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"The timorous may stay at home."
~ Murphy v. Steeplechase Amusement Co., 250 N.Y. 479, 483 (N.Y. 1929)



Monday, December 22, 2014

On being broken, rehab and recovery


Before I begin, let me preface that I am not a medical professional and hold no qualifications or certifications (even meaningless ones where you pay one thousand bucks for a t-shirt), and the last anatomy class I took was a 3 week unit in 9th grade biology. I am, however, a lawyer, so I know I need to cover my ass because inevitably someone may rely on this shit. So what I’m saying here is solely based on my own personal experiences, observations, and the ever trust-worthy interwebs. Follow at your own risk.

8 weeks before WTM
Injury is an inevitable part of being an athlete. It feels kind of weird to say that, for two reasons: (1) I’ve never really considered myself “an athlete”, and (2) up until about a year ago, aside from a few broken bones growing up, I’ve never really been injured. Hurt, yes – but never a diagnosable injury that has taken me out of training for more than a week or two at a time.

Within a week of turning 30 (so stereotypical, I know), the wheels began to come off. 2014 was a year of recovery/rehab from one injury, only to lead to another injury, probably resulting from compensating from the previous injury. Frustrating, to say the least.

So when people ask me how I came back so quickly from knee surgery to win World’s Toughest Mudder, I tell them – LOTS of practice. Like any sport or skill, I’d like to think you can get really good at rehab.  While a lot of it has been through trial and error (I still have a problem finding a good balance), but I’ve learned a fair number of things along this rehab journey.


My best friend for many weeks
Focus on what you CAN do. Ok, so you’re injured – it’s extremely easy to wallow in self-pity and complain on social media about everything you are missing out on. But I guarantee, in almost every injury scenario, you are not doomed to sit on the couch and waste away to nothing for months. There is almost always a way to train around it. For example - the day after knee surgery, I was on the handbike. A few days later, I progressed to the ski erg. I could still do pull-ups, push-ups, ride the Airdyne with my arms, and LOTS and LOTS of bench press. Once the wounds healed over, I was in the pool swimming with a pull buoy between my legs until I was able to kick and aquajog.

No, it’s not going to be as satisfying as your track workouts or your heavy squats. But if you’ve ever erged a 10k on a ski erg, lemme tell you – it ain’t no walk in the park. It’s going to be a different type of fitness you work on, perhaps, and you may lose a little top end, but you’d be surprised how much you can do (especially to maintain that cardiovascular fitness) when you think outside the box.

And it also keeps you busy and helps you avoid pity party, table of one.

It’s the little things. Physical therapy is kind of funny – almost any lower body injury can be traced to your hips pelvis, and glutes. If there’s one thing in vogue, it’s blaming weak glute meds. So a lot of the exercises are going to be the same whether you have a torn meniscus, a strained hip flexor, or lower back issues. PT exercises aren’t glamorous – they are boring, tiny little movements. They are time consuming. You will use, at most, a few pounds to work on the stabilizing muscles. But failing to do these things, or even stopping for a few weeks once you’ve started, can mean the difference between full recovery (or, preventing injury), and another few months on the IR.

Even when I’m not injured, I take 20 minutes most days of the week to go through a routine of
core/back/hip exercises. Prehab is the best rehab.

stiiiiiim
One size doesn’t fit all. In the world of recovery, there are TONS of modalities – your standard rest, ice, compression, and elevation, plus fancier things like e-stim, lasers, ultrasound, dry needling, acupuncture, ART, Graston, massage, electroshockwave, prolotherapy, PRP, and the list goes on. Some people swear by certain ones, but for every believer, there is a naysayer on the other side. Everyone’s body is different, so explore those that work for you. I’m lucky to live a block away from the [the coolest place ever] Chicago Recovery Room, where I can access most of these modalties on a daily basis. And through trial and error, I’ve learned a number of things – such as, dry needling is amazing on almost everything but the calves, ice baths get easier the more you do them, and the Compex stim machine plays rad music.

All the cool kids do it
Get over yourself. When you consider yourself an athlete, rehab is humbling. When someone suggested aquajogging to me as a non-impact way to keep up my cardiovascular endurance, I balked. Images of 80 year old women in flowered bathing caps sprung to mind. But I swallowed my pride, joined a Chicago Public Pool with a deep end, strapped on the oh-so-stylish blue Aquajogger belt, and “ran” laps. Did I get stares? For sure. But after a few minutes, I got over it.  #zerofucksgiven

Likewise, accept that you may have to start from ground zero. I’d been Rx’ing CrossFit workouts for years. But after knee surgery, I had to rebuild my squat from ground up. Air squats, then just the bar, then super light weight. Weights that once were negligible felt impossible. I’m still not anywhere close to where I was pre-surgery, but I’m not going to push it solely for the ego-boost of that tiny designation next to my name on the leaderboard.  

Or, for instance, being banished to the elliptical because you have to stay low impact. Look, there’s nothing more I despise and think worthless than the elliptical. And getting on it made every part of me cringe. But if it’s the elliptical or nothing, I’ll take my 90’s machine any day.

