Kind of a weird posting on a forum about this but not getting good advice from PCP regarding training.
After a non-lift day, I had some serious rectal bleeding, literally trickled out after pushing, almost a pour. Decided to avoid any strain for a few days until I was able to see PCP, so no training. Finally got in to see doc today, after 3 days of continued bleeding.
Anyhow, nurse gave TERRIBLE advice when I brought up training; resistance training = bad sort of stuff, so ignored that part. But he took a gander and he noted grade 2 external hemorrhoids, but no active bleeding. Referred me over to MD. MD is ordering some tests but assumes internal hemorrhoids may be source of bleeding. Gave me cream and suppositories, but suspects this won’t stop bleeding. Need to get labs, stool sample, colonoscopy, and then referral to specialist (likely proctologist). Told me to just bare through it until I get all this done, unless bleeding gets worse or remains the same for another 3-4 days, then go to emergency which would fast-forward the above process.
Now, more of what I ask from you all. Asked him about training and he recommended against it for the time being but couldn’t say much else outside of that. What would be your advice when it comes to physical activity in the meantime? Current training:
Cardio:
- interchange between biking and running, mostly biking last 2 months due to general right knee pain
- HR between 115-145
- 3-4 x/week
- 30-45 min (try to get 150 min total/week) Resistance:
- Powerlifting type stuff
- 3x/week “heavy” days
- 2x/week GPP Worried about biking now and running has bothered my knee. Maybe trying getting my step count up (e.g., 10k+ steps)?
Avoid valsava for now? Lower intensity, higher rep count? What about squat and deadlift? Wait until profuse bleeding stops?
Thank you in advance if you can provide any advice.
If you are bleeding “profusely”, then more urgent medical attention would be recommended.
Regarding the rest of your questions, this is entirely based on your individual response and tolerance. I cannot broadly say “no valsalva” or “lower intensity, higher reps” or anything else specific with respect to programming, because I cannot confidently predict how you will respond / tolerate it. If your symptoms improve/resolve and you can “test the waters” with these things and tolerate them well, then carry on until you can get more definitive treatment.
I wish I could provide more specific advice here, but it is really a “trial and error” type process on an individual level, assuming no medical emergency is ongoing.
Hello Dr. Baraki,
I appreciate the response. I ended up going to emergency yesterday, as it was still bleeding. The emergency MD presumed the same, some sort of burst internal hemorrhoids or lesion to internal tissue. Every time I strain, it keeps opening up. CT scan and bloodwork showed nothing abnormal, discharged. Asked about training, and same thing, recommends against it as it will increase pressure and may worsen the injury. Contacted GI for the colonoscopy but it’ll be 3 weeks until they can see me.
I’ve had several injurious over time, and I’ve worked around them and never thought twice about it. This is the first injury I’ve had where I’m genuinely scared to train. What if it whatever is going on down there rips open while lifting and I just bleed everywhere? I intuitively knew it’s trial and error, similar to previous injuries, but this is terrifying. Kind of scared to even jog at this point. Doesn’t everything involve straining at some point?
I guess my question is should I lay off the training until this improves or I have it fixed? Then again, won’t it bleed anyway since I have bowel movements daily so I might as well train?
Forgot to add to that. Do you all still do those medical consults? I feel I should be paying for this sort of post…
If the bleeding is that significant, and is exacerbating by bowel movements, you should probably be on some stool softeners/laxatives and may need to hold off on intense training until they can definitively be addressed.
Thank you Dr. Baraki. Maybe yoga and walking will have to suffice for the time being. I appreciate the response.