The Work Behind the Work · Kona 2026
In December, Lisa Perterer had vascular surgery on her right leg. For two months she wasn't allowed to get her heart rate above 90. In April, just as she felt fit again, she crashed her bike on the same side.
In October, she finished 6th at the IRONMAN World Championship.
This is the story of that comeback, in Lisa's own words: what went wrong, what she did about it, how LEVER fit in, and what any athlete coming back from surgery, a crash or time off can take from it.
6th IRONMAN World Championship 8:52:53
10 Months from surgery to Kona
90 Max heart rate for 2 months after surgery
5:00/km On LEVER by week 2 from 8:00/km on the ground
1The Comeback Map
Ten months, one surgery, one crash. Here's how it unfolded, and where LEVER came in:
2024 to 2025Two years of pain nobody understoodWhenever she ran hard, a strange pain hit her right leg. She had to stop for 10 to 15 seconds to let it settle before she could keep running. On the bike she could compensate. Running, she couldn't."...everyone was thinking I was getting old or whatever, I get slow, but no one really understood my pain I have in my right leg."
November 2025A win, then a diagnosisAfter winning IRONMAN Cozumel, she went straight to the Netherlands. The diagnosis: iliac artery endofibrosis, in both legs, much worse in the right.
December 2025Surgery on her right legShe chose surgery on the right leg, knowing the recovery would be long.
The next 2 monthsHeart rate capped at 90No training. Not even an easy walk that would push her heart rate past 90."Like I had never done this in my life, like two months off from moving, you know?"
Back to running8:00/km at a heart rate of 120Two months without training took its toll. On the ground, even 8:00 per km sent her heart rate to 120."I was like, I don't like that."LEVER: 6:00/km in week 1, 5:00/km by week 2
April 2026Fit againFour months after surgery, she felt ready for an IRONMAN. Only an illness held her back."I think, yeah, I felt fit in April."
End of April 2026The crashShe crashed on her right side, the same side as her surgery. A big swelling on her hip turned into fluid in her quad and a muscle edema she kept running through."I would just keep going. I would say, ah, it's going away, it's going away. But it got worse and worse..."
IRONMAN HamburgRacing in pain, and her best runThe day before Hamburg, she couldn't run across the street. She raced anyway, and ran her best run there."...what helped me to run sometimes pain-free, I ran a lot on the LEVER, especially my longer runs..."LEVER: longer runs, pain-free
October 20266th in the worldTen months after surgery, she finished 6th at the IRONMAN World Championship in 8:52:53.
2Same Heart Rate. Two Minutes Faster per Kilometer.
This is the clearest picture of how LEVER helped Lisa come back. In her first week back, at a heart rate of about 120, she ran 8:00 per km on the ground and about 6:00 per km on LEVER. By the second week she was running 5:00 per km on LEVER.
Lisa's first two weeks back
Running speed after 2 months off
Week 1, on the ground · 8:00 per km (heart rate ~120)Her starting pointWeek 1, on LEVER · 6:00 per km (heart rate ~120)2 minutes per km faster, same heart rateWeek 2, on LEVER · 5:00 per kmAnother minute per km faster, one week laterBars start at zero. Paces from Lisa.
"So I was using actually the LEVER system a lot to recover from that because I could just run faster with a lower heart rate, and which also gives me more motivation and just gives me my fitness back very fast..."LISA PERTERER
Learn moreWhy your heart rate shoots up after time offWhen you stop training, fitness drops quickly. Your heart pumps less blood with each beat, so it has to beat faster to do the same work. That's why an easy jog can suddenly feel hard and push your heart rate high.After some surgeries, doctors also set a heart rate limit while you heal, like Lisa's cap of 90. Taking some body weight off lowers the effort of each step, so you can run at a more normal pace while staying inside the limit. And as Lisa says, running at a real pace again is a big boost for motivation.•Follow your medical team's limits first. They set the ceiling, not your watch•Use support to bring pace up while heart rate stays in range•Reduce support as fitness returns, week by week
3Is It More Than a Niggle?
Lisa ran through two problems longer than she should have. Tap the one that sounds familiar:
Pain or a "dead leg" only at high intensityWhat Lisa had for two years · tap to open
Sounds likePain, weakness or numbness in one leg at hard efforts that goes away within seconds of stopping
Could beA blood flow problem like iliac artery endofibrosis, common in cyclists and triathletes
Why it's missedThe leg looks normal at rest, and many tests are done at rest
Do thisSee a sports medicine doctor and mention it only happens at high effort
Swelling that won't go away after a crashWhat happened after Lisa's crash · tap to open
Sounds likeA big bruise or swelling that spreads, or new pain nearby a few days later
Could beFluid collecting in or around a muscle, like Lisa's quad edema
Don'tAssume it will go away on its own if it's getting worse
Do thisGet it scanned early and adjust training while it heals
Fitness gone after time offLisa after two months without training · tap to open
Sounds likeEasy pace feels hard and heart rate is much higher than normal
MeansNormal deconditioning, not a sign something is wrong
Do thisBuild back gradually. Reduced-load running lets you run at a real pace while effort stays low
PatienceLisa says even a comfortable one-hour run took a long time to come back
This is general information, not a diagnosis. If something doesn't feel right, see a doctor or physio.
