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HEALTH AND FITNESS: ASK THE COACH
Katharine McCoy
January 31, 2009
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Doesn't everybody wish that they
had access to a personal coach for their questions about training and fitness?
Road Bike Action recently caught up with Johnathan Edwards M.D. Dr. Edwards
is a practicing sports doctor and anesthesiologist in Las Vegas, Nevada. He has been
a sports doctor for American cyclists as well as in Europe. He also worked with
athletes during the Paris Dakar rally. As a former professional motocross racer and
current Cat 2 road racer, he understands the health and training needs of
cyclists of all levels.
I'm an avid cyclist. I had a total knee replacement five years ago. It's been a long road to get back to being able to ride well again but I'm almost there. In September I had an unfortunate accident. I was riding out by Bonnie Springs on Rt 159 with a large group of riders. I rode away from them and some young buck (I'm 60 and retired) tried to catch and pass me. He thought he was around me but he wasn't. His rear chain stays under my front wheel. My Independent Fabrication and I went down at 30mph. It was ugly. I had a lot of road rash and received a fair amount of stitches. What I didn't know at the time was that I suffered a hernia. It took awhile to show. I now go under the knife in a few days.
I've always been one who mind over-rides what their body is telling them. Just how long through recovery should I wait till I get back on the bike? I know I should listen to my surgeon. But I feel he's going to give advice based on the average person, not somebody who at one time in his life used to run 2000 miles a year and ride 6-8 thousand miles on the bike. And that was while I was living in the snow belt. I know I should give myself some time to heal but I don't want to lose all of my fitness base and have to start all over again. I was up to 150 miles a week before this happened. Any advice would help. Thank you for your time
PS. I have a trabecular metal non-cemented knee made by Zimmer. I was fortunate in that somehow I avoided hitting the knee during the accident.
–Gene
Dear Gene,
Your problem is a common dilemma. Cyclists undergoing a surgical procedure and the recovery afterwards are a grey area in regards to when to begin activity on a bicycle. The answer to these problems and others like it depends on the procedure being performed, age, medical condition, and level of the cyclist. Regarding hernia surgery and cyclists, the main factors are the size of the mesh or hernia that is being repaired and where it is in relation to your umbilicus (belly button). If the hernia is repaired below the umbilicus, more time is generally needed for the tissues and fascia to heal. This is because the approach to get to the hernia involves a lot of the abdominal muscles being cut and re-sewn together. Also, the position in which a cyclist exists on a bicycle can strain a hernia repair and possibly cause it to tear.
Concerning the amount of time one should stay on or off the bicycle after the surgery is truly a question between you and your surgeon. While most surgeons are not cycling privy, they do know a great deal about healing of hernias and the complications they have seen after the surgery. I asked my general surgeon (who is sports minded) what he thought was a proper time after hernia surgery to start cycling easy on a trainer, and his response was 4 – 6 weeks. I would also agree with this amount of time, because significant tissue healing has to take place before your hernia repair will withstand the force of your abdominal muscles during cycling or other activities. Furthermore, start off cycling easy for the first week and then advance as tolerated. Other advice around the time of a hernia surgery is to be sure your vitamins are being taken regularly such as vitamins C, D, B, E, calcium, omegas and zinc. There are many more, but those are some of the basics. Vitamins will aid in wound healing and may be one factor to a speedier recovery.
Hope this helps,
Dr. Edwards
The information provided in the ASK THE COACH column does not
constitute formal medical advice. The information provided on this
public web site is provided solely for general interest of the visitors
to the site. Information in this column does not constitute medical
advice nor establish a doctor-patient relationship with Dr. Johnathan
Edwards. Readers of this column should not act upon any information
contained in the web site without first seeking medical advice from
their personal physician.
If you have your
own question about health or training that you would like to ask a
coach please send them to fitness@roadbikeaction.
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