August 09, 2024
Provided Image/Louis Bezich
Louis Bezich, above, had a small facet cyst surgically removed from his left leg earlier this year, but he found ways to modify his workout routine – a process called prehabilitation –so that he could keep exercising before his procedure.
Starting and sustaining an exercise routine is tough. The numbers tell the story.
Little more than 20% of American adults meet the federal guidelines for muscle-strengthening and aerobic physical activity. Though men do better than women, they still come in under under 30%. Then there's the effect of aging when physical activity decreases by 40% to 80%.
So, in this context, what happens when the inevitable occurs and even those most committed to a healthy lifestyle are sidelined by an injury or condition that knocks them out for a while? Is there anything that you can do to increase the odds that you will bounce back and resume your exercise program?
Recently, I confronted this very situation, when surgery totally disrupted my hardened routines. It was time to practice what I preach about maintaining a flexible attitude, managing stress and coping with the mental strain that comes when Mother Nature serves up a curveball.
About three months ago, I began to feel pain in my left leg when running. Initially, the pain burned off afterward, so I just chalked it up to sore muscles. No big deal. So, I thought.
When the pain got worse and didn't subside, it was time for a trip to Cooper Orthopedics and Dr. Dave Gealt, a sports medicine physician who's navigated me through numerous aches and pains over the years. At first, my symptoms looked like a pulled hamstring, so it was off to physical therapy. It was reminiscent of prior experiences so again, no big deal. However, this time it quickly became clear that therapy was not the answer. So, it was back for a second look with an X-ray and an MRI.
Sure enough, the cause of my pain was not my hamstring but rather a small facet cyst that was pressing against a nerve in my back, creating the sharp pain up and down my leg. Medical experts cite the common cause of facet cysts as degeneration and wear and tear that weakens the facet joint, allowing synovial fluid, which normally lubricates and nourishes the joint, to leak out and form a cyst.
As an older guy who runs and works out, the diagnosis fit. That's when I was introduced to Dr. David Clements, a spine surgeon at Cooper University Health Care. I know a lot of our doctors, but I had never met Dr. Clements. With more than 30 years at Cooper, I felt like I was in great hands. I was.
After discussing the options, I chose to have the cyst removed. I wanted to get back to my routine as soon as possible, and though removal meant surgery, it looked like the most expeditious route. Bottom line, I'm now four weeks out from the surgery and the pain I was feeling is gone. I'm deep into physical therapy and working through some residual discomfort, but all is going well. I'm sleeping better, improving every day, and looking forward to a return to my regular exercise routine. It's not been an easy process, but one that I've been able to navigate with a bit of strategy and creativity that may help other guys (and gals) like me who live for their exercise regimens.
Running was the first casualty of my condition. From the diagnosis stage until the surgery, the pain made it difficult to walk and impossible to run. As an alternative, I used a stationary bike to keep my legs limber, worked my abs with a machine that stabilized my lower back, and exercised my upper body with a light version of my normal resistance training. I knew my regular routine would be put on hold, so I wanted to do as much as possible to extend my muscle tone over the recovery period. What I was drawn to intuitively is actually an established approach to orthopedic surgery (and other surgeries) that can potentially improve postoperative recovery. The process is called prehabilitation.
According to the Cureus Journal of Medical Science, "studies have suggested that a physical exercise regimen in the weeks leading up to a surgery can improve recovery, physical function, reduce postoperative pain and decrease the length of the hospital stay after orthopedic surgery," though more research is needed.
And, while joining the call for more studies on the topic, the American Academy of Physical Medicine and Rehabilitation says prehabilitation programs represent an "opportunity to improve the patient experience, clinical outcomes, and medical costs." Among the programs studied, all "improved health-related quality of life and psychological well-being."
The mind-body relationship is a central to sustaining an exercise program. The ability to recover from a sports injury highlights the importance of this relationship. Sports psychologist Dr. Matthew Sacco, at The Cleveland Clinic, cites research that shows an optimistic outlook can enhance your recovery when measured against a negative disposition. Sacco also suggests that an all-or-nothing attitude centered on perfection can be a roadblock to reestablishing your regimen.
Finally, while the road back from injury may be challenging, it's important for those of us over 50 to do as much as possible to avoid injury and maximize the effort we put into exercise. The experts at Johns Hopkins Medicine recommend checking with your doctor before starting any program to identify any risks that may be present. Additionally, they advise that you start slow and progress gradually. Stretching is high on their list as a means of countering the thickening and less elastic tendons that come with age. And strength training is another important tactic to counter the decline in muscular strength that aging provokes. It can help maintain strength, prevent muscle atrophy, support bone density and reduce the risk of fractures.
When I started physical therapy, I also resumed my gym schedule, with a temporary new twist, just to get back in the habit of getting up and out every morning. Until I am medically cleared to return to my regular cardio and strength training, I do my therapist's-approved stretching and cycling workouts. With room to stretch out on the mats and easy access to stationary bikes, I've built a new routine that gives me that "check the box" feeling each morning, which is as much a psychological boost as an installment in my physical rehabilitation.
For anyone over 50 who sustains an injury or needs a little repair work, I can tell you firsthand that while it can put a major crimp into your routine, it has the power to add strength to your commitment. I'm feeling it every day. You can too.
Louis Bezich, senior vice president and chief administrative officer at Cooper University Health Care, is author of "Crack The Code: 10 Proven Secrets that Motivate Healthy Behavior and Inspire Fulfillment in Men Over 50." Read more from Louis on his website.
