Walking The Road With Injury

Injury.  Nothing takes the wind out of an active life quite like injury.  Injury doesn’t care about your race calendar, your personal goals or your vacation plans.  It exists as one of those unpredictable “gotchas” in life, always seeming to strike at the most inopportune time… like early spring: when the event calendar is just starting to look up.

“Life is what happens while you are busy making other plans.”
– John Lennon

The company I work for decided late last year to put together a relay team for The Pittsburgh Marathon and asked if I’d be interested in running. I was happy to.  I’d run 6.3 miles on a relay team last year, and was being tasked with the same leg.  I was looking forward to the event – mostly because of how the event highlights the city.  The experience of seeing thousands of strangers cheering on runners and encouraging them to “keep going!” is truly wonderful.

This was what I was really looking forward to.  I’m not a fast runner, but like most in the GoRuck family, I’ve built up my stamina over the years to where 6.3 miles should not have been an exceptional challenge for me.  After completing my 2nd GRC just a month prior, I had aspirations of completing my leg of the relay and running straight through to the end (~16 miles total), but life had other plans.

The GoRuck Challenge leaves ALL its alumni with is the understanding that we are capable of far more than we ever imagined.  That realization is something I wouldn’t trade for anything, but it can come with pitfalls as well.  Specifically: the tendency to over-train.  I haven’t tapped my contemporaries for consensus on this, but I’d be willing to bet that I’m not the only one who has ramped up their training intensity in the weeks following a Challenge.  When you see what you’re capable of, it makes you want to do more in your day-to-day training.  That feeling of “I can do anything” is a great one to have, but our bodies don’t always get the memo.

In the three weeks between my April GRC and my slated participation in the Pittsburgh Marathon, I ramped up the intensity of my workouts.  Longer runs, more intervals, and so on.  I felt great at first, but in hindsight I believe it was too much, too fast. A week prior to the marathon I had to cut a scheduled run short 1/2 way through, because my knees had had enough.  Dull, burning pain all around my knees and stiffness that worsened with every stride stopped me dead in my tracks.  I wouldn’t be going any further that day and I knew that my plans for the following Sunday had suddenly gotten a lot more interesting.

The week of the marathon now meant light workouts, lots of stretches, lots of ice and a few chiropractic visits for me.  I almost convinced myself that I’d be just fine, but on some level I knew I wouldn’t.  I taped my knees up well, but even so, my supplies for the day would include ice packs and a knee brace.  My cell phone was coming with me on the run as well.

I would discover on this day, that dealing with injury during an event means navigating The Five Stages of Grief.

The ‘Denial’ happened the moment I took the trolley car to the start line, and it would only take me 1/2 a mile past there.  I took it slow early on, and really felt fine at the start.  I was beginning to delude myself into thinking the day might go as planned… then ‘Anger’.  The 1st little jabs of knee pain inside of 1 mile told me things would NOT be going as planned today.  Cursing through IT band stretches and making my 1st stop at a med tent segued right into ‘Bargaining’. “C’mon knees!  Don’t do this.  Just suck it up for one day and we’ll take a few weeks off from running, ok??”  Injury has no interest in bargains though, so the transition to ‘Depression’ was quick, and it would follow me for some time.

It was a beautiful May day in Pittsburgh, and all around me people were achieving their goals.  Smiling faces from volunteers and other runners were little consolation to me at this point.  “I can’t believe this shit.  This had to happen NOW?  I had so many events I wanted to do this summer!”  Injury doesn’t give a damn.  Runners and walkers who were much earlier on in their fitness journeys than me began passing me by the dozen. The day’s “run” was over for me, as my knees seized up and slowed me to a limping walk inside of 2 miles.

I was well into the ‘Depression’ stage at this point in the game and I knew, of course, that our relay team’s time was completely shot.  I briefly considered withdrawing from the race, and made some calls to that effect, but somewhere around mile 3, as I limped to the 2nd med tent of my leg, ‘Depression’ dissolved into ‘Acceptance’.  “I can still walk.  I’m a HEALTHY man.  The sun is shining.  It’ll take some time, but I’ll heal.”  As people who had suffered injuries far more egregious than my own began passing me, and the “I run for Boston” shirts jogged by in increasing numbers, perspective finally paid me a visit.  Things could be SO much worse.

I had a medical volunteer wrap a bag of ice tightly to my knee and I made the decision to limp the last three miles to the end of my relay leg.  I sent my teammate on his way by way of a phone call at this point, both of us knowing that our time as a team would now no longer be counted.

The rest of my trek through the streets of Pittsburgh on this day would leave me plenty of time to think about recovery, loved ones who are suffering (and have suffered) through injury and illness far worse than mine, and how others have dealt with injuries of their own.  As I neared the end of my leg, virtually all runners and walkers had passed me.  The few of us that remained saw our scenery slowly transition from cheering supporters, to volunteers cleaning up and closing down their stations.

When I finally arrived at my relay exchange point, it had already been torn down.  Not the triumphant finish I had hoped for, but at this point, I was OK with it.

