Becoming Fit Again After Surgery Can Be a Long Process

Due to the popularity of last week’s column, Stephanie Oakes will now answer a fitness-related question each week. Topics will include trends, exercise programs and problems experienced by beginning or experienced athletes. E-mail her at stephoakes@aol.com. She cannot respond to every query.

Question: I’ve been in training for my second marathon, and I just injured my right knee (I turned it and my ankle swerving off my running path to avoid a skateboarder). My doctor says I’ll need surgery. How long will it take to lose my “fitness”? And, after I recover, how long before I’ll get back my peak condition?

--MARY IN SANTA MONICA

Answer: Laboratory tests have shown that even the most gifted athletes are indistinguishable from sedentary individuals after six to 12 months of inactivity. But all physiological changes associated with the muscle’s ability to produce energy do not decline at the same rate.

In general, there is no significant loss in performance for five to seven days. As a matter of fact, athletic performance may even be improved after two to five days of inactivity. Such “rest” periods allow the muscles and nervous system to recover and rebuild from the stress of heavy training, thereby providing the athlete with improved reserves and greater tolerance for endurance exercise. Taking a few days of rest before a major competition is nothing new to most athletes.

With rest and a rich carbohydrate diet, the muscle’s fuel storage, glycogen, is increased, providing the energy reserves needed for a good performance. Training plays an important role in this process of muscle glycogen storage. Well-trained, rested and properly fed athletes have more muscle glycogen than untrained individuals. With detraining, this fuel advantage is gradually lost. By about the fourth week of inactivity it may be gone.

As for recovery, that’s a gradual process. It took me a full year after an injury and surgery to feel that I’d reached my standard for “fitness.” It depends on your age, and the type and extent of your surgery.

As long as your doctor approves, it’s OK to start recovering knee strength and flexibility right away. You can begin with leg extensions and leg lifts in bed. You can also begin some upper-body exercises; I suggest sticking with calisthenics such as push-ups, crunches and light upper-body weight lifting.

Once you’re on your feet, you’ll need to continue your rehabilitation to regain agility, balance, strength and range of motion in your leg. Later on (six to eight weeks), with your doctor’s permission, you can begin lifting weights and using an exercise bike. Cross-training (varying your exercise routine) will give your knee a break while still increasing your fitness. How long it takes you to regain your “peak condition” is really up to your training, your knees and your doctor.

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Stephanie Oakes is the fitness correspondent for Discovery Health Channel and a health/fitness consultant.