Running with Crohn’s: Returning to training

Running with Crohn’s: Returning to training

Over the last two years, I have undergone four surgical interventions.  I was also actively training for marathons.  This segment deals with how the surgeries affected my training and how I reintroduced myself to running after the doctor cleared me for resuming normal activity.

This brings me to the most important part of this entry:

1)     I am neither a medical professional nor a sports trainer; when I discuss medical issues please remember that I am relaying my experiences as a patient and not as a doctor.  If my experiences / advice ever contradict anything your doctor says, follow the advice of your doctor!

2)     When dealing with medical issues you should tell your doctor that you are runner, tell your doctor about your goals, ask your doctor about when you can resume your training, and ask your doctor if there are any special considerations about running.

When you want to resume high levels of activity after surgery or injury, seek the advice of your doctor!

The procedure for surgery involves a pre-operative appointment, the operation, and a post-operative follow-up.  In the pre-operative appointment, ensure that you inform your doctor about your normal activities.

Things to tell your doctor:

1.     “I am a runner”

2.     The distance you are training to run.

3.     Any other pertinent medical or running information

Things to ask your doctor:

1.     How long do you need to wait after the surgery before resuming your training?

2.     Are there any special considerations that you should know about?

3.     Is it OK to use pain to guide you on your training difficulty?

4.     Is it OK to continue training until the day of your surgery?

If the doctor indicates that running will not harm me or interfere with the surgery, then I keep training until the day of the surgery.

For every minor surgery that I experienced (as of 8/4/2013 that is 7), the doctor permitted me to resume “normal activities” at the post-operative follow-up appointment.  At each of these appointments, I specifically asked, “Is it OK for me to resume running?”

After my major surgery, it took me many *months* to resume my normal level of activity.  My sport of choice at that time was swimming.  Before the surgery, I had been swimming a mile or more during my workouts.  Ten weeks after the surgery, I was permitted to resume swimming.  However, I was only able to swim a single lap on my back, using elementary backstroke, because doing anything else was too painful and difficult.

In my post-op notes, my doctor usually says something like “resume normal activities *as tolerated*”.   The phrase “as tolerated” means as long as it does not hurt.  If it hurts, do not do it!  The few times that I did not feel good during my post-operative runs, I either cut the run short, or replaced running with walking.  The reason for cutting things short is that if you are hurting during the run, there is a good chance that you are harming yourself.  If you are harming yourself, then you are delaying your recovery.  The best thing that you can do for yourself at this point is to heal quickly.

For my most recent surgery, the doctor explicitly told me to *not* use pain as a guide.  He wants me to take it easy regardless of whether activity hurts or not.  His reasoning is that the surgical repair he performed was to glue tissue together.  He is afraid that activity like running & lifting objects could pull the glued tissue apart.  Therefore, I have remained in bed almost 50% of my day since the surgery.  The little activity that I have done has consisted of cleaning our kitchen and grocery shopping.  In addition, I do walk prior to my post-operative follow-up appointment.

The following is an example of my returning to training after surgery:

After surgery (with doctor’s permission):

Day 1: rest

Day 2: minimal slow walk for a short distance or until you feel any changes for the worse

Day 3: rest

Day 4: As long as you do not feel worse than Day 1, another minimal slow walk.

Repeat days 3 & 4, either adding distance or speed *slowly*.  Harming yourself by overdoing it will only slow your recovery.

After getting permission to return to normal activity (usually at your post-operative follow-up appointment):

Day 1: run at your slowest pace 1/4 of the distance of your previous long run (for me that was 2 miles).

Day 2: rest and see how your body responds

Day 3: if you had no problems on Day 2, add distance (for me that was adding a mile).

Repeat Days 2 & 3 until you feel like you have performed the equivalent of your current long-run capability.  Use this as the basis of your current level of fitness and resume your training from this point.  I do not do trail running, hills, speed, or other special workouts until I have a better idea of how my body is responding to the running.  I also do new runs at the slowest pace I can do.  The idea is to get your body used to running again.

During my recovery of the spring of 2012, I was able to use this process to get back up to a long-run distance of 3 miles.  During my recover of the summer of 2013, I was able to use this process to get back up to a long-run distance of 6 miles.  I was at a different state of fitness going into the surgeries of those two years, so the fact that I had different capabilities coming out of the surgeries was no surprise.

Another way of doing this using the C25K training, is to run one work-out from each week of C25K until you feel like you are working as hard as you were when you had to stop running.  When you find a work out that is “hard”, then resume your C25K training from that week.