As fate would have it, in the days following the marathon I found my way to a GoRuck Facebook group dedicated to rehab and recovery.  Here I ran into Mark Robinson – someone who’s knee had suffered a much worse fate than either of mine.

I learned that Mark was not only recovering from severe injuries of his own, but his work as a Physician’s Extender at an orthopedic sports medicine facility afforded him a unique perspective on injury and what it takes to recover from it.  I asked Mark to offer some insight into his injury and his work, and he was happy to do so.  I couldn’t be more grateful that he was.  The following are his words:

My Injuries

Posterior Cruciate Ligament tear, Posterior Lateral Corner tear, Medial Collateral Ligament tear, Popliteus muscle avulsion, Medial tibial plateau impaction fracture, medial meniscus tear. (basically a true blown out knee)

Mechanism

Front flip that landed short, All my weight forced my knee backwards while coming down from about 6 feet.

Outlook

My outlook has always been “Eye on the prize”.  It didn’t matter what I was told, it was always balls to the wall, 100% of the time. No feeling sorry for myself. Shit happens.  Once you are allowed to restart, move on, keep moving and never look back. I now am a great example for patients, friends and co-workers. No excuses, no one can stop you but you.

Doctors & Surgery

At first, my knee was so unstable I couldn’t straighten it with any weight on it or it would shift and give out on me.  Because of this, the first doctors I saw were from the practice I work for. These people are bad asses at what they do, and they looked at me and told me they only see this severe an injury once every 8-10 years or so. They were surprised I didn’t blow out the artery and nerve in the back and lose my leg. They told me they would be experimenting on me if they did surgery on me, so they referred me to Rush in Chicago. I got the surgery 1.5 weeks after the injury. I was told if I waited too long (longer than 3 weeks) I might have lost my leg. My joint fluid was leaking out the back of my capsule into my soft tissues (not good). I had 4 surgeries within one year. The doctor in Chicago referred to me as the “nut-job”.  He is an awesome dude and I praise and thank him every day. I went sky diving 3 days before my 3rd surgery and ran a 7 mile race 2 days before my 4th surgery (I think that is the definition of a “nut-job”).  He knew I would not be stopped. Never did I have a doubt or a negative thought, and if one started creeping in my head, I would promptly punch it right in the throat.

Rehab

We see a lot of girls that tear their ACL’s in the clinic. They are up to 9 times more likely to tear the ACL than a guy (for various reasons). When they come in it is like ground hog day (same thing every time). Some break down and cry like their life is over, but there are some that get that little twinkle in their eye and basically are saying “bring it on and let’s get this recovery started”. Those are the ones that get back within 8 months and do great. The ones that pity themselves and completely talk themselves out of their sport and their social network are the ones that take up to a year or more to get totally better and they have more pain with recovery.

I have a little soap box every time one of these athletes come in. I tell them that I know exactly what they are going through due to my own injuries. I tell them to go ahead and feel bad for yourself and cry if you need to for the next 24 hours. But after that, realize you are an athlete and cannot be stopped. This is just one of those road blocks that, after it is all said and done, will make you stronger as an athlete and a person. If you weren’t training to better yourself before, both physically and mentally, then let this be your eye opening experience, and when you come back, you will be a force that cannot be stopped. Through true adversity do we build character.

While I was doing physical therapy, there was a guy that was involved in a work injury.  He was in a fire and lost his right hand and sight in his right eye… he was pretty badly burned on his right side as well. I loved talking with him because he took the attitude that “I’m just thankful I’m alive and I have another hand and another eye to use”. He would set these crazy goals in therapy, despite the therapist trying to get him to aim a little lower.  Sure enough, he would work his ass off and reach those damn goals!

I have so much more respect for the human body and human spirit now.

I live with mild pain every day and I honestly love it. It reminds me how far I’ve come and how much a human body can take. I also realize that if I wasn’t in good shape, this injury could have turned out a lot worse. But I always told the therapist when they were trying to force my knee back to break up scar tissue, “keep pushing! If I pass out, then great… push it all the way, because I won’t feel it!!!” I never passed out, but came damn close quite a few times.

Fun Fact

about 10 days after my last 3 surgeries, I would leak about 100 ml of synovial fluid out of my scope holes.  When I was in therapy I could feel them bust open and the fluid gush out, but I could have stopped forcing it if I chose.  If I stopped, then I would not have gotten the motion back. I still am lack a good 15 to 20 degrees of flexion in the injured knee compared to the other side, but it works and that is freaking sweet!!!!

– Mark Robinson

Mark’s words were probably the best medicine I could have asked for.  I don’t know the extent of my injuries at the time of this writing – I’ll find out in about a week – but I have reason to believe that it isn’t anything that a few months of healing won’t fix.  Regardless of what my diagnosis holds, I needn’t look any further than Mark’s example to show me how the process should be handled.  Whatever is ahead can be bested with the right attitude and a dogged determination to keep moving forward, no matter what the future has in store.