class with modified movements where I wasn’t the only person who couldn’t do all the things.

The question is, can I keep my ego on the shelf and not wish for the knee I used to have? I think maybe I can.

I think, come fall, I’ll visit the Aikido dojos here in Guelph.

#deanslife · accessibility · equality · fitness · injury · racing

Stairs are not Sam’s friends

Image description:
The Girona Cathedral, also known as the Cathedral of Saint Mary of Girona, is a Roman Catholic church located in Girona, Catalonia, Spain. It is the seat of the Roman Catholic Diocese of Girona.
Also, it has lots and lots of steps leading up to it!

Oh, old European cities. I love you. But I hate your stairs. SO MANY STAIRS.

Why do I hate stairs? They hurt my knees. It’s seriously painful even on days when I’m walking pain free. Down is way worse than up. Handrails help. I’m now a person who notices when they’re there and when they’re at the right height. I also sometimes worry that the stairs are making my knees worse.

So I turned to the Internet with my question. Dr. Google, do stairs simply hurt my arthritic knees or do they make things worse? Here’s a good a survey of the relevant literature.

“Stair climbing increases loads on the knee joints. And if we take into consideration the mechanical factor for appearing and progression of degenerative joint disease, it is clear that damage to joint cartilage increases with stair climbing. So reduced loads are beneficial for knee arthrosis.”

“Combination of stairs and weight or better loading and repetition of it is discussed as having some effect of knee joint degeneration. It is calculated that when someone is walking on plain ground he puts about 5 times the body weight or load in every step into the joint. When stairs are used or walking up or down hill the person is loading the knee up to 7 or 10 times the body weight or load according to the speed used. So repetition (circle of loading) – weight (and load) – and inclination of the ground has possibly effect of degenerative knee disease”

“The reasons why patients are advised to avoid them when OA shows up is that stairs are stress raisers, especially descending them. The point is that OA knees regardless the severity,  are often unstable and in these conditions stairs may  induce shear stresses on the cartilage and speed up the degenerative process. “

So I guess I should try to avoid them. I raised the issue at the knee surgery clinic on Monday when I was there for my regular appointment. Their message was clear. “You need to modify your activity. Avoid stairs when you can.”

See you on the escalator/in the elevator!

Though in these old cities there isn’t much choice.

Image description: Yellow brick buildings flanking a narrow walkway of stairs, in the old city of Girona.
accessibility · aging · inclusiveness · injury · weight loss

Sam is checking in for February, #monthlycheckin, cw: mention of weight loss

Good news!

My knee survived a week in Europe with many days of mega steps. I paid a lot of attention to how it felt, wore the knee brace sometimes but not at others, took anti inflammatory medication regularly, and stretched lots. Sarah helped lots too.

Now that I’m back home physiotherapy continues, massage therapy continues, personal training continues, and I’m back to my bike on the trainer, bike commutes, and dog walks. All of that counts, except the massages, on my quest to workout 219 times in 2019.

I’m so happy to see all the hard work paying off.

Next up: NYC 5 Boro Bike Tour in May.

After that, lots and lots of training before our 10 day bike tour of Newfoundland in June.

Bad news!

Weight loss is hard. (We all know this.) You might think that if you had a serious medical reason to lose weight, then you’d do it. But your body doesn’t know your motives. It doesn’t care what your intentions are. It’s super hard.

Wish me luck.