Do your research, but don’t break the Internet.  Ho boy, this is a doozy. Google any injury and/or recovery times from said injury, and you’ll find horror stories upon horror stories. A simple torn meniscus search tunrned up messages boards of people saying their knee still was painful a year post-op. It was enough to drive me into a panic – it seemed like NO ONE had a good experience with recovery. However, I had to take a step back – the people who are going to post on internet message boards are obviously the ones who were unhappy. If you had a smooth recovery and no complications, you aren’t going to waste your time posting sob stories online.

That being said, a bit of research is a good thing just to have a basic knowledge of your treatment options and the injury itself. Learn your anatomy, and how interconnected everything is. See if there is a treatment modality you are looking for available in your area. But stay away from message boards, chat rooms, and the like, no matter how alluring.

Find a good treatment team. Speaking of doing your research – take the time to find a good doctor and physical therapist (thanks Liz!) who understands your athletic background, your goals, and your chosen sport. Or a knee surgeon who understand (despite rolling his eyes), that you want to run for 24hours 8 weeks post-op.


mmm..tastes like cow hooves
There is no magic pill. Boy, I wish there was. I’ll admit, I’m a bit of a supplement fiend. The list of my daily vitamins and herbs is rather nauseating. But while probably 95% of those are worthess, but I also believe in the power of the placebo effect. Tumeric, collagen, hyaluronic acid, arnica, glucosamine, tart cherry juice, quercetin – you name an alternative remedy, I probably have used it.  And despite my pill popping, I can’t really tell you that any particular one has made any difference (I could also probably blame that on a very unscientific method of testing - the "kitchen sink" method). But if it makes you feel better to be proactively doing something, then I’m not one to judge.

You can’t outtrain an injury. I’ve tried. You can add in all the physical therapy baby exercises you want, but if you are still doing the offending activity that caused the injury (e.g., running), you aren’t going to recover.

Rest Day
Sometimes less is more. Everyone knows the ills and dangers of overtraining. But have you heard of over-rehabbing? Probably not, because I just made that up. If you are like me (and I'm assuming lots of athletes out there are), you want a solution to the problem, and you want it now. And if you hear that ART and acupuncture and ice baths can help, then you are going to TAKE IT TO THE LIMIT and do all of those things, in every spare waking minute you have (which is a lot more than you usually have, since you can't spend that time training). 

But, just like your body needs rest from training, it needs rest from rehab. Things like dry needling are great, but only within reason. Sometimes, your body just wants a break. Do nothing. I've heard (though I can't confirm), that it's excellent at healing itself. 

Find out who you are, aside from racing (or physical activities). Completely easier said than done. Over the past 3 or 4 years, so much of my identity has been completely wrapped up in obstacle racing. My friends, my social media feeds, my day-to-day all involves training and random people covered in mud. And there's a great sense of loss, of confusion, when that is taken from you. So then rather than dwell on missing that (I actually found disconnecting myself from social media to be a necessity right around my surgery), find out what else you love. Pick up a new hobby. Rediscover something you used to do or love. For me, that was picking back up my old daily New York Times Crossword habit, connecting with friends I had neglected for too long, realizing that I also really kind of like lawyering, and watching a LOT of professional wrestling. Thank God it's also football season, so I could fixate on my fantasy team get annihilated (thanks for awful season, Drew Brees) and (obviously) the Seahawks. Granted, these things can't replace the hole you feel from being sidelined, but they can certainly distract. 
Yes, you. You will be back.

Injuries happen, and I've resigned myself to the fact that, as long as I keep pushing my body this hard, I'm always going to be battling little niggles here and there. But it's about catching them early, and being smart (or, smarter than I normally am).

So here's to a happy, healthy, and injury-free 2015.  

(Now someone find me some wood.)

4 comments:

  1. Reading this makes me feel a little better about my broken crotch (groin injury) and me thinking that I'll never be able to run again. I'm 6 weeks into recovery and every day kills me a little more but this just made me smile and brought out a little hope in me. Thank you so much for this.

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  2. Really great post. I"m adding more core work/back work/hammy work to my routine to hit problem areas and hate the time it's taking, so whenever i whine about that I'll read this and think "prehab is the best rehab."

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  3. I love this post! I broke my foot in January at the Temecula Super. When ever I feel like having a pity party, I read this post. It has gotten me back to the gym a number of times. I had to start over from zero and learn a new way to workout, with one foot. I want to be in the best possible condition by my next Spartan Race. Thank you for all the motivation!

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  4. Thanks Amelia for posting this! I know that it was months ago, but it sure inspired me! I broke my foot on the ladder/wall combination obstacle at the Salt Lake City Super in June, had to have surgery and am sidelined with 3 months of non-weight bearing. All I wanted to do was have a pity party. But, I watched you on the NBC Sports airing of the Montana Sprint, and just fell in love with your story, then found you blog. You are a true inspiration out there to all female athletes!! I am so glad you were able to return to racing. Good luck on everything you do in the future!! :)

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