Photo: Athlete Director Dave via Flickr.com

This is the first in a short series of posts that I introduced a few weeks ago. These posts are essentially my tenets for training with Lyme. I’ve had to change many aspects of my approach to exercise in order to be able to maintain a consistent level of activity. These posts will detail what I do. I don’t imagine for a moment that they will help everyone, but if they help someone (hopefully you) that’s great.

Introduction

Before I get into it, let me say three things…

First, it should be plainly obvious that I’m not a doctor or even a health professional, but if you haven’t figured that out let me say it now, “I’m not a doctor of a even a health professional.” I coach a little and work in a running store. I know a lot about running and biking, but please… take what I say with a huge grain of salt, do your own research and talk to a real doctor before you make a major change in your routine.

Second, I write these from experience. They’re my thoughts based on my experimentation over the last year and a half of dealing with Lyme. I know some doctors say that exercise is bad for Lyme patients. Some says it’s good. I don’t care. My experience is that it’s been a key part of my recovery plan. That’s good enough for me. You decide for yourself. Or, if you don’t want to take my word on it, take Dr. Burrascano’s:

“Those with long-standing tick borne illnesses end up in poor physical condition. Even with successful treatment of the infections, chronic Lyme patients will not return to normal unless they pursue a formal program of therapeutic exercise…”

~ Dr. Burrascano

Lastly, when I say “exercise”, “training” or “activity” I’m basically talking about running, biking, elliptical or other similar cardio-type workout. I’ve never really done much yoga and my weight-training experience comes from reading my coach’s book. That said, if you’re not interested in these activities, or are unable to participate in them, I still think that you can benefit from reading this. You’ll just have to adapt what I’ve put together for your preferred activity.

The First Step, Acceptance

If you’ve been struggling with chronic Lyme, especially neuro-Lyme like I am, you’ve probably already become acutely aware of this — everything is different. Your body, your relationships, your entire life, your everything is not what it once was. This can change through treatment (so I hear), but while you’re in it, life is a whole new game whose rules you’re constantly relearning. It can take several month or years to get through it, but for now, life is different.

I think that for everybody, understanding and accepting this fact is an important first step in getting better. However, if you were any sort of athlete prior to becoming ill it’s a critical one. If you harbor even the slightest dream of returning to your previous form you need to come to terms with the fact that you’re past achievements are truly in the past. Dealing with this difficult and painful reality should be your top priority. I, for a long time, made it my last and I suffered for it.

Relearning Everything

After my initial illness, I was out of action for over three months. I barely ran or did any exercise at all. I thought that rest and relaxation would help me bounce back. Later, as I realized I wasn’t going to get better any time soon, I started to test the boundaries. I began to inch back in to running.

It didn’t go well. I would endeavor to run an easy three to five miles, but be wiped out for the rest of the day and into the next. Unaccustomed to my body failing me like this, my mind started to fail me as well. I began to be nagged by the idea that “this” could be my last run ever. The fear would chase me down the road and I would endure to make my final run a memorable one; something that I could look back on and feel good about as I sat on the couch watching The Biggest Loser. I’d run hard and bury myself. I was in an unsustainable cycle of self-destruction.

The epiphany

Long-time readers may remember — a year ago I wrote about a run I did during which I caught a falling leaf in my hand without breaking stride. Previous to this run I was struggling. Struggling to hold on to my pre-Lyme mindset of training to improve, race and excel at every level of competition. Fortunately, the touch of that leaf landing in my hand started an avalanche of thought on my passion for endurance sports. It forced me to look deep into myself and as I did, layer after layer slid away and the true nature of the mountain beneath was revealed.

For the first time in a very long time I was reminded why I so love endurance sports and what, at the end of the day, is really, really important for me in athletics. It’s not racing, or even competing, it’s the pure beauty of the effort. The question of how far or how fast is inconsequential when compared to the to the question of “can I go at all?” Just getting out the door, moving my body and experiencing life in motion is the gift that exercise gives me. I realized it was time to go back, way back to basics. Both in my mind and with my body.

What I do now

Freed from having fear as a motivator and the self destructive cycle of trying to maximize my every “last chance”, I’ve become a different athlete. When exercising now, I’m still focusing on today, but I’m no longer evaluating everything by my performance. Everything is done with tomorrow in mind.

I still strive to make every workout a quality one, but I never (okay, almost never) take it to a level of intensity or duration that threatens my being able to function on a day-to-day basis. Being released from the pressures of performance and improvement allows me to manage things in a more sensible manner. It frees me to run for myself instead of the watch. It allows me to bike for myself instead of the wheel of the other guy. It allows me help my body to become healthy instead of punishing it because it isn’t.

