Sunday, July 20, 2014

The Art of Injury Recovery - Yes there is an Art to it!

Lately, my favorite motto is - I'd rather my body be hurting because I'm using it rather than it be hurting because I'm not.  Pushing your body in athletic endeavors provides great dividends but the down-side is that sometimes injuries happen.  While our bodies are made for action, maybe born to run, bred to swim or conditioned to bike, eventually we push it just a bit too far, train a little too hard, ignore warning signs, and neglect preventative therapies.  Fortunately or unfortunately, some athletes get very good at injury recovery - like me.  I'm almost a profession injury "recoverer."  Here are some things I've learned.


A few years back, in early 2010 I had been enjoying a great season of training, racing and improving performance.  I was in my early 40's at that time and felt like I'd been born again into a new running career as a master athlete and I felt invincible. After a long year of racing that included a Half Ironman, a bike race, 5 half marathons, some 10K's, 8K's and 5K's and even a road mile, all without even a hint of injury, I began setting my sights and training on a particular early Winter half marathon "target race."  The previous races were strength and confidence builders but the target race was serious.  Preparation went well until a few weeks before when I felt a weird pain in my left Achilles tendon during the cool down of my speed workout.  "No problem," I told myself.  I'll lay off a few days, let it recover, and I'll be right back to full training without anything lost.  The problem was, when I tried to run a few days later it was absolutely no better.  A few more days off and then another try, and the pain remained.  I remember feeling panicked as my race, my precious, serious targeted race was only a week away.  Was I losing the fitness I worked so hard to gain?  Was I even going to be able to run?  In the end and to make that particular long story a bit shorter, I did not recover from the injury but attempted the race anyway.  I ran 4 of the 13.1 miles, pulled out of the race, limped and dragged my devastated self back to the starting area and spent the next 8 months trying to recover from this simple little Achilles injury.  Eight months.  Eight months of laying off, thinking I was letting it heal, trying to run, trying to run through the pain, having to lay off again and again and again.  Before long I wondered if I'd ever recover. 


Finally it did in fact heal, however I can't say it healed well.  Fast forward only 4 short months and one day during one of my interval workouts on the track, I felt a pain develop in my Right Achilles.  Different leg, same exact injury.  Apparently my Achilles heel is my Achilles heel.  But surely I would address this one a bit smarter having learned a thing or two from the previous year.  Nope.  I had the same experience and attempted the same things to recover from this new injury.  And I had the same result only this time, 8 months came and went and it still had not healed.  Every runner will relate to the absolute mental and physical anguish that comes with injury.  The inability to do what you love, an isolation from your training community, a fear of what the future holds, anger every time you see someone else run happily and pain-free down the road, sadness at watching opportunities pass you by while you're side-lined.  Particularly for a master runner, you begin to look at the passing months as parts of your running life you will never be able to get back.  After close to a year of this anguish, I finally turned to John and said, "I can't do this anymore.  I can't hurt, I can't try to train through it, I can't wait for it to heal, I can't discipline myself to get better.  I need help."


Particularly with sports related injuries that were somewhat obvious, I wasn't one to go to a doctor.  With what I was suffering with, I told myself time and again, there isn't anything anyone can do to make this better.  It just needed to heal.  With that mental obstacle standing in the way of me and running, I needed to therefore resign myself to the hope that maybe there is something that can be done, someone who can help.  This led me to the doorstep of "one of the best discoveries" I have ever had as a runner.  Dr. Ernie Ferrel. 


There was one thing I knew about this injury (and the one prior), it had a cause.  I wasn't interested in therapy.  I was interested in full healing and prevention of further injury.  Dr. Ferrel did his first evaluation and  in doing so squeezed the area that had been injured for almost a full year - and I almost went  through the roof.  It was still acutely injured and tender.  His evaluation revealed a leg length discrepancy, which could be considered a "cause" but because he thinks the way I hoped he would, he knew there was another reason why the legs were off.  I had bio-mechanical imperfections that over time caused a chain reaction.  And there were causes  to the bio-mechanical imperfections.  Not only did the Achilles need help to heal but other areas needed work.


The first thing Dr. Ferrel did was pulled me completely off of running.  I had attempted many lay-offs from running with no good results (which always therefore tempted me to just run through the pain), but he needed me to discontinue the aggravation to the injury.  He was not going to allow me to run again until this thing was well under control and also until the area of cause was also under control.  So I followed instructions but the difference was that this time there was a plan and a purpose and I wasn't relying on my own discipline. I felt like this lay-off was going to be different.


Within a few weeks, with all of his arsenal of tools to heal, and his knowledge of anatomy, physiology and the mind of an athlete, experience with the highest level of athletes, Dr. Ferrel worked what I considered to be a near miracle.  How long had I tried to work through this stubborn injury?  And within a few weeks there was clear progress.  The Achilles was in bad shape and whatever prior healing had taken place was not functional.  I had developed scar tissue that was in fact non-functional and restrictive.  Left to heal as it had been, I might well have ended my running career.  Instead, I was infused with hope and confidence as Dr. Ferrel had me back on my feet and training for my next race.


That was over two years ago.  As much as I'd love to think I am invincible, I certainly learned that I am in fact NOT.  My plan is to train and to train hard.  I have goals as a runner and I'm going to pursue those.  So ... Dr. Ferrel is an integral part of my training plan now.  Two and a half years later I am still and regularly in Dr. Ferrel's office.  I have benefited 100 fold for this very smart decision.  I batter my body and Dr. Ferrel basically puts it back together or helps keep it together - some of both I think.


Recently, as mentioned in my last post, I did in fact injure my left Achilles once again.  This was the same one (the original one) that took 8 months to heal last time and when it finally did heal, it had healed badly.  Re-injury was somewhat inevitable. 


Here's the reason why I write this post today.  I injured the left Achilles two months ago - my fault totally and I knew I was pushing it too far.  Today (two months later) I am running hard again.  With the help of this amazing doctor who not only knows what to do, but cares about this patients, cares about our efforts, goals, hopes, who himself is an athlete and a coach, we caught it early, dealt with it properly and the outcome has been amazing.  I have not had the words to express the gratitude as I feared the worst would again happen, but instead the best has happened.


What I have learned in the process:
1. I do not have the discipline within myself to NOT run when I need to not run.  I need someone who I trust to tell me not to run and tell me when it's ok again.  I need that.
2. To get the full benefit of injury treatment and prevention, it needs to be a part of my training plan.  I go 2-8 times per month without fail and I see this as just as important as my long run, my cross-training, my mental preparation, my quality workouts. 
3. If you want to heal, you have to let go of the control you think you have and give it to the one who can help.
4. Do everything Dr. Ferrel says to do.  I keep a training journal for Dr. Ferrel and myself and it reflects not only what I am doing but how it is affecting me and it is used to gage the next move.
5. Don't just get treatment when you're injured.  Get treatment as part of your recovery and to prevent injury.


I would like to thank you Dr. Ferrel from the bottom of my heart.  As hard as it has been to deal with yet another Achilles injury, it is behind me so quickly that I can almost be thankful for it.  Yes, I missed some races and have had to sit on the side-lines for a bit, and yes I'll have to work hard to gain back what I might have lost but I also learned how to heal properly, I was forced into an off-season that I needed anyway, I have gained confidence, I have had my hunger for running re-charged.  I'm getting older and wiser I guess.