By Lucy Roberts
Millions of people in the UK are currently waiting to have an operation and that number has only grown since the start of the Covid-19 pandemic.
Head coach Arj Thiruchelvam
It was estimated in February 2021 that by April as many as 10 million patients would be waiting to have surgery, which has left people unsure of how to stay active and prepare their body in the best way they possibly can.
Performance Physique head coach Arj Thiruchelvam has shared his top tips to patients on how to stay healthy whilst waiting for their operations and what to eat to help preparation and recovery.
Thiruchelvam supports Team GB athletes with their fitness and health and he also revealed why he loves helping them improve their personal best times.
Q) What would be your top three tips to patients wanting to stay healthy while waiting on an operation?
A) I think the most important message to remember which overrides everything is that every kind of surgery, every bit of treatment does have its own special requirement. So, it’s obviously really important to work with your health practitioner in finding the best solution, but as much movement as possible is absolutely vital. It will really give you the best chance of a faster and speedier recovery after the surgery. If it’s possible accumulating those steps, it doesn’t need to be 10,000 steps, but something which allows someone daily activity really, via walking which is a great option, if the surgery they’re going in for allows that to happen. My second tip would probably be, if there’s an opportunity to improve their diet in some way, so for example if we have someone who needs a knee operation or knee replacement, they’ll very often be told that they have to strengthen their quadriceps, their thigh muscles basically, and it can obviously be very difficult to do that when you’ve got a knee injury itself. But we can increase the amount of protein we have in our diet, whether that be chicken, fish, eggs, milk – all of these kinds of things. And that actually has an effect on the muscle tissue, the technical term is muscle protein synthesis and that basically means the body has a trigger, a bit of stimulus to develop muscle or at least look after the existing muscle even if we’re not exercising. So, if we’re down for absolute minimal exercise we need to look after that muscle tissue if we eat enough protein, we can still achieve those results. And then the third tip really is, it sounds crazy, but we can actually make quite sufficient efforts on looking after various parts of the body which are uninjured just by thinking about it and concentrating on it. There have been some really exciting studies where basically patients who have perhaps lost a limb and they have a mirror set-up, half way up their body, they can only see their active limb and they connect some electrodes to perhaps the amputation or something like that and they found that by focussing on the abled bodied side and by performing a bicep curl or such, the other side was still being stimulated so the area which perhaps had the amputation still received some of the electric signals. And that basic principle we found does work all around the body so for example if we’re doing a leg exercise and we’re perhaps awaiting a shoulder surgery or an elbow surgery, something like that, so it means we can’t use our upper body much, if we make a special effort to think about those movements, we can still get benefits all around the body even if the exercise doesn’t specifically target that area.
Q) In terms of diet and nutrition, what should a patient’s diet look like while waiting for an operation and what foods should they be staying away from?
A) One of the easiest ways to look at it is that a source of protein with every single meal is going to be a good starting point. We have ideals, so we can strive for those ideals, it usually averages out at about two grams of protein for every kilogram of body mass. But that’s a kind of thing that certain individuals like to get down to, like weighing foods and that sort of thing. So, if you focus on a portion of protein per meal then that’s really useful and that portion could be like a Greek yoghurt or it could be a piece of salmon, it might be having three eggs at lunch – something along those lines. That’s really, really vital. When we talk about staying away from things there’s only realistically trans fats, so hydrogenated fats, these are the foods which are really highly processed which usually include these things that we should be completely avoiding. It would probably be more beneficial that we just make sure that we’re not eating mass quantities. The last thing we want to do is consume an awful lot of calories meaning that we gain weight, we reduce our mobility as a result and we actually find recovery and preparation for surgery is more drawn out. I never restrict whole foods or anything like that from my clients or athletes, it’s just about finding a very flexible lifestyle approach realistically.
Q) How long should patients wait to get moving again after their operation and where should they start?
A) It’s quite an interesting area of research and there’s a lot to be said in the hospitals when they say they [the patient] has to stay over for several days. There’s a lot of anecdotal research which has shown that basically if they get walking, they get mobile the day after surgery, their discharge is actually sped up. Even if it’s low-level activity it basically improves your rate of recovery and this can be simply down to improving the circulation of blood which carries the oxygen around to the different tissues. We will often find stuff like abdominal surgery needs something like four weeks as a minimum before you can return to any kind of exercise protocol, so like appendix removal for example that can be four weeks before you can do any kind of lifting even like a heavy vacuum cleaner or anything like that. Whereas we might actually find that after two weeks of just doing a little bit of walking for some of the surgeries on shoulders or something like that, you can actually start loading the lower body at least with some additional resistance, so that might be in this case right now just using resistance bands but when gyms reopen, going back into the gym and doing some leg extensions. After a few weeks it’s quite possible that the differences based on each surgery are quite varied, but the main message is get walking as soon as possible.
Q) Do you get a sense of achievement when you help someone, whether that be a novice or an athlete, improve their personal best time?
A) Yeah absolutely. It’s a very odd sensation but it’s possibly almost as rewarding for someone else achieving a goal with your support as it is for yourself achieving something. For example, every Friday I have check-ins with athletes and clients that are perhaps working with us but not on a daily basis face-to-face, or virtually right now. And that Friday is a fantastic day, I always put down the phone at 4pm when I’ve finished all those calls to hear about their successes, it just fills you with a sense of pride, a sense of you’re still doing the right thing, the thing you’ve done for the past 16 years, it’s still working for people and that’s a great feeling really. Successes of someone else and making them feel more confident in themselves is probably the most rewarding sensation I’ve had.
Q) Have you seen an increase in the amount of people signing up to your online and performance coaching throughout lockdown or have the numbers remained steady?
A) Yeah, there’s definitely been a substantial increase for those who want online coaching where, where a camera is not necessarily required, it’s more they use one of our apps. They communicate with us via email, or they pay to have phone calls with us. But the uptake in people wanting to have flexible training written for them, whether it’s with our apps or if it’s just without those, the uptake has been substantial, it’s certainly doubled.
Q) What would your advice be to people who want to start taking their fitness seriously but don’t know where to start?
A) I think the most important message is just start. If that means you’ve not exercised before and you’re really worried about what your very first session should be, just do something for five minutes. Get really comfortable and confident with that five minutes and it’s more important that you make it a habit as opposed to doing really long durations of exercise for example. If it means that you fit in five minutes every single morning before you head down to breakfast or whatever, a power walk or some squats and some press ups and you do that every Monday, Wednesday and Friday, that habit then grows and making the commitment to 10 minutes then 15 minutes, it just becomes more and more manageable. I would definitely say do that stage and then I would also encourage that individual to write down what it is you would be super proud of in six months’ time. So, if you were sat in a coffee shop, hopefully that’s able to occur, with a friend of yours and you were able to say: “Oh I’m so glad I did blah blah blah,” what would that message be? And then you can work out with a coach, someone like myself, of how you’re going to take that journey. But I think we’ve all kind of had our eyes opened into how much we actually value our health in this lockdown, and I think people will start, and they already have haven’t they, really investing in their health like they do their phone contract.
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