[Fiend]

Sorry for another tedious DVT topic but I wanted a thread with a clear and focussed approach to the training and recovery side...

My general fitness pre-DVT was pretty good. Running 30-40 mins fairly often, climbing well, managing to walk-up to Kinder without dying etc etc. Obviously now my fitness is considerably less, partly due to the enforced rest and partly due to the clots themselves and reduced blood flow in my legs. Walking on the flat is okay but a little tiring, swimming is fine, climbing is fine, except for bridging and anything with thigh stamina which is rapidly tiring, and walking up-hill / up stairs is very hard and fatigues my legs and myself very quickly.

I've been improving steadily, however both the vascular and haematological consultants I've seen have said that whilst I will continue to improve for a few months, I will reach a point where I don't improve any more and my legs are unlikely to return to full fitness due to damage to the veins and valves there-in affecting the blood flow for the foreseeable future.

Obviously I wish to return both my legs and myself to the best fitness as soon and as persistently as possible. Legs can be a bit of a hinderance whilst actually climbing, but I need them to walk into Cloggy, Cadair, the Cobbler, etc etc - which at the moment simply wouldn't be possible.

And this is where I'd like some advice:

Any general suggestions?

How far can I push myself to regain fitness? (at the moment I am stopping if my legs get very tired or show any signs of swelling)

Will doing strength exercises on my legs (easier for me than stamina exercises) be benefical for uphill walking etc?

Alternatively, what about lots of flat walking, which isn't so CV but my legs seem to cope with it?

Would doing lots of swimming be better for my CV as I can do it until I get tired / get a stitch, without it affecting my legs?

In fact, what exactly does CV entail? I presume heart, lungs, and muscles all play a role. Given my legs will have poor blood flow, are there other aspects of CV I can train to compensate? (e.g. getting more oxygen into blood etc?)

Ta in advance.

[webbo]

are you allowed to cycle or is this a no/no.

[psychomansam]

sorry to hear about yer dvt, hopefully your climbing fit body (  ) will beat the doctors recovery schedule!

Seperating some power training (weights/squats) and endurance training (flat walking) should help with muscle recovery, specificity is generally a good way to go, especially if it means you can get more done (than with up hill-walking/jogging). That said, swimming should be very good training as it is a very low-risk form of exercise (depending on where you're swimming of course) as it's low impact, self-cooling and you're generally less likely to overdo it.

Swimming is also good CV training as opposed to walking/weights.

CV, cardio-vascular training is basically defined by your heart-rate. Your cv-training zone will be circa 130-160bpm for an extended period of time, at least 30 mins. We tend to also mean good aerobic training by cv-training, but that's generally going to happen anyway.
As such your cv/aerobic fitness is a separate issue to you leg fitness, but it's pretty fecking hard to do cv training not involving your legs a lot. Swimming sounds good, another option could be a decent bit of circuit training.

As an aside, if you go for swimming and your pool has a sauna, i'd normally recommend this because they're a very good way to extend your CV training slightly while chilling out. Not sure how this would work for your legs, but it would either be really good for them or i imagine you'd notice pretty quick if they're not happy. Do note that this is pretty much the exception to the rule in that it's CV training without aerobic training. I could go on lots about why saunas rule, circulation, stretching, breathing control etc but i prob shouldn't bore you!


Hope some of that is useful!

[Fiend]

Thanks for the replies. GCW where have you gone??

Webbo, I'm allowed to do anything except raise my heart rate to stupid levels, and, errrr, climbing is discouraged :D . So, yes, I could cycle, I don't have a bike but have tried a cycle machine and it tired my legs out suitably so it could be a useful alternative.

Sam, good reply. Is it the case that there's two things to consider here: How CV fit I am as regards heart-rate, and how my muscles can use that fitness, thus I can compensate for my legs' relative inefficiency via improving overall CV fitness??

I will try to do more swimming, I went today and was crap, but will keep at it. I'm also considering using a rowing machine too, it will involve my legs being horizontal which is good for them, and could work well. I wonder about speed climbing too, steeper routes quickly on big holds (ugh, big holds). Hmmm. I think flat/gently uphill walking might be okay too, half an hour of that is tiring but not totally debilating (unlike half a minute of steep uphill walking :S)

As for the sauna, I'm glad that gets some approval, as I've been using a pool with an adjacent sauna (where I seem to meet Dense quite often, with a different bird in tow each time), and my sauna-swimming time ratio tends to be about 3-1 :D I use it for relaxation, soothing my muscles, and a precursor to stretching, and yeah my legs are fine with it.

[psychomansam]

Is it the case that there's two things to consider here: How CV fit I am as regards heart-rate, and how my muscles can use that fitness, thus I can compensate for my legs' relative inefficiency via improving overall CV fitness??

