February 2014 – Chronically Human, Practically Healing

Chill with what my body tells me: another lesson in maturity

So I’ve been trying this new thing lately. Something I have maybe not done as much as I should’ve in the past.. and I’ve learned the hard way that doing it every once in a while is a good thing. It’s that whole “listening to and respecting what your body is telling you” thing.

Turns out mine has a lot to say.

Shocker.

We’ve had our differences in opinion, my body and I. Whether it be through injuries, spontaneous tailbone cysts, impromptu illness and food intolerances, or just reacting to the stress of what I try to pass as a sane schedule- we’ve had to learn how to learn to listen to and tolerate each other in some interesting situations. Almost a year ago now I started the journey of modifying my eating habits to better serve my body, and while there have been some ups and downs with that- I’ve been rewarded in more ways then one for my choices.

Any athlete, at one point, has to learn to deal with injuries in a more productive way then letting the injury control who they are/want to be, and I am very thankful I learned that lesson before this most recent injury. Being one of the first injuries directly related to sport that has knocked me out of commission for a long recovery, I’ve managed to not let it get into my head too much. Whether it’s maturity, or years spent figuring out coping mechanisms (are those things the same thing?).. I’ve treated myself with moderate patience so far through the rehab process, and because of that made pretty significant gains in month following my accident.

Last summer and into the fall when I was recovering from a concussion, I struggled with listening to what I needed. Anyone who has had a concussion will likely have gone through the same experiences. Tasks that were once no big deal become Mt. Everest, yet you are the only one who can see that mountain. There is no cast on your leg telling those around you that you can’t climb.. all there is is symptoms within your head that only you experience. It’s lonely, it’s depressing, and it’s scary. It is an impossible task for those go-getters among us to not try to push through those signs telling us to stop.

Going to a prof (especially one who may not know your regular personality), or a classmate, or a friend- and saying things like “studying for this exam makes me dizzy and nauseous, and I can’t follow even the simplest material…I don’t think I can do this right now” can be absolutely terrifying. What will people think of you? Will they see me as a flake? Am I not trying hard enough? The conversations I had during this period were some of the scariest of my life. Symptoms of this injury can seem so ridiculous.. until you experience them first hand. Those experiences are partly responsible for giving me some respect for what my body tells me.

Being a student in a health field brings a whole new side into things. Talk about overthinking, try knowing every possible outcome to injuries- and then having said injury, or having someone close to you have that injury. Then you will really understand overthinking. However, again maybe it’s maturity coming into play, there comes a point where you recognise that all you can do is what you can do- that’s it. Control is relative, and intuition is a fantastic thing to utilise. Being honest with yourself about how you’re doing is a really healthy skill. Not trying to micromanage yourself is another beauty of a talent.

I spent most of last week studying for the exam I wrote on Monday: Ergonomics. This is a challenging applied biomechanics course I quite enjoy, and it’s a subject I’ve chosen to do a directed study on next year with a focus on rider mechanics and fitness. That being said, I put a lot of weight into doing well on this exam- because it would be a tad awkward if I didn’t get a good mark in this course- yet wanted to pursue research in the area. I planned it so that I could spend my study time during reading week on this course, and then use the remainder of this week to study for my other heavy exam on Thursday (Exercise Physiology- not a course I particularly enjoy).

The first half of my plan worked quite well. I walked away from my Ergo exam feeling like I managed a half decent mark (for me that’s a B ish), and ended up with an A (!!!). The second half of my plan.. not so much. Over the weekend I started getting sick (viral like symptoms)- and then got better for Monday. After my exam Monday, it all came back (damn you reading week for slowing down my immune system!!!!). My whole body felt weak, headaches, dizziness, faintness, all of which got worse when I tried to study..or move.

After day two of trying to study and only making myself sicker- and then stressing myself out thinking about how writing this exam on no preparation could only mean I was a failure….I decided to listen to my body and see a doctor (What? Me? See a doctor voluntarily?). When rolling over in bed causes me to feel like I had recently run a marathon- I reach my limit. Lets not talk about how stairs make me feel right now, and that’s not even from a busted leg perspective.

