Aug
22
2012

Q&A: Dealing with Injury, or Comebacks!

by hillarybiscay

I often receive questions about dealing with injury and / or surgery and keep meaning to put my thoughts together into a post here! So this is actually a response to many different questions, but since reader Colleen posed a question on the topic last week, I will use hers here.

Question from reader Colleen:

I am currently facing hip surgery now and am depressed beyond anything at the thought of not being able to run etc. for a while. How do you deal with injuries mentally? Have you ever had to totally shut down?

My two cents:

I actually have a lot of experience in the realm of hip surgery and not being able to run. Back in March of 2004, I broke my hip when I ran too long on a stress fracture and developed a crack clear across the neck of my left femur. At that point in time, I had never suffered a major injury and simply did not know how to interpret what was too much pain—what to push through and what not to . . . Long story short, I ended up crawling the final miles of Ironman New Zealand when my hip finally gave out.

Since this post is about how I dealt with the aftermath of all this, if you aren’t already familiar with the above story and want more gory details,  you can read more here and here.

I ended up having a surgery the docs call “ORIF,” or open reduction-internal fixation; this meant the doc used three titanium screws to secure the neck of my femur. I was on crutches for two months. This means no walking for two months, and it was another 6 weeks or so after that until I could attempt to “run.”

2004 was to be my last year racing as an age-grouper. I had already qualified for pro status many times over, but wanted one more year to get stronger and have another crack at Kona as an age-grouper. But because I hadn’t made it to the finish line of Ironman New Zealand and ended up needing surgery, Kona was out of the question. Suddenly I was dealing with my plans and goals for the year going out the window, who-knows-how-long of no running, and certainly no smashfests of the sort that I loved.

Here are my COMEBACK TIPS based on my experience with hip surgery:

Acquire temporary amnesia about your old “normal.”

This is essential. After a surgery or the like, assume you are starting at zero. This is the only way you are gonna be able to get excited about 20 minutes on the recumbent bike at zero resistance, but believe me, that feeling is possible if you forget about what you used to do . . . Indeed this is where I started after a couple days in the hospital and then a couple more stuck in bed at home, so when the docs allowed me to do this, I was pumped! It was a step forward from zero—the first step in my comeback.

Set small goals.

I focused on just doing a little more each day—from 20 to 25 minutes on the recumbent bike, to the stationary bike, to adding resistance, and finally to the trainer . . . That was all I could control—just improving a little bit from where I was each day.

Set big goals.

While every day I would wake up thinking about what I could do that day to take myself one more step forward in my comeback, I also set big, long-term goals. These gave me motivation for, say, boring PT exercises and aqua-jogging—things like that.

My goal was to finish an ironman before the end of the year.

Focus on what you can do and max that out!

Once my stitches came out, I could get back in the water. Granted, I couldn’t use my left leg, so at first this meant everything was done with a buoy, open turns, and one-legged push-offs from the wall. Although I eventually mastered one-legged flip turns, in the beginning, I had to be happy with just doing laps like a lap swimmer. Real swim workouts were, in the beginning, a thing of the past. So every day, I did as many laps as I could! If I could do that without slowing my hip’s recovery, by all means, I was going to “swim” as much as I could and hang onto every last ounce of fitness that I possibly could.

Find another outlet for your energy.

I think the easiest way to keep your mind off what you can’t do is to keep yourself busy! For me, this meant going from about four hours per day of training to, well, starting back at twenty minutes. Granted, physical therapy can get pretty time-consuming. But to keep myself from sitting home contemplating the long run I would wish I could have been doing, I studied harder. At the time, I was in graduate school and teaching at USC. There was really no end of studying to do, and I’d skimp on that during hard training, so I poured myself into my work while I was recovering.

Expect a bumpy road.

Okay, this one is in hindsight. Once I was able to start jogging, it was not a steady progression back to “normal.” By the way, I remember my first day back and being thrilled to “run” eight minutes! But for the first two months of running, there were days when I’d limp around for the rest of the day after a run. It almost felt like I was re-injuring myself, but I wasn’t. It just took about two months after I started running for me to be able to run consistently without pain again.

