With the New Year fast approaching, lots of people will be making those often ill-fated “resolutions” in the eleventh hour, promises that they will better themselves in every possible way, eliminating any bad habits for good.  For many, one of the top resolutions is some variation on the theme of getting in shape, losing weight, etc.  Such a goal is often difficult for many, particularly for those with a chronic illness and possible physical limitations.  The inclination tends to lead more often than not to the extreme, the dramatic and the not-very-sustainable category, one that can be particularly detrimental to those whom are already working from a physical and nutritional deficit.

Gyms and other fitness centers will hop on this all-in-or-bust attitude, and discounts on memberships and personal training sessions abound during this time of the year.  It is certainly tempting, and can be a great thing if you use your head.  I am all for getting in shape and using exercise to help combat stress and enhance one’s mood, but there are a few things you need to be mindful of, whether you are in perfect health or not.

“Personal Training” can mean many things, and while this statement is certainly not applicable to all gym staff, many of them have taken only basic courses to certify them in personal training, and are simply using the profession as a stopover on the way to some other professional destination, rather than treating it as a career in and of itself.  Just because someone is certified in fitness doesn’t necessarily mean they have a firm understanding of the mechanics of the human body, let alone one that is chronically ill and/or surgically altered.  While the old saying “you get what you pay for” can certainly apply in these situations, it really goes beyond that, as many of us need someone familiar with those with physical limitations.  It’s all fun and games until someone gets a hernia, something that anyone who has had abdominal surgery is at a higher risk for.

One of the benefits of having had as many surgeries (and subsequent recoveries) as I have is that the physical therapy that follows each surgery is often very informative in the long run when it comes to physical fitness.  There you are, with an actual Physical Therapist, trained for many years in body mechanics and the overall recovery process.  While you may not appreciate it at the time, this is a wonderful thing.  Should you find yourself in this situation, use the time wisely, and pick their brains during sessions.  Ask questions about what exercises to do, and what to avoid given any physical limitations you may be dealing with.

So what if you don’t have access to a physical therapist right now?  First, keep in mind that things don’t have to be complicated to be effective.   Walking is one of the most effective exercises that can be done by virtually anyone; even in the worst stages of my recovery after the obstruction surgery that left me with a nine inch open abdominal incision and connected to four different tubes, I was marched up and down the hallways each day, and my mother continued this at home during my recovery, bringing me downstairs each morning to do 30 minutes on the treadmill.  You may not be able to walk quickly or for long durations at first, but with time, it will improve.  Gadgets like the Fitbit or similar options can help as well, offering a motivational kick by tracking your activity each day.

When it comes to resistance training, be careful.  After any kind of surgery, you definitely want your surgeon’s blessing before you begin, and doing too much at first can lead to injury, a hernia, or worse.  You can check with them to see if they can refer you for a physical therapy consult and also check with your insurance company to see if physical therapy services (even one or two sessions) may be covered.  It never hurts to ask.  If PT isn’t an option, you may have other options as well.  There are chiropractors out there (mine is one of them), who have sports medicine backgrounds and offer physical therapy services within their offices.  Often a session with one of these chiropractors can be tremendously beneficial and you can come away with some of the same information, in addition to a chiropractic adjustment, which is never a bad idea anyway.  Do a search for “Sports Medicine Chiropractic” in your area and see what comes up.  Many insurance companies cover chiropractic care, so it likely won’t cost more than your usual copay.

To speak from personal experience, last year when I began strength training again after getting my blood counts back in check and being physically well enough to do so, I scheduled a couple of sessions with a highly qualified trainer at my local gym.  She was one of the senior staff members there, and while I was confident with most of my strength training regimen from learning from physical therapists years ago, I wanted a couple more exercises to work my abdomen and lower body.  My core has been sliced and diced so many times that I’ve suffered from low back pain for years now, and I thought strengthening these areas would help stabilize me.  One of the key exercises she recommended for me were barbell squats, which I began to do religiously at the gym, starting with light weights and moving up from there.  She helped me with my form, and I felt confident that I was doing these exercises safely.

The weight on the squats gradually increased, as did my back pain.  When I finally found my current chiropractor, who is trained in sports medicine, he was blindsided that she had recommended this for me, and when x-rays were taken of my back, the source of the pain was revealed.  Between two of my lower vertebrae, the disc that should have been between them was virtually gone, likely a combination of aging, massive doses of prednisone taken over the years for flares and because of the very exercises that I had been doing supposedly to help the back pain.  Think about it: you’re putting a heavy bar across your shoulders, compressing the back even more – it’s completely counterintuitive.  And perhaps for a normal person, this would have been fine, but given my surgically compromised abdomen (which I did disclose to her during our consultation), it wasn’t.   My chiropractor was able to suggest a couple of exercises I could do that would work those same areas without compressing my spine, and now I visit him every two weeks to lay on the decompression table after my adjustments so that my spine can be pulled apart gently to help recreate some of the space between my vertebrae that is now gone for good.

Again, by no means am I saying that this applies to every personal trainer out there, but I am hoping that you’ll take some of my suggestions and develop your own strength training regimen with the assistance of highly qualified professionals who are there to help you.  If your body has already been to hell and back, why do more damage in the name of trying to build it back up?

As for what I have found that personally works for me, I normally do 30-40 minutes of circuit training using mostly my body weight or light weights (I use a lot of my Jillian Michaels tapes for this, rotating between Ripped in 30, Killer Abs, Killer Legs and Yoga Inferno), I walk my dogs 3-4 miles every day, and I do strength training sessions at the gym four days each week for about 45 minutes at a time.  I alternate days between upper and lower body, making sure to get two days of rest between sessions.   Upper body days consist of pull ups, triceps dips, chest presses, shoulder presses, lat pulldowns, Russian twists, weighted crunches, seated rows, bicep curls, shoulder flys and planks.  Lower body days consist of glute presses, calf raises, quadriceps extensions, hamstring curls, weighted abductor and adductor presses, incline leg press, deadlifts, hack squats and a poorly named exercise called sky humpers, which is basically doing a glute raise while lying on the floor with a weighted barbell lying across your hips.  Every couple of weeks, I change up the amount of weight on each, the reps, and the sequence to keep my body from getting used to the pattern, and I rotate in some TRX work here and there to keep things mixed up.

Again, I will stress that this is what works for me, and that each body is different.  This certainly did not happen overnight, and has taken the better part of a year to really understand which exercises worked for me and which ones didn’t.  Be patient, seek expert advice and GO EASY on yourself.  Even with all that I have mentioned above, I certainly do not have anything close to a six pack and probably never will, and that’s okay.   I’m not training for that.  I’m training so that the next time I have to be gutted like a fish again (and odds are it will happen at some point), I’ll be that much stronger and my recovery and rehab will be that much faster.  So you can keep the itty bitty micro shorts, tiny sports bras and spandex camel toes so tight they likely make a suction noise when finally freed.  I’ll be the one in the corner, mostly covered up, doing my sky humpers and glaring at the douche that left 400 pounds and a sweaty mess on the leg press machine.  Also known as yesterday.

Wishing everyone a happy and healthy New Year!!!