Training for Surgery

After twelve weeks of intensive marathon training, I was in the best shape of my life. I had been training knowing full well that I was going to be needing a surgical intervention. In just eight days in the hospital, I saw my hard-earned fitness evaporate (along with fifteen pounds). We've been told how quickly fitness declines with injury or being sidelined, but that isn't the whole story. Training would prove invaluable in ways I never expected.

Medical literature tells parallel stories about fitness and surgery. One documents the rapid decline in muscle strength and cardiovascular fitness during post-surgical recovery. The other reveals a compelling case for pre-surgical training, showing how patients who build fitness before procedures often experience better outcomes and faster recoveries.

The decline in fitness during hospitalization happens with shocking speed. Based on the research I found, I expected to lose around 1% of my hard-earned muscle mass and VO2 max per day during my hospital stay. When I was released from the hospital eight days later, I found that I had lost 15 pounds, likely the bulk of it was lean muscle mass. Calculating that loss against a rough estimate of my lean mass pre-surgery, that represents about 11%. But a drop in fitness is only half the story - the other half lies in the power of pre-surgical training to transform recovery outcomes.

Research shows that patients who engage in pre-surgical training experience significantly better outcomes, with studies documenting reduced complication rates and shorter hospital stays. The original surgical plan from my doctors involved three procedures to remove mesh in my abdominal area from a previous surgery over ten days. My training was a major factor in helping avoid the third procedure and shortening my stay by an additional two days. Since January, I had been building up to running 30 miles per week (along with some stationary bike workouts), combined with two core strength workouts and mobility work every week, which aligns with studies on pre-surgical programs.

Perhaps the most meaningful validation came from my colorectal surgeon, who commented after that it was the first time she had not seen any adhesions inside. Adhesions are bands of scar tissue that form between organs and the abdominal wall—like spider webs binding organs together—painfully restricting movement, and causing other complications. For someone with Crohn's disease, where inflammation and surgical interventions are common (I have had over twenty procedures with my surgeon in the last ten years,) finding zero adhesions felt like a remarkable achievement, highlighting how my commitment to training, nutrition, and recovery had transformed my body, inside and out.

With six weeks before I can return to any physical activity beyond walking, I expect to lose even more fitness and strength. Getting on the Peloton will be my first activity when I get the go ahead from my doctors, followed by easy strength work, with running still out on the horizon. I named my blog Step One because I've learned that progress isn't always linear—we are always starting from a new vantage point with the trail of our experience behind us. While I knew I wouldn't be running a marathon when I began this training cycle, the investment paid dividends in ways I never expected and will carry me through this recovery, as it has many times before.

For more on my approach, check out: The 5 P's of Gut Health and Inflammation Demystified: Where Endurance Training and Autoimmunity Meet