Why And How to Maintain Cardio Fitness During Rehab

Why And How to Maintain Cardio Fitness During Rehab

“All you do is slow me down and I’m tryin’ to get on the other side of town”
Photo by Kyle Lin on Unsplash

The best predictor of an injury is a previous injury. This validates a thorough rehab before getting the green light to return to your sport. Yet this green light is often one-dimensional and rarely covers the assessment of our cardio fitness. 

Returning to sport with low levels of cardio fitness elevates the risk of re-injury.

Are the heart and lungs and everything that comes with it ready for the return? Low cardio fitness means you’ll get tired quicker. And the more tired you’ll get, the harder it becomes to move well. Hence the reason for frequent re-injuries.

One way to improve the odds of staying healthy is to spend time re-building cardio fitness between rehab and the return to sport. The downside is that thus further prolongs the time away from doing the sport you enjoy. But there is a better option.

Maintaining fitness during rehab allows a quicker return to outdoor sports.

A more efficient way is to do whatever possible to maintain cardio fitness during rehab. This could mean not having to go through a long and tedious re-conditioning phase before returning to running, hiking, climbing, wrestling with polar bears and whatever else you decide to do. 

And here’s how you can get it done safely.

Test cardio fitness at the start of the rehab

This test establishes a clear goal to aim for at the end of the rehab. It’s a cardio fitness green light for returning to your sport. 

During the early stages of rehab you probably can’t test your fitness by doing what you normally do for conditioning. Those who adapt win. 

For low body injuries you might be able to test your fitness with a rower, or a bike. But a skierg (or more likely a DIY banded alternative) or battle ropes are probably the safer alternatives. Especially if done seated or kneeling.

For upper body injuries, a bike might work the best.

Checking conditioning before and after rehab

  1. At the start of the rehab do a fitness test that mimics, as closely as possible, the conditioning demands of what you do in your outdoor sport. Be it long distance or intervals. Use equipment that allows you to do this without exploding.
  2. At the end of the rehab repeat this same test to see how much, if any, conditioning you need before returning to your sport. What’s the difference between the first test and the second test?

If your second test spits out lower results compared to the first one you need to spend some time re-conditioning. But hopefully the gap is small, or even non-existent. Because of the hard work you put in to maintain your cardio fitness during the rehab.

Maintaining fitness with low body injuries

Most people associate conditioning with lower body work. Whether it’s running, hill sprints, hiking, biking, kettlebell swings or doing a lightweight low body strength medley. And all of that makes sense. Using the big muscles of the low body is a sure way to drive up the heart rate. 

So it’s no wonder why we so often decide to do nothing because we can’t do the things we are so used to. But unless we want to dive into the dark abyss of poor conditioning, we need to find a way to keep elevating the heart rate. 

Eliminate the injured area

Doing hill sprints with an injured ankle doesn’t fly. Unless the goal is to do single leg hill hops. Which in itself only makes sense until you are about to fall and need to catch yourself with the injured leg. Don’t get me wrong, it’s great for us others watching the replay of it on YouTube. Not so much for your rehab efforts.

Instead, let’s look for upper body options for conditioning where we can rest the injured area. Depending on the injury, it’s possible to do these by kneeling on the ground or sitting on the ground or on an elevated surface. You know, a box, chair, guitar amp…

These might even work in standing as long as they don’t aggravate the injury. But let’s acknowledge that this can be difficult to do in the heat of the moment.

Med ball throw variations against a wall 

Think presses, overhead throws, side throws and so on. If you have a ball that doesn’t bounce a whole lot you might get away with slams as well.

Rope work

Waves, both alternating or synchronized, and slams work quite well in both kneeling and standing.

Skierg machine

If you are lucky to have access to one of these, you can really crank the heart rate. A DIY alternative is to attach one or two resistance bands to a chin up bar and use them to do the same thing. Err on the side of lighter bands.

Spin bike

This next one might sound unfeasible, but can actually work. As long as you are able to rest the injured leg safely on the frame. Or perhaps on a box or a stool next to the bike. Just use the healthy leg to do all the work. Again, go lighter on the resistance. You have to cycle the wheel 360 degrees with one leg. Six to twelve o’clock is tough on the quads.

Maintaining fitness with upper body injuries

As with low body injuries, it should go without saying to eliminate the injured area. You might actually still get away with your typical conditioning options, but I would reduce impact on low body activities. Even if you think that you can run, the bouncing and impact are probably not the best things for a joint that’s trying to heal.

Single arm work

Kettlebell swings, low body conditioning circuit (kettlebell rack squat, lunge variations etc), rope work. I am hesitant to include kettlebell cleans unless you’re a master at them. There is a chance that an occasional catch is not a soft one. Just adds an unnecessary risk of impact.

Weight vest

Can work for a low body conditioning circuit and an uphill walk.

Prowler

You can try using the prowler if it is possible to grip it with a one hand and push without going around in circles. Otherwise you might get dizzy, that’s all.

Spin bike

Out of all the typical conditioning options, this is the safest to do with upper body injuries. Idiot proof, really. More the reason I’ve used it for myself in the past.

Single arm rowing

You might get away with this as well. If so, you win in the convenience department.

Tying it together

Getting a green light from an allied health professional is one thing. But as movement quality deteriorates when tired, we still need high levels of cardio fitness to return to sports as safely as possible. 

Test your fitness at the start of the rehab and again at the end. Make up the difference before returning to your sport at your usual intensity.

Finding alternative ways to maintain, or even improve fitness during rehab helps you to bounce back quicker to your usual wickedly awesome self. From a purely conditioning point it means that you might be able to skip the re-conditioning phase after rehab and go straight into doing what you enjoy.

Maintaining conditioning during rehab often requires you to find alternative ways to crank up the heart rate. And those ways might not be what you would normally choose or enjoy doing.

But they’re well worth the effort.


And by the way, all of this applies to strength training during rehab as well.

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