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THE GOOD NEWS:

I went from not walking on May 1 to racing Ironman Florida in November—exactly 6 months later. I actually had to get my pro license just to gain entry into this race and attempt my goal of completing an ironman that same calendar year. But surprisingly, I managed to avoid embarrassing myself by PR’ing not just the distance but my ironman marathon as well; I finished 10th out of 21 pros and decided I’d stay in that category from then on!

{ 7 comments… read them below or add one }

Jenny August 22, 2012 at 7:45 pm

Good links, good tips! This stuff is confusing and hard – I ran my first ever half-marathon with an agonizing pain that I did not know was a stress fracture in 2 places in pelvic bone (I think the second was the result of changing gait some weeks earlier in response to the very painful first!), your point about the pleasure and relief of running, say, 10 minutes very easy during comeback especially rings true with me..

Reply

Pearson Smith August 23, 2012 at 10:57 am

Hilary, as a reader of your blog, I did not know you had this injury. As a runner who suffered through some of the same emotion this January, the stress fracture in my right hip seemed to be the end of the world. Perspective is something that I have drawn from the recovery and I will never forget the moment I decided not to do a half-marathon, a week after the hip had been plaguing me. Depression overwhelmed me. Day by day, I re-adjusted my mental boundaries, a method to coping you have proposed. 3 months later, 8 minutes of running was a blessing, aqua jogging was acceptable in my world, and now, back on the road, pushing hard is a blessing. Thanks for sharing your story.

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Paul Thomas August 23, 2012 at 12:25 pm

Hillary,

After reading a a few of your blogs, I am kicking myself in the ass for not consulting with you on various topics that have bewildered me. Your ability to connect with the everyday athlete via your writing style is awesome.

Can’t wait to read more! In the meantime, “keep it lean!”

PT

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lucy francis August 23, 2012 at 1:08 pm

I also struggled with an injury last year that took ages to be diagnosed as a stress fracture (in the hip bone too – inferior pubic ramus – horrible!). I couldn’t run for 8 months and totally identify with the dispair of not being able to train/race and ahving several DNS against my name.
I agree that once you concentrate on recovery and on a gentle but gradual return to training you start to see the light at the end of the tunnel.
And this is what’s important to remember “you will recover fully and one day you will be back to normal”.
Today on my hilly run, whilst huffing and puffing, I actually tought to myself:” last year by this time I couldn’t do this, what are you complaning about? be grateful!”

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Jim Reed August 24, 2012 at 5:43 am

On Dec 4th, I finished my first Ironman, in Western Australia. I registered for the event with a suspicion that things weren’t good in my right shoulder, and that I needed a significant goal to focus on to motivate recovery. Ended up having total rotator cuff reconstruction, decompression, bone spur removal, and bicep tendon reattachment. Spent 10 weeks sleeping in a recliner, wearing ice packs continuously before I could do any effective training again.

When I was able to train, all focus was toward smaller goals that would lead to finishing the Ironman. That I had registered for an Ironman was kept quiet among my regular training partners to keep the stress down; it was MY event. Every distance and pace improvement was documented and used as motivation to step up. I also had a great coach to help prepare my head for the event. There were setbacks during the recovery, but by early November, it was becoming clear that a finish was very much within reach.

Without having a goal, I am sure my recovery would have taken much longer.

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Robyn May 24, 2013 at 6:01 am

I never post on sites like this, but this one I had to . You and are have very similar injuries and I am so glad to know you got back to your old self so quickly. I also had a left hip stress fracture that I continued to run on and suffered a total displaced femoral neck fracture in March of this year. I won’t share the gory details of my story, but it was a very traumatic experience for me . I also had an ORIF after my injury, was on crutches for 6 weeks, and am finally getting back to my old self now. I have my 3 month follow up soon and am hoping to run again. Thank you so much for sharing this, I can not wait to run again and it is great to know your story.

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hillarybiscay May 30, 2013 at 6:49 pm

robyn! so happy to hear this was helpful. i feel your pain sister! you are one resilient athlete and i hope you get the “go ahead” very soon! thanks again for writing.

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