How long to recover before marathon training?


Question from Nosweat: I used to run marathons (slowly). Now during chemo I can hardly run/walk 3 km. How long is realistic to expect recovery to take after chemo, surgery and radiation before I will be able to train hard again?
Answers - Julie Gralow, M.D. First of all, I want to make sure that you aren't being too hard on yourself. I normally tell my patients that during breast cancer treatment to expect an average of 60% of your normal energy level. Sometimes it will be less, sometimes more. That's number one: give yourself flexibility, but keep trying. Once you're finished with your treatment, a lot of people and their families think the hard part is over and you should be okay now.

I try to make clear up front that it takes at least six months to a year to regain the point where you were before you started all this treatment. Especially if you really had to back off in your training, you lost a lot of ground. But in six months you should be starting to get back to normal. Use a heart rate monitor to make sure you're not pushing yourself too much—about 65% of your maximum heart rate—and don't try to go too much above that. But once you're finished your treatment, you can start pushing your heart rate up again.
Miriam Nelson I'm a marathon runner, so I empathize. I think sometimes people are way too tough on themselves. They're going through a major medical issue that is impacting them physically and emotionally, as well as mentally. Their bodies have become very de-conditioned, and they're not used to that. They're used to being able to just go out and run and train hard. So first, be kind to yourself.

Once everything is finished and you're on the road to recovery, you need to come up with a schedule that has to be revised here and there, depending on how you feel, that progresses in terms of mileage over each week very slowly. So you think of it almost as a year, in terms of really getting back and feeling like you used to. That's probably a good rule of thumb. It will kick back in, but you have to give yourself time. The other thing is that your progress may not come back in a linear fashion. It may be you're training and one week you feel better, but then it's another two to three weeks before you feel better than that. So slow progression and listening to your body is the best thing you can do.
Judith Sachs Both doctors have made interesting points that exercise improves emotional fitness as well as physical. Exercise is something that increases your self-esteem and makes you feel good as a person, so not being able to do as much as you're used to can lower your self-esteem. Sometimes people who have been marathon runners or weight lifters may want to step back and look at less strenuous exercises, like yoga or tai chi. Yoga can be done with props, so if you're fatigued you can get support from a bolster, block, or strap as you do the movements, yet you still get benefit in flexibility and balance and breathing that happens with these less aerobic activities.

On Wednesday, January 18, 2006, our Ask-the-Expert Online Conference was called Physical Activity and Breast Cancer. Miriam Nelson, Ph.D., Julie Gralow, M.D., and moderator Judith Sachs answered your questions about the many issues related to physical activity and breast cancer.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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