New Perspectives In Action

As part of my new approach to training I created a series of guidelines to keep me on track. I would suggest that if you’re considering starting to exercise or you’re struggling with your current activities that you follow them.

1: Be conservative

When beginning any new activity, provide your body with at least one day of rest between sessions — even if you feel good on the day after. If you need more than three days, you did too much. Cut back and try again.

Sometimes it can be hard to tell how you’re doing. You may wake up and feel bad, but later feel better. Does that mean you’re recovered from your previous activity? One way to objectively observe whether you’re still recovering is through tracking your resting heart rate (RHR). This is easy and doesn’t require a heart rate monitor.

To do this, simply take your heart rate for 60 seconds every morning. Do it when you’re still in bed, before you move around, turn on the TV or wake up too much. Also, try to do it while laying on your back and not your side — the weight of your body and internal organs can cause your heart rate to fluctuate.

Write down the results for one week and then average the numbers together. This will give you your target resting heart rate (TRHR). Next, take your TRHR and add 3 beats in either direction to get your target resting heart rate zone (TRHRZ). For example, my TRHR is 49. So my TRHRZ is 46 to 52.

Now that you have your target and zone, continue to keep track of your heart rate each morning. On mornings that you fall outside of your zone (generally it will be too high), take the day off from exercise. After while, you should start to get a sense of how much is too much by comparing your RHR with your exercise schedule. This should aid you in finding a healthy balance of rest and activity.

2: Build slowly

Whether increasing duration or intensity, you should be careful.

First, as you build endurance (struggle less) and want to start increasing the duration (exercise longer), begin reducing the interval between sessions BEFORE you start increasing the duration or intensity of each session. If you want to do more, try doing two short activities on the same day instead of one longer one. This approach was very helpful in getting me back to running longer distances. I sometimes ran to work and back (two miles in each direction) instead of doing a single four–mile run. Other days, when coaching, I would run a slow mile to meet my groups, rest for 15-20 minutes while we talked and then run three or four miles and then rest again for another 15 minutes before I did another slow mile home. I wasn’t able to run a full six miles, without over doing it, but with breaks in between I was able to increase

3: Go easy

Keep the intensity low and aerobic. I normally council new or beginning athletes to forgo the use of a heart rate monitor. It adds unneeded complexity to the activity and distracts from the experience. However, this is an instance where using a heart rate monitor can be advantageous. This is a good, cheap monitor if you’re going to get one.

To do proper HR zone training involves a lot of math and mental juggling that even pre-Lyme I had trouble keeping up with. There’s a pretty detailed article on it here, but do your self a favor and simply use the charts below. The left is for men, the right for women. They were created for non-Lymies so don’t get caught up with the “optimal heart rate” and “maximum heart rate” labels. They’re for the healthy. You’ll be one of them soon, but for now, the blue section is your optimal zone.

Max heart rates for men and women

When starting out, keep your HR in the blue zone. It’s best if you can find a flat area of road or sidewalk since hills will tax you unnecessarily and drive your HR up. If it does start inching into the white, back off. Walk if you have to or sit down even, just don’t let it stay in the white zone.

Experiment with this level of effort and see how it goes. If you’re not exhausted afterward and your resting heart rate (see #1) is healthy in the morning, try upping the frequency (see #2). Then, if you’re able to do things more often, try upping the distance.

Only when you’re fully able to exercise  on a normal cycle of five days a week should you start experimenting with the white zone. To do this, incorporate some intervals of increased activity into one of your weekly workouts. For runners this could mean mixing in alternating hard and slow efforts into a run. For example, try a cycle of three minutes of running at your regular pace and then a throw in a minute of  hard effort. Be sure to watch how you feel for a day or two after to ensure you didn’t over do it.

Now Get Started

So there ya go… everything you need to begin. I know… easy for me to say, right? Yes, I’ve been lucky enough to be able to continue a pretty active lifestyle while fighting my illness. I realize and appreciate the fact that for some going 1/2 a mile is equivalent to my doing a 1/2 marathon. However… and this is really important… you need to do something.

There are countless studies which prove that exercise is highly beneficial in the battle of everything from a cold to cancer. Lyme is no exception.

So, you see, it’s important that you be active as much as you possibly can. You can do it. Just be realistic, honest with yourself and maintain the outlook that exercise, along with the many other things that you’re probably already doing, is helping your down the path to wellness. While today you might not able to get out and pound a new personal best or go farther than you have in the past, keep in mind that someday you’ll get there.