Ask Stew: When to Start Training Again After Rhabdo, Pneumonia or Heatstroke

Sometimes in advanced special-ops selection programs, people get ill, avoid medical personnel and push themselves to keep going. The tough physical fitness standards are hard enough for a healthy person during the average day of spec-ops training.

When you add in dehydration and lung congestion, the long day of spec-ops training can lead to heat exhaustion or heat-stroke quicker than normal. That can aggravate the lungs and bronchial passages and cause bronchitis or pneumonia, which can lead to a case of rhabdomyolysis.

Stew, after getting rhabdo, preceded by heatstroke and pneumonia, I am now out of the hospital (one week now). It has been a long road in training -- luckily I am getting rolled to the next class vs. being dropped, but I need to get back in shape. When is the best time to start training again? I do not want to relapse and get sick again, but also don’t want to continue this downward fitness slide. Thanks. Shane

First, make sure you get medical approval before training again. After rhabdo, you could have some kidney issues or find other bodily functions seriously compromised. The last thing you need is to have another round of IVs, antibiotics and hospital stays. Make sure medical and training staff approve any training outside of the program.

My advice is to treat yourself like a beginner for the first week back into training. Stretch, light cardio, basic calisthenics and mobility work are a good way to start. Do that every day. Avoid getting overheated; consider an easy swim after the light calisthenics or cardio workout to help keep the body temperature cooler. Consider the mobility day like this:

Repeat 4-5 times

Bike, elliptical, or row or swim 5 minutes

Stretch, foam roll, massage tool 5 minutes

Practice techniques in the water:

Swim 10 minutes

Tread water 10 minutes (drownproofing skills)

Dynamic stretches in chest-deep water 10 minutes

If you want to see how you feel, try the system’s check workout, which is very similar to the mobility day sequence but with added exercises to test out your joints.

Consider a heat tolerance test: After heatstroke, it can take weeks or months (or even longer) before your body temperature reacts normally to exertion in hot environments. Stay hydrated when sweating profusely, and adding electrolytes to your system is critical to your recovery.

Pneumonia – Whether it was a bacteria, virus or swimming-induced pulmonary edema (SIPE) that caused your pneumonia, recovery after such lung congestion can take from several weeks to a few months before you can build back up to even 50%-60% of your max heart rate.

Rhabdomyolysis – When you get rhabdo, be patient as you are susceptible to relapses as with the above two issues. As with normal training progressions, the answer is to rebuild yourself from a beginner/intermediate level of fitness and not start back up where you left off. That will be frustrating, but patience is required to kick this potentially deadly combo of ailments fully.

To be honest, you are lucky that you’re still alive, so the reintegration into spec-ops level activities may take a few months. See a recent study on the phases of increased activity. Just moving to 25% of what you used to do can take at least a month. A return to training the way you did before selection may take another month or two.

You need to recover. Any one of these three ailments wreaks havoc on your body for considerable periods of time. If you get all three in the course of a few days, it will require a special balance of patience and getting medical supervision throughout the next few months to ensure recovery.

You will need two months to recover and slowly build back up, then an extra month to train harder to get back to where you were. That’s the minimum amount of time to get you back to spec-ops selection shape.

Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you’re looking to start a workout program to create a healthy lifestyle. Send your fitness questions to stew@stewsmith.com.

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