Building endurance after long term injury

Question

Several years ago I injured my lumbar spine at the gym. As a result of that injury I have been unable to do, well, anything for about 3.5 years now. Needless to say, any sort of physical fitness I had at the time, which was fairly limited to begin with, has long since gone out the window.

I recently underwent a procedure that actually seems to be working. I am in less pain and I am more physically able now than I have been at any point since the initial injury. On my doctor's advice, I am slowly getting back into fitness training to try to recover some of what I lost. In particular, I've started swimming regularly. However, even after several months of doing it consistently, my endurance does not seem to be increasing even slightly. I am wondering what I can do to maximize the impact of my "workouts" given that my goal in the short term is to increase my general stamina.

A few things to keep in mind:

I cannot lift anything heavier than ~8 lbs without causing further damage to my spine. This number is steadily improving (up from about 4lbs!), but weight training is simply not an option yet.

I can swim. I can do about 250 meters at this point before my lungs give out, and I'd like to improve on that. Swimming does my back no harm at all, so the limiting factor there is my general stamina, not my injury.

I can do a limited set of core body-weight exercises. These are going reasonably well and I am noticing some improvement there in terms of what I can do. I also have a very good sense of what my injury can and cannot tolerate in this area, so I am generally able to know ahead of time what is and is not safe.

I can use an exercise bike, and I am starting (slowly) to experiment with light jogging. No more than a minute at a time right now, but so far it has done no harm so I can probably start to increase that. If things continue to improve I am considering purchasing a regular bike this summer.

What can I do (workout details, diet, lifestyle, etc) to maximize the impact of the exercises I can do, given that my immediate goal is to improve my endurance in the short term, and to lose a small amount of weight in the medium term? You can rest assured when giving advice that I am well aware of the possibility of further injury and I will be very careful when implementing any suggestions.

Answer 1

As someone who trains triathlon and has suffered badly from a cervical disc herniation, I suggest you stick with swimming for quite a while.

The flat truth is that swimming is unique. I can run for miles and bike for hours, but the first time I got in the pool, swimming 25m was ridiculously hard.

Swimming is almost entirely about technique. There is an endurance factor to it but once your technique gets better, turning 250m into a mile is actually not that big of a leap.

For several months, there is a very real likelihood you will develop a significant amount of muscle with swimming. I know I gained about 8 pounds of (mostly) muscle when I started - most noticeably in my lats, shoulders, traps, triceps, and chest.

I think the idea is to swim to support growth in other avenues. Focus on your technique, and build your core swim development up. It will take some time but you’ll also make progress relatively quickly.

Swimming did improve my run and my bike but I can honestly say that I don’t think the run and bike help my swim at all. It’s a unique animal, fantastic exercise, and probably the safest thing you can do.

Answer 2

I’m not sure how intense your swimming and cycling sessions are, but if the answer is “moderate” or less, then try creating some HIIT routines around swimming and cycling.

An example of something you could try would be a 25 minute session of something like...

• 5 minute moderate effort warmup round.
• 10 rounds of 30 seconds of max effort swimming/cycling and 60 seconds of moderate effort.
• 5 minute moderate effort cool down round.

You’ll want something beeping for you while this is happening so you don’t have to stare at your phone and for that I would suggest a free app called “IntervalTimer”. Of course, there are many other ways to have something to let you know when to switch between intervals, but that’s just my suggestion.

...

On the nutrition side of things, make sure you get enough protein (1.5-2x your kg weight throughout the day) and calcium to help give your muscles and bones what they need. You could also try supplementing with creatine as it helps to further strengthen the muscles and provide energy.

Answer 3

All these answers are well and good, but they don't address your issue.

The fact that you can only do 250m before your lungs give out means you are not using a structured training session. As one answer mentions,

• 5 minute moderate effort warmup round.
• 10 rounds of 30 seconds of max effort swimming/cycling and 60 seconds of moderate effort.
• 5 minute moderate effort cool down round.

What is the point of this? None for a swimmer who is not competing at a significantly high level. At the moment, you are just in the stage of being able to swim full stop.

My suggestion is to start with something like sets of 10 x 25m with 30 secs rest. Then rest 2-3 minutes between sets and see how many sets you can build on. From there you can start to increase distance via something like this, 5 x 50m with 30 secs rest and then go to something like 5 x 100m with 30 secs rest. The main thing is to swim without pain in any joints.

Answer 4

Swim coaches love to give their athletes kicking workouts when they're coming back from a break or the offseason. In case you're not familiar with the term, "kicking" just means "propelling yourself with just your legs". Here's what that looks like: https://youtu.be/a68dwrlRQGg.

Swimmers do this to get back in shape because there's not much technique to focus on, so your mental energy can go into just pushing through the burn of kicking hard. It's easy to get your heart rate up and keep it there, essentially.

I would get a feel for moderate/high intensity kicking while holding onto the wall first, like the swimmer in that video does. Once comfortable with the action of kicking, then move into a kicking workout. Swimmers typically kick either laying on their back facing up, or laying on their front facing forward and holding a "kick board". Whatever is most comfortable to you. I like kicking on my back.

A super simple workout could be doing short sprints (one length, maybe working up to two lengths) high intensity kicking, separated by short rests of about 15s. No more than 3-4 at a time, making sure the last sprint in the set is as fast or faster than the first. It should be pretty exhausting, so you should separate rounds of these sprints with longer rest periods (2-3 minutes).

Answer 5

If you do not have a swimming background, the statement "I can only swim 250 before my lungs give out" suggests that you either have a form problem, don't know how to properly breathe, or both.

If you want to swim for fitness, and don't really care about the performance aspect (either swim meets or triathlons or similar), then what I would recommend is a program such as the 0-700 or the 0-1650 (1 mile). These are programs designed to get you to a swimming point where you can comfortably swim a mile, and then from there you can go further into swimming if you want.

If you get into the program and are still having problems with breathing, I would suggest a session or two with a swim instructor. Most likely suspects are not kicking correctly, and/or not breathing correctly. Both will really hinder you in swimming progress.