Thankfully the doctor confirmed my suspicion of just a frustrating virus being the culprit (although a blood panel is being run to rule anything else out, of course).. and decided for me that anything involving school tomorrow (including the monster exam) is out of the question. Sometimes me listening to me is really just me finding someone who will indirectly push me to make the right decision for me. This is why I surround myself with wise people. They indirectly make me smart… occasionally.

Pretty much as soon as I emailed my profs explaining what the doctor had told me, and acquiring the note to back all that up if need be- I felt so much more relaxed. The monster exam seems less big and scary now that I will have a chance to prepare for it. Sometimes being a dedicated student (or athlete) means knowing when to slow down and take the time to recover so you can perform your best.

Why did it take me so long to learn this??

Photo cred to Jenaya MacKinnon of Out of Focus Photography (click pic for link)

165 minutes in the pool, and a neuropraxia (a week in the life…)

I chose to give the amount of time in the pool instead of distance, because time makes me feel way better about myself..

I’ve been in the pool as much as I planned to be this past week, and very glad I’ve found something I can do to stay active! I’m able to do more and more on the land as the days pass as well, and with plans for my horse to be moved back into training come April- I’m hoping that I’ll be fully back into some sort of training by then as well. I’m amazed at how busy I’ve managed to keep myself even while being limited in the amount of things I can do.

Swimming in the early morning before classes has been a welcome addition to my schedule, and I’ve managed to get my nutrition back on track just time time for midterm season (thank goodness). Work and clinic shifts have been added back into the schedule, and finally getting around to more of an ad for my class got done as well. That plus classes and being a patient filled up my week pretty quick!

We noticed while doing exercises with the leg on Friday that my fibula was moving a little bit too much for logical anatomical function… and decided that it might be time to get a doc’s opinion on the neural and ligament damage happening. Pain has greatly decreased, thankfully- but I’m still not quite up to full function (far from it, actually). The weekend passed too quickly, spending it with friends and teaching my FTC class at MORfit. Teaching with only being able to half demo exercises is getting super hilarious….

To start this week off I enjoyed a low-key holiday Monday, spending a good portion of it with Lauren and Megg at the pool, and then having lunch discussing some plans for our future as pentathletes. I was able to kick for a full 25m in the pool (up until yesterday I haven’t been able to use my legs at all). Today I got into see a sport med doctor, who confirmed my AT and I’s belief of destroying pretty much all the ligaments connecting my fibula to my tibia, and a neuropraxia to my peroneal nerve.

English translation: a nerve in my leg is a little bit angry/temporarily dysfunctional because of the trauma of the original accident. This would explain the loss of sensation in my lower leg and parts of my foot, and the initial difficulty controlling certain movements. Positive to this? It’s temporary, and although I’m having an MRI done anyway, he predicts it will clear up.. eventually.

The rest of my day was spent working on a poster for my class, and working. Didn’t get as much studying done as I’d hoped..but that’s what tomorrow and the rest of reading week is for I suppose! Which is unfortunately already half over… Sad face.

An early morning at the pool awaits me, so I will leave it short and sweet!

Agility for the rider: mind and body

Defined as the ability to control direct of the body, or body segment during rapid movement, agility is a commonly used training method in many sports. Agility has also become common in the equestrian world as a way to work with horses, training obedience and giving riders a fun way to work with their partners. Unfortunately, it isn’t as common to see riders doing agility training for themselves. Agility is related closely to reactivity, and any rider can appreciate the potential of being reactive in the saddle. Reaction time is the time between the onset of a stimulus and completion of the action, the stimulus could be your horse falling to the outside and your resultant action of using correction aids to re-balance around a corner.

Athletes of all sports, riding included, rely on complex neural pathways and biofeedback to keep them performing at their best. It could be argued that as agility training is meant to improve quickness and reactivity in sports where athletes are asked to do a variety of quick movements with their bodies and riders are sitting on another animal doing majority of the movement that agility isn’t a key aspect of our sport. However, while riders do have four extra legs moving us through space- riders are required to react to a variety of things throughout the course of a ride. The decision making process involved with the sport can only be enhanced by training the body to speed up the neuromuscular response.