You're right that it's two issues to consider, but that they are connected. Your CV system has it easier when it's being used to service more efficient muscles (nice toned climbing muscle as opposed to bodybuilders useless show-off flab-to-be muscles), and your muscles have it much easier when they're being served by an efficient CV system.

I would have to go with no for compensation there though. Not exactly anyway. The legs are still going to be the weak part in the system and unable to take advantage of your cv system until recovered. That said, it's still a good time to be working on your cv, and theres no harm giving it a head-start over your legs, as long as you don't go pushing the legs too hard.


Well if it makes you feel better, i grew up on the coast and can't swim! I did a length in the pool last year and had a look from the lifeguard like "oh shit, he's a big one". Keep at it!

The speed climbing sounds good, again, wish i could do overhanging routes at all, let alone at speed!!

The rowing's an interesting one - i'm currently working my way back to fitness, and last time i was fully fit was as a rower, so i'm well acquainted with that particular brand of pain/endorphin goodness. If you do use it, A. don't be afraid to lower the lever down to give you less resistance thus making it more speed and less power on your legs. B. Just be careful with your back - the majority of power in rowing comes from the legs, if you don't provide the power from the legs, the next natural thing to pull with is your back, and hello slipped disc! (You should use your back in rowing, but since it's so posture/technique dependent, i'd recommend avoiding it to stop getting injured!) Pulling with your arms on the other hand is good climbing training - i'd recommend having a go with just arms as part of a warm up (sit with legs locked straight, sitting up straight, leaning back very slightly and just isolate the rowing to your arms and shoulders).

Saunas are great, i use the sauna/steam room for stretching out quite a bit though i do get funny looks. Can i ask where you've been going? ...hopefully gonna b back in shef and looking for a gym to join soon

[webbo]

i was going to suggest a static bike anyway fiend as you can have much more control over the resistance which is what you want in a rehab scheme.
have you thought about those steppers or similar they have in the gym again you can adjust the resistance to suit your needs.when i was at physio rehab for a leg injury they made me warm up on a combination of stepping and static cycling.

[SA Chris]

Fiend, where in your legs is the actual damage? If you are going to do any rowing, just be careful where the pressure is from sitting on the slide, it may restrict blood flow, especially if you do it for any lenght of time. I know I used to get a numbum from prolonged rowing sessions.

[Fiend]

Thanks for the further comments...

sam - I didn't expect to be able to fully compensate for my legs' lack of fitness by increasing my heart/lung efficiency, but I do hope to be able to compensate a bit e.g. if my legs are down to 50% fitness permanently, but I get my CV system up to 120% of previous fitness (not sure quite how!) then perhaps that would make the legs 60% which would be, well, better than nothing. I don't know how it will all pan out.

And yes I'd intend to do rowing with low resistance high reps.

webbo  - I could use a stepper too....but equally I could go outside and walk up a hill for 5 minutes which would have me panting and gasping

Chris - any damage is likely to be fairly deep inside, and I think, from the pains I've experienced, more on the inside of the thighs than the outside / back of the legs.

I haven't had time to put any of these ideas into practise yet....but I did go for a gentle and tenative run last night. This was....quite difficult. I could run for maybe 4 minutes initially before having to walk a minute, after that it was more like 2:1 or even 1:1. My heart/lungs felt okay, legs felt very tired, particularly my calves which don't normally ache as much as my thighs. Not really sure what to make of this but if I don't suffer any ill effects (I haven't today), I might try it again...

[webbo]

my point about using a stepper or any other piece of gym equipment is that you can gradually increase the resistance/time etc so you can get a very structured rehab.where as ploughing up some hill is much more variable and harder to assess your progress.
as well as its easier to stop if your fucked.

[Fiend]

I've got quite good at stopping on hills when I'm fucked - usually involving a sideways slump onto lying on my rucsac 

Any thoughts on the running?? And where's GCW buggered off to??

[webbo]

have you thought of using a heart rate monitor it might give you an early warning if you are over doing it.i.e. h/r hitting 300 plus

[slackline]

have you thought of using a heart rate monitor it might give you an early warning if you are over doing it.i.e. h/r hitting 300 plus

I'd hope I'd be able to realise when my h/r was getting close to +300 bpm without the need for a monitor!

[webbo]

the 300 plus was a bit tongue in cheek.

[slackline]

the 300 plus was a bit tongue in cheek.

 

[Fiend]

300 bpm is pretty much accurate when I've been walking two minutes uphill!!


Spoke to my vascular surgeon yesterday, he says running is fine and presents no real danger to my legs nor veins, again assuming I keep it sensible.

[slackline]

Fiend out of curiosity do you have any congenital disorders that increase your pre-disposition to DVT such as Factor V Leiden (my wife is homozygous recessive for this trait, but hasn't had any problems).

