Stroke recovery

Hello,
I am 52 and suffered a head stroke injury after a heart attack 7 months ago. I have been able to slowly ride since 3 months but it is very frustrating and my ftp has gone from 240 to 160 and I am incapable of riding over an hour. I was wondering if it would be more profitable to ride 35 to 40 minutes everyday or an hour every two days and whether I should just keep recovering at my current ftp or try pushing a bit around 200. I have been encouraged by the doctors to do training since nothing seems wrong with the heart. If anyone has advice after such an injury it would be welcome.

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First of all, congratulations on getting back on the bike and doing anything after what you have been through.

I’m not sure if you had cardiac rehab after your heart attack but if you did you will know that exercise is a fantastic thing to do after such an event.

If you can get on the bike most days in the week and doing relatively low intensity work you will be well on your way to getting back to where you were. Don’t beat yourself up about not managing the intensity/duration you had before - you will get back there.

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Hi there, double kudos from me for being back on the bike, it really is scary after what you’ve been through.

I had a heart attack in Sept 2017, when I was 47, whilst on a bike ride with some friends. At first I ignored the chest pain as I thought it was heat burn from the breakfast stop, but after it came back 4 or 5 times and I could no longer turn the pedals I realised something was wrong and reluctantly stopped! I was extremely lucky as it turned out that I had a totally blocked LAD artery but it had blocked gradually rather than suddenly (which usually results in a cardiac arrest) and could have been blocked for months or even years. I have been fortunate to have a procedure to re-open the artery and insert a stent using some new technology, rather than having a by-pass.

I attended cardiac rehab but this is the UK and unfortunately the National Health Service physios are not used to dealing with very fit people with heart issues, they are used to dealing with people who never exercise and are generally unhealthy. So I really struggled for advice on cycling, other than they wanted to reign me back in! Eventually they advised me to stick to 85% of my max heart rate whilst recovering, but this was following a ramp stress test (they put you on a treadmill and increase the ramp every 3 minutes for 12 minutes and take ECGs each time). When I first got back on my bike I stuck to Zone 2 only (up to 75%), but once I had a scan which confirmed I was out of ‘heart failure’ I did start to push into Zone 3, and outside on a group ride it’s very hard to stay within that limit so I did sometimes stray into Zone 4.

i was lucky to have a friend who suffered something similar the previous year and he pushed himself too hard during his recovery and ended up back in hospital several times. His advice to me, based on his own mistakes (which I admit I didn’t strictly follow) was:

Stick to Zone 2 for 3-6 months (let’s call it to the end of March for now). If you have had no issues by then, you should be ok to start riding Tempo (Zone 3). If you want to recover safely, I would not try and do anything much beyond that (i.e. threshold/anaerobic stuff) until about 12 months into your recovery (I started a little earlier than that, but my consultant always insisted my heart muscle was still strong). I started using TrainerRoad again last November (2017) and I basically stuck to Sweet Spot Base 1 and 2 until the Spring and although I took FTP tests, I still manipulated my FTP setting to enable me to work out to how my heart rate responded. You may well find at first that your heart rate is a lot higher than it used to be at familiar intensities - this will be due to both your heart muscle still recovering plus your obvious loss in fitness. if you stick to the same power settings and Zones, what you should hopefully see is your heart rate will slowly lower for the same effort, as the heart recovers and as you start to build up your base fitness again.

Another thing I noticed during my recovery was I got fatigued or felt wiped out far more easily than I used to after a ride. This carried on for a good 6-8 months. By the end of summer this year I was pretty much within 10% of my old FTP, although I was still not able to keep going for very long at threshold efforts (this may well be more psychological than physical though). I am now recovering as easily as I used to prior to my cardiac event, if not better than I used to. My FTP is now within 5 watts of my previous best but my issue now is I am struggling to complete VO2 max workouts. I never was very good at them before though, so this may not be due to my heart! So I’m planning to lower the intensity of these so I can complete them (I may well have a lower VO2 max ceiling naturally). I am having no issues with my heart doing them, it’s more my legs and lungs (which I guess is all linked?).

As you have been told your heart is still healthy, it is very much a mental battle, perhaps more so than the physical issues. I am 14+ months into my recovery and still not quite back to ‘normal’ but I can assure you that if you’re patient, things may not be as bad as they currently seem. Sadly, there are no guarantees when it comes to the heart, as they can never tell you exactly how much damage has been done or how well/fully your heart will recover.

I wish you good luck with your recovery. One thing is for sure - if you do nothing you will never recover! And remember, you won’t win any prizes for trying to ‘man up’ - take your time with it and listen to your body: rest when you need rest, eat well and recover well. Improvements come during recovery and you may need more to start with.

Finally - above all else, enjoy riding your bike and be grateful you are still with us, whatever else happens is just a bonus…

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Congratulations! My wife had a stroke 8 months ago – no one could tell us why as all normal factors were negative. She had planned on starting to run right when the stroke happened, but she is now running 3x a week and has done 3 5k!

First, listen to your body. Your brain is going to take time to recover. My wife still needs more sleep than she did before. When a night falls short, it takes her a couple of days to recover. So expect that.

Second, keep asking around and find a rehab person that works with sports people. KEEP asking. And KEEP asking. The folks my wife worked with said they would not know what to do with me if I had had the stroke. (mainly as I would have insisted on my bike and trainer be put in my room).

Tell us where you are located – this forum is full of resources (just look at Nate’s “I’m sick” thread) – someone may have a contact for you.

My suggestion: Ride short periods every day and see how the body responds. If too tired, take the day off or shorten it. Small, consistent doses seems better than major influxes and then trying to recover. While the difference may not seem like much to you, to your body they might.

You may need rehab- cardiac and PT at least and maybe OT and speech. As someone who sees patients with strokes on a daily basis I highly recommend you don’t follow the advice about post stroke care from anyone here. The characteristics of your stroke and need for exercise are personal and different from anyone else. Please consult your physician.

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Thank you very much for all your replies. It has since been determined that I have paroxysmal nocturnal haemoglobinuria which has caused my strokes. The medecine for this costs 500 000 euros a year. I am afraid cycling will be the least of my problems. Thank you

:frowning: That drug can have serious side effects as well.
Something like this puts everything into perspective pretty quickly…all the best and you’re in my prayers.

Hi merlin !!Hope you are doing well …