Recent research has shown that agility like training can help improve concentration and focus in athletes (and general population). Moving your body in quick sequence in reaction to any given stimulus takes brain power- it’s something I do a lot of with my older adults class. Working on the agility ladder every week, giving them new patterns to do- they always tell me they can feel their brain working just as much as their body is- trying to coordinate their movements and focus their mind on the task.

I talk a lot about confidence and how improving fitness can lead to increased confidence. One of my favourite quotes related to this comes from Harvey Penick:

“If there is doubt in your mind…how can your muscles know what their supposed to do?”.

A rider’s reaction to any given thing while in the saddle (or on the ground or that matter) can mean the difference between a clear round and knocking a rail, or a perfect transition and a sloppy one. The horse’s performance is a mirror of our own, how can we expect them to be sure-footed and agile, if we are slow and uncoordinated with our cues. From another point of view, reaction and agility can make a big difference when it comes down to staying the tack during unpredictable incidents. Yes, there is only so much a rider can do if a horse decides to bolt, stop, rear, etc. They are large animals with their own thought processes. But a rider who has trained their body to react quickly and efficiently no matter the situation is much better prepared to make a good recovery then one who is a few milliseconds off of the movement. You find a long spot to a big oxen half way through a course- wouldn’t you rather be able to react appropriately and not be left behind, compared to the sketchy alternative?

Much of athleticism is thoughtlessly performing complex movements and making split second decisions. Often the difference between good riders and great riders is in the subtle decisions. Finding that perfect distance every time doesn’t just take an ability to see the distance, it takes appropriate timing of cues, and following through with each decision before, during, and after each jump. The same can be said for riding a dressage test, performing a reining pattern, on the endurance trail, or any other sub-division of the sport. Each has its own set of decisions to be made. Decisions are much easier to make when there is efficacy behind them.

While riders aren’t required to directly move quickly, change direction, and transition through movements- they are indirectly responsible for coordinating all those things through appropriate use of their body weight, fluidity of their joints (requiring stability), effective use of aids, and good timing. We’ve all seen riders who are lacking in any of the above qualities, and it’s not always nice to watch. Agility incorporates many factors from the body: balance, coordination, joint stability, strength, power, and flexibility. It asks the mind to focus and builds reactivity throughout the entire body as a result. If we expect it from our horses, we have to expect it from ourselves. Why wouldn’t you want it in a training program!

Oh my fibula!

Are you getting sick of my leg-injury related titles yet? That makes two of us. Well, I’m sick of my leg- not the titles. I think those are witty.

So I’m walking. The debate is out on whether I should be or not. What I should be doing is studying.. while sitting, and not moving. Instead I’ve taken up a new sport, put minimal effort into studying, and eaten more pizza in the last 4 days then I have in the last 2 years. Close enough?

Before you all panic about the whole “taking up a new sport” thing, I’ll clarify that I am not using my legs or weight bearing while participating (yet). Right now the extent of this new sport is swimming laps in the mornings, not kicking- getting a solid arm and core workout. Why have I started this?

A) I’m going a bit stir-crazy not being able to do much training, and

B) I am actually taking up a new sport: pentathlon. Yes, the one that has swimming, fencing, show jumping, running, and shooting. That one. Doesn’t it sound fun?! Long story short, Lauren, Megg, and I decided that Manitoba needs a pentathlon team, and are seriously in the process of organizing ourselves to begin training. As Lauren put it today, “it’s not if, but when..”. We will need all the help and connections we can get, so if you or someone you know knows people in any of the above mentioned sports or the pentathlon community- hook us up!

I’ve been able to go back to work this past week at MORfit, and kept up with teaching at the University. Obviously HC is still out for a while. My older adults class is very concerned about me, one knitted me get well socks last week, and this week I was cornered by a couple of them and interrogated as to why I wasn’t on my crutches, and as to whether or not I was okay. The past two weeks I’ve also been able to run my Functional Equestrian Training class, last week being a class where I demoed absolutely nothing, and this week I demoed a bit more (and immediately regretted it). It’s very cool to see those coming regularly to the class progressing as I had envisioned. I’ve noticed big improvements already in postural positioning, and absolutely love the enthusiasm I receive every time I come out with some new things to try. It’s actually getting very difficult for me to not get distracted during lectures by all the ideas I have for this class! Perfect timing for midterm season!

The past week and a bit has been fairly busy, as mentioned above I’ve started back a work and kept up with my classes. I wasn’t able to do any clinic work, although I am in the clinic every day as a patient pretty much. Either icing myself, or at one of my actual appointments. I started out the week with crutches, and then was able to progress to no crutches later in the week. By Friday I was walking pretty good, and able to start doing some balance work (and it is needed) on the bad side (after my spending 3+hrs in the clinic being worked on… all 4 injury sites got some attention). Friday night I managed to accidentally put too much pressure on the leg, and got a nice pop/mobilization at my prox. tib/fib joint, which ticked off a few things… which lead to weight bearing being problem again for the early parts of this week. Then there was yesterday when I walked into a low table in my apartment, stubbing my toe and hitting my leg on the corner…..

Sigh.

It has been getting slightly better though, each day has it’s ups and downs and new feelings, but the inflammation has stopped- all the pain now is stemming from the actual damage.. and I’m learning what bone bruising feels like… It’s not a good feel, just fyi. However, less parts of me hurt now… which I suppose is an improvement. There has been many moments where I’ve almost thought someone should stick me in a cast, or semi-permanently attached crutches to me so I don’t keep trying things above my current ability, or accidentally hurting myself.. It could very possibly make my recovery process go a lot smoother.

I’ve discovered that when I’m injured, and it’s exceptionally cold outside… All my body wants to eat is junk. I definitely ate pretty much a whole pizza last friday, the next morning survived off coffee (and I am not a coffee drinker usually..) until later afternoon where I ate BP’s pizza burger (bacon burger wrapped in pepperoni pizza…), Sunday I ate up to my usual standard, but then Monday I ate a individual sized pizza (with a large kale salad..) from the University. Seriously.. more pizza then I’ve eaten in the last year probably. No regrets though. Since Monday I’ve been eating quite well again, trying to get myself back onto the program (midterms are here…). I also finally had time and the ability to do a serious grocery shop, up until this week I was living off the bare minimum as I didn’t have the energy, time, or pain tolerance to do a good shopping trip.

Sooo what’s up for this week? Shuffling between the pool, classes, work, therapy appointments, and repeat. Oh and trying to concentrate long enough to study for my one pre-reading week midterm. Reading week…So close, but so far. Once that is over (Thursday), it’s a full week of time to do nothing! LOL JUST KIDDING, I already have my reading week full. I even have something to do and someone to see on Valentine’s day, that doesn’t involve the traditional eating Ben & Jerry’s and brownies while watching chick-flicks with Emily. Exciting! For now I’m just about to get on the bike for my 4:30min allowance… and then I have a 6AM date with the pool, my arms, and my core muscles. Yay physical activity! One slow day at a time!

Learning to walk again.. slowly but surely.

Today is the first day I’ve been able to walk almost… mostly… normal. Me being me I’ve been pushing it a bit. And regretting that. However, I have next to no limp today and that has lasted longer then it has previously (Friday was max 5 minutes before I couldn’t move again, today is close to 2hrs of limp free ambulation!).

I’ve been able to start doing some isometric work with the injured side, to try and maintain the muscles I haven’t used at all in the past week or so. Awesome how fast strength disappears, isn’t it! My strength in my ankle went from a 2/5 earlier in week to a 3-4/5 by Friday. The rest of my leg is a slightly different story. I can’t really maintain any position against gravity from my knee up right now. I tried this morning to hold my leg up (while laying in bed) and resist gravity’s pull, that idea lasted for about 5s until I watched my leg slowly but surely lose the battle and sink back to the bed. Meh, gives me something to strive for I guess.

It’s slightly weird to have gone from leading such an active life, and getting excited about things like running hill intervals, or getting a pb on my Oly lifts in between work and classes to getting excited about being able to straighten my leg while standing on it, or move my ankle pain free. This has definitely been a lesson in patience, and seeing how much most people take for granted those basic human abilities (like being able to walk, run, drive, move…). I had a similar experience when recovering from my concussion, although that was more just plain frustrating to go through as it wasn’t an obvious injury to anybody else. This, at least, people can see the disability. And I’m very thankful it is a temporary disability and that I’m surrounded by many people who are more then willing to help me with things in the meantime.

Other then leading an extraordinary gimp life, school