[webbo]

Spoke to my vascular surgeon yesterday, he says running is fine and presents no real danger to my legs nor veins, again assuming I keep it sensible.

i take it then he's no idea of what you get up to.

[Fiend]

Au contraire I had a long consulation with him and explained my preference for physical activity including climbing, walking up hills to get to climbing, and running - the latter two being necessary evils of course. Okay I didn't fully describe my climbing activities but to be fair climbing has been considerably easier, less tiring, and less achey than walking, running, or even standing still for a long time...

I described in detail the little jog I tried and he confirmed a couple of times that it was not going to cause any damage, and the running could be beneficial although I should expect to be noticably hampered. I've been constantly asking anyone I have a consultation with what I should do/avoid as far as physical activity goes.

Slackers: All of my blood tests so far (dozens of the fuckers) have come back completely normal. There were a couple of tests they didn't manage to do before I went on Warfarin, and I think I will be having those done in a few months time when I can come off Warfarin (albeit likely temporarily), so it is possible I have a thrombophilic blood disorder, but at the moment I don't know. However:

Fiend out of curiosity do you have any congenital disorders that increase your pre-disposition to DVT

Well, yes - a severely constricted possibly entirely sealed inferior vena cava, I think that's enough of a disorder on it's own!!

[slackline]

Slackers: All of my blood tests so far (dozens of the fuckers) have come back completely normal. There were a couple of tests they didn't manage to do before I went on Warfarin, and I think I will be having those done in a few months time when I can come off Warfarin (albeit likely temporarily), so it is possible I have a thrombophilic blood disorder, but at the moment I don't know.

Factor V Leiden is a blood disorder that means that the chemical which breaks down coagulents (released into the blood when you cut yourself) aren't broken down as they normally would be.  As a consequence it means that if you carry two bad copies of this gene your blood clots very easily, and this in turn increases your risk of DVT

This can't be assessed via a "blood test", you would use the blood to perform a genetic test.

However:

Fiend out of curiosity do you have any congenital disorders that increase your pre-disposition to DVT

Well, yes - a severely constricted possibly entirely sealed inferior vena cava, I think that's enough of a disorder on it's own!!

If you've a blocked blood vessel its either been like that since birth (in which case its congenital, think being born with a hole-in-the-heart type scenario) or something has caused it to be blocked (such as a blood clot which may occur more frequently in those who are homozygous recessive for the Factor V Leiden), so just because you've got a constricted/sealed inferior vena cava doesn't necessarily mean its congenital (although it is a disorder that causes serious problems!).

[Fiend]

All the relevant parties believe my IVC constriction is likely to be congenital - hypoplasia or aplasia.

When I next speak to a consultant I will ask them about Factor V Leiden.

In the meantime my leg is sore from standing around doing DIY. I should stick to running or climbing 

[Fiend]

I'm back. Back and my fitness is still fucked.

Slackers I managed to see some information on one of my files and I don't have Factor V Leiden, okay.

It's now been 3 months since D-Day and although I made good progress in the first month out of hospital, in the last month or so my progress with fitness has been pretty shit - at best no progress, at worst, regressing. All other physical aspects are okay (apart from being fat and weak...).

I've found myself getting exhausted and out of breath, not just in leg intensive exercises, but in more arm orientated stuff like climbing and swimming (the latter which I did pretty well when I was soon out of hospital). I've had many occasions of getting pounding heart and aching lungs and even hazy vision a couple of times, way before feeling much fatigue in my limbs. Running is also bad and the most I can do is 10 mins running split into 2/1 running/walking intervals over 15 minutes - this naturally fatigues my legs too.

This is all very concerning, the distinct lack of progress and the non-leg-based chest fatigue, I have mentioned it to a vasc surgeon and am being booked in for a CT scan to check my lungs are okay (they have felt un-okay on a few occasions).

Other than that I am not really sure what to do except keep plodding on. In the previous month I've been too busy to exercise regularly or look after myself, things have calmed down now so I hope to both train and relax more....As always any thoughts are welcome.

[robertostallioni]

Full woolen body sock?


(I would be shitting it). Best wishes

[robertostallioni]

For winter obviously, maybe this for summer

[Fiend]

Oooh nice, open crotch, I wonder if it's open bunghole too...

I am wearing calf-length stocking things. They gave me full length ones to try but I would literally rather risk death than wear those. The calf-length ones might be fucking stupid but then again getting ruptured and ulcerated blood vessels from post-thrombotic syndrome would be more fucking stupid. At any rate my trousers are usually "hood" enough that undergarments are fully over-shadowed.

More pertinently the fucking stupid things make little i.e. no difference to anything useful going on in my legs e.g. lack of fatigue etc etc.

[Falling Down]

Sorry to hear it's dragging on.  Have you looked at Ashtanga Yoga?  It's quite aerobic and really focused on breathing but not as fatigue inducing as running/cycling/swimming...