Come back like Lisa
Run at a real pace while your body catches up.
LEVER turns your treadmill into a body-weight support system, the same tool Lisa used after surgery and after her crash.
Shop LEVER4Three Ways Lisa Used LEVER
After surgery Fitness back, heart rate down About 6:00 per km at a heart rate near 120 in week 1 (8:00 on the ground), then 5:00 per km by week 2.
After the crash Pain-free running Much of her running moved onto LEVER, especially her longer runs.
Every week Mileage and leg speed Easy and recovery runs after hard run days, plus short fast reps to get her turnover back.
"...I focused more to get back into, like, more mileage, like, on, like, easy runs or recovery runs after a hard running day. Or to do, like, speed work, like, probably 30 seconds that I just learn how to move my legs fast again, my turnover."LISA PERTERER
And the session that made her feel like herself again:
1Minute on, minute offLisa's session · getting your speed back
SupportAbout 8 kg off
Session3 sets of 10 x 1 minute on, 1 minute off
OrThe same thing with 30-second reps
Why"I think this gives me the feeling to run fast again."
Short reps with a little support let your legs move fast without the full impact of every landing. For most runners, 8 kg is roughly 10-15% of body weight.
5Her Kona: How the Day Felt
Swim54:33About 3 min behind the leader
Bike4:43:534th fastest among the top 10
Run3:08:308:52:53 finish
Splits tell you how fast. Lisa told us how it felt. Here's her day, moment by moment, in her words:
The swimHigh"Last year I lost over six minutes or something, and this year was, I mean, three minutes or so after Lucy."
Start of the bikeLow"I feel like crap, but I still stick to my plan and try to just push the first 15 to 20K."
After 20 km on the bikeHigh"...surprisingly, after that, I find a good rhythm, and I could really, like, put the power down I wanted."
Coming down from HawiMixed"...I had some down points that I think maybe I pushed a little bit too much. But it changed again."
End of the bikeMixed"I slowed down a little bit in the end, but not because I felt tired, because I was scared of the marathon..."
First 5 km of the runHigh"...changing to the run, I felt great. I was, like, probably too great."
Running up PalaniLow"My legs were just not there anymore. And I knew it was going to be a long way to the finish."
Running with Imogen SimmondsMixed"But it was nice to have someone."
The last 2 kmLow"...I think I just got very scared of it happening to me. And I just wanted to finish this race."
The finishMixed"And I was happy finishing, but at the same time, I was a little bit disappointed about myself."
Learn moreWhat Lisa's day teaches about racingEvery long race has highs and lows, even for the world's best. Lisa felt terrible at the start of the bike and great 20 km later. She felt great for 5 km of the run, then her legs went. What matters is not panicking in the lows and not overspending in the highs.•Bad patches pass. Her worst moment on the bike turned into her best rhythm•Feeling "too great" early is a warning. Hold back in the first kilometers of the run•Run by feel, not the watch. Her #1 tip, below
"...to not focus too much on the time, just focus more how you feel and listen to your body..."LISA PERTERER, HER #1 RUNNING TIP
6Lisa's Mental Toolkit for Coming Back
The physical comeback took months. Here's what kept her head in it:
MINDSET 1Believe you'll come back"And I know if I keep mentally strong and I believe in myself... I know I can come back."It wasn't her first injury. Remembering past comebacks gave her proof.
MINDSET 2You're more than your results"...life is not just about always performing."She found other things to enjoy while she couldn't train.
MINDSET 3Rest is earned"...I was telling myself I really deserve this break..."After a big season, she treated the time off as something her body needed.
MINDSET 4Remember why"I knew I made the surgery to be faster again and not slower."The surgery was a step forward, not a setback.
"...it gives you also the possibilities to work on your weakness. If it's mental weakness or whatever, strength weakness or something..."LISA PERTERER, ON USING INJURY TIME
7Steal Her Race-Ready Test
Close to a race, this is the workout that tells Lisa she's ready:
15-4-3-2-1Lisa's session · Ironman and marathon runners
Session5 km, 4 km, 3 km, 2 km, then 1 km
StartThe 5 km around Ironman pace
Rest1 km easy between each rep
BuildEach rep a little faster than the last
Ready?If you still feel fresh on the final 1 km, you're ready to race
8What's Next
After a mental break with no structured training (and, in her words, a six-hour ride just for fun), Lisa plans to race T100 Dubai and IRONMAN Cozumel, where she won last year.
More miles. Faster recovery. Fewer setbacks.
