Exercise and Pain

Question: As a young kid I contracted polio in my right leg. Apparently it was a mild case because I had no noticeable effects until my late 40s or 50s. At that time, I experienced right leg pain if I had not exercised for several days or about a week. If I exercised moderately then I had no pain. If I exercised very intensely then my right leg would end up much more sore than the left one (and recovery took longer).

I discovered this on my own, never even thinking that the polio might have something to do with it. But I came across an article about post-polio syndrome and a light came on. At that time, I learned about your organization and have followed your publications ever since.

For the past decade I’ve been a competitive cyclist, racing from April through August and training intensely year-round. I mostly compete in road racing, but have also participated in extreme endurance mountain bike races like the infamous Leadville 100 in Colorado.

I had my legs tested for cycling power and discovered that my right leg generates substantially less wattage (a measure of cycling power) than my left leg, at all levels of effort. Needless to say, training is problematic. I often have to reduce my training days per week because my right leg has had enough, yet my left leg could do more. If I do more, then my right leg suffers. The best scenario for pain prevention seems to be frequent easy-to-moderate exercise. But that’s not too conducive to high-performance racing, in which I’ve done pretty well in my age-group categories, including a New York State Championship.

The real issue is, what am I doing to my right leg with all this intense exercise? I lift heavy weights in the gym to strengthen my legs for ski racing in the winter. I realize I’m very lucky compared to many people with post-polio syndrome, and in fact I’m not even 100% sure that’s what I have.

I am 64, and as the years go by the condition of my right leg gradually gets worse, and I fear for my later years. So the whole subject of exercise and pain is something I’d like to learn more about. I wonder if I should just stick to easy or moderate exercise, but that would mean giving up competitive cycling, which I’m loath to do.

Answer: Thank you for sharing your story of polio with later life development of leg pain and its relationship to exercise. You have basically been doing well and making good decisions. I would like to offer you my thoughts about your current concerns about what to do now with exercising in order to best preserve your future function without pain or deteriorating strength in the involved right leg muscles. I think you should continue to focus on “easy or moderate” exercise for the right leg to maintain its strength, prevent pain and not increase the realistic risk that it will further weaken as you continue to age.

Relative to “giving up competitive cycling,” I do not like to encourage people to stop doing things they enjoy and that are healthy for them to do!

However, being focused on competitiveness to the point of risking damage to yourself is a different matter. I would ask you whether you could still enjoy participating in competitive cycling without being driven to win or even being driven to push yourself to your absolute best possible performance.

If your answer is “no,” then perhaps you should give it up and participate in a road biking club for “fun and companionship,” or try teaching/coaching biking skills. If the answer is “yes,” then just enjoy the race experience and exercise at the level you can comfortably do it and without the right leg later “suffering.”

Response from cyclist: From everything I’ve read and studied, I was afraid that is what the answer was going to be. I have not yet decided what path to choose. Intellectually, I know the path that you recommend is what I should do. Emotionally, it would be difficult to give up competitive bike racing. Sooner or later, at some point I will likely cut back to much more moderate exercise intensity and just experience the joy of riding for fun, which is still pretty nice. It may also be that issues with my right leg may force me to cut back. Naturally declining performance as I get older may just make it too difficult to compete with all the youngsters out there. But, I do give them a good run for their money.

Post-Polio Health (Vol. 32, No. 2, Winter 2016)