How to Avoid Muscle Loss and Fat Gain After Surgery (Full Protocol)

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What Happens to Your Body When You Stop Training After Surgery

A lot of times what happens when people go through a period of forced inactivity like surgery they get hurt, some type of injury or something of that nature, what ends up happening is they don't necessarily lose all this muscle, what happens is they get fat. The muscle loss is slower than people expect. The fat gain is faster.

That mismatch comes down to the fact that muscle tissue is defended by your body while body fat is not.

When you stop training, your muscle does start to decline, but on a timeline measured in weeks, and the first thing you lose is not contractile tissue but glycogen and the water bound to it, which is why your arms look flat four days after a knee surgery even though nothing structural has changed. Your body is slow to dismantle something it spent years building.

Fat gain has no such protection. The moment your daily output drops, every calorie above your new requirement goes somewhere, and it goes there within days.

The part of your daily burn that collapses after surgery is not the part most people think about. Training itself might only account for 300 to 500 calories a day. What falls off a cliff is everything else: walking to your car, standing while you cook, fidgeting, carrying things, taking the stairs. The term for that is NEAT, which stands for non-exercise activity thermogenesis, meaning all the movement you do that is not formal exercise.

For an active person, NEAT can be several hundred to over a thousand calories a day, and surgery takes almost all of it at once.

So you lose the gym session plus the twelve thousand steps that surrounded it, and your appetite does not get the memo.

Because you're less active, because you're not training in the gym, you don't modify your diet to fit. You eat the way you ate when you were lifting four days a week, and the surplus shows up on your waist while you are sitting on a couch with your leg elevated believing you are doing everything right.

Protein stays where it is, because protein is the signal that tells your body to hang on to tissue it is not currently loading, and during a period where you cannot train, that signal is doing most of the work by itself. Carbohydrates are what you cut, because carbohydrate needs are driven almost entirely by activity, and your activity is gone.

You're going to require a significant less amount of carbs, obviously you're going to need to maintain your protein intake.

Fat intake I would keep moderate rather than slashing it, because it supports hormone production, and your hormonal environment is already taking a hit from the stress of surgery and poor sleep.

So you should be recalculating, remeasuring and tracking your weight, your body fat as you're going through this period of inactivity to mitigate the fat gain that would come from you not adjusting your diet. Not once at the start. Every two weeks, because your activity level keeps changing as you recover, and the number you set on day three will be wrong by week four when you are walking again.

But there are things that you can do to at least stay active so you don't get fat.

Train what is not injured. A shoulder surgery leaves you with two legs. A knee surgery leaves you with a full upper body and a working arm bike. Isometric contractions on the injured limb, where you tense the muscle without moving the joint, keep some signal going once you have clearance. And if you can walk at all, walk, because recovering NEAT is the fastest way to close the gap.

The guys who come out of surgery looking the same as when they went in are not the ones who healed faster. They are the ones who treated the eight weeks off as a cutting phase with a medical reason attached.