View Full Version : Getting Fit While Rehabbing

Susie Rosenberg
11-08-2008, 06:46 AM
Hey, folks!

I'm looking for suggestions as to structuring a week's worth of activity to regain a modicum of fitness, given some significant limitations. I'm a 53-year-old woman.

Here's my story in a nutshell:

Five years ago: 100 pounds overweight and sedentary.
Two years ago: Lost weight from low-fat, low-calorie diet, spin classes, and typical weight circuit on the machines.
One year ago: Lean, strong, and Crossfit with great endurance and growing strength. I felt tireless and wonderful.

Six months ago: had extensive surgery on my cervical spine, in the early recovery period, developed adhesive capsulitis (frozen shoulder, left side). The surgery and the pain from the frozen shoulder really knocked me flat. I'm just starting to feel remotely like my old self.

Here's what I can't do: can't run, can't lift with left arm, can't lift heavy, especially overhead. Can't walk more than 30 minutes without pain. Can't do anything explosive that puts stress on my spine, like cleans. I can't do pushups (except against a wall). Still in physical therapy, therapist says I can do rows, triceps extensions, and biceps curls. Of course, when I talk about squats, he says, "You don't need to squat." So I'm a little lost. (I can't do weighted squats now because of the stress it puts on my shoulder, has nothing to do with legs or spine.)

Here's what I can do: can walk for 30 minutes, can sit a stationary bike (not a spin bike, though), oddly enough, I can row. I can stretch, and I can lift light weight with my right arm. I can do unweighted squats and lunges and I can do declined situps and back extensions (carefully and slowly).

My diet stinks. Without the motivation of being athletic, and eating for comfort and pain relief, I've put on 15 pounds and I feel soft and mushy, tired and miserable. I know I've got to get it together nutrition-wise.

Given the things I can do, how would you put together a week's worth of activity for somebody as limited as I am? I used to LOVE the long Crossfit metcons, but I can't do Crossfit as written anymore because of my limitations. But I loved feeling tireless, and I loved being strong, and I'd like to start the slow return to fitness.

But how?

Any suggestions for programming would be very, very appreciated. My goals: lose weight, develop endurance, get stronger. My ultimate goal is to be able to ride a bike (albeit not a road bike because of positioning issues) for long distances.

Thank you in advance,

Gavin Jones
11-08-2008, 07:26 AM
Hi Rosie,

Hope this helps....

- I would concentrate on getting back on track with eating properly, the better quality the food - the better the repair and recovery.

- Add some Vitamin C, MSM and fishoil supplements to your whole foods

- Walk for 30 mins every day. Preferably in the countryside and preferably with a dog

- Stick with the bodyweight exercises and build them up first

- Go along to your re-hab consistently


Steven Low
11-08-2008, 10:22 AM
Stairs -- could be your new best friend.

Stationary bike -- can you do intervals? That was what the tabata method was originally made for... cycling.

Telling your PT to sit on the ground and then stand up with legs in front (aka a squat). At the very least, you could probably do squatting from a chair to stand if you wanted to.

Rows and pushups are good. How about lunges?

Diet as you know is diet. No excuse! :)

It's interesting that frozen shoulder tends to develop mostly in females when they get into their 30s onward. Keep working it and stretching. Depending on how bad it was you can get through that in a month or two.

Ben Moskowitz
11-08-2008, 11:23 AM
Stationary bike -- can you do intervals? That was what the tabata method was originally made for... cycling.

This is what I did while I couldn't do anything else. The interval may have to be a adjusted a bit to accommodate the nature of aerobic machines: more like 30 seconds on/30 seconds easy.

This website is pretty useful. (http://musclemedia.com/training/hiit.asp#hiit)

If the thing doesn't shut off, like a fully mechanical bike erg, than just set it hard and do the 20/10 like in the study.

here's some useful info from the study
They were encouraged by the supervisor to complete seven to eight sets of the exercise. Exercise was terminated when the pedaling frequency dropped below 85 rpm. When they could complete more than nine sets of the exercise, exercise intensity was increased by 11 W.

Steve Rogers
11-08-2008, 12:58 PM
Farmers walks and swings with kettlebells or dumbbells might work for you.

Patrick Donnelly
11-08-2008, 02:18 PM
You could always try hip-belt squats if you want to work on your strength.

No loading on the shoulders or upper spine.

Susie Rosenberg
11-08-2008, 04:49 PM
These are great suggestions. I think I am ready to tackle Tabata intervals, and I can do those on stairs or the bike. Those hip-belt squats look terrifying, but give me food for thought, for sure, if I can't use my arms.

It helps a lot having these items on a "menu" to think about constructing a recovery program from.....

Steve, my orthopedist said frozen shoulder mostly hits women of middle-age under conditions of stress. Dealing with two kids' serious illnesses this year, pluse two spine surgeries qualifies as stress, I think. Orthopod also says the natural course of the condition is that it resolves by itself in about 18 months, but can speeded up with cortisone injection (which I had) and PT, which I'm religiously doing.

I'm feeling better enough to want to work out harder, but haven't been systematic about anything. These ideas are all helpful in thinking through what's possible and what's effective. Thank you all so much.


George Mounce
11-08-2008, 04:55 PM
Walk, row, bike. I see kettlebells in your future as a possibility as well.

Garrett Smith
11-10-2008, 09:10 AM
Based on the frozen shoulder, dietary habits, and "stresses" lately (ie. surgery), you might want to try a trial run of B12 injections--since I know you have access to that sort of stuff. B12 injections are dirt cheap and easy to do. Don't believe that oral B12 works the same.

Here are some links that may be of interest to you.
http://www.ncbi.nlm.nih.gov/pubmed/16540210?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/15160668?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/13565208?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/13069085?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/13119092?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/13428343?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum


Taking a course like Z-Health, joint mobility stuff, will be of great importance to your "physical" future. Muscles (strength) are ruled by the feedback that the joint proprioceptors give the nervous system.

The main tip I can give you is to always think about relaxing your suboccipital muscles during any exercise, and try not to lift past the point where it becomes necessary to "make faces" due to effort. Both of these things will help to keep unnecessary tension out of your neck muscles.

Susie Rosenberg
11-10-2008, 09:36 AM
Garrett, thank you for all those informative links. I've skimmed through all of them, and find the B12 link provocative. Thanks for taking the time to post all that!


Wade Smith
11-16-2008, 07:20 AM
Susie, do you have access to a more upright bike (ie; mountain bike, hybrid, or recumbent)? I know you've enjoyed cycling in the past.

The road bike geometry would likely put too much pressure on your neck, but I wonder about an upright bike. Might be worth buying a cheap cruiser-style bicycle to take it easy on the next few months.

Susie Rosenberg
11-16-2008, 10:44 AM
Hi, Wade, thanks for jumping in.

I was hanging out last night with some cycling buddies, and a couple volunteered their recumbents for me to try. THere's even---get this--a recumbent, tandem TRIKE available!

I do have an old cycle-to-market single-geared baby fitted with rear and handlebar baskets, and I will for certain try that first come spring. It's flat from here to the market.

I haven't quite given up on the idea of long-distance cycling, but my biggest problem right now is mental: I'm terrified of going downhill. I feel fragile in a way I never did before, and that's no condition for cycling long distances over the mountains.

I'll have to exercise my nerve as much as anything next year. Fear is a real downer.


sarena kopciel
11-16-2008, 03:41 PM
Susie, it was great seeing you today!! Thanks for stopping by. Gonna email you the photos too!!

Susie Rosenberg
11-16-2008, 04:36 PM
Susie, it was great seeing you today!! Thanks for stopping by. Gonna email you the photos too!!

Hey, you, too Sarena! You did a great job judging at the meet today. I hope you soon feel ready to lift again yourself. It ain't easy bein' sidelined, is it?


sarena kopciel
11-16-2008, 05:05 PM
Hey, you, too Sarena! You did a great job judging at the meet today. I hope you soon feel ready to lift again yourself. It ain't easy bein' sidelined, is it?


Thanks, no its tough being sidelined thats for sure. But in all honesty, I loved the ref job and was grateful for that too!! Being in the energy of a meet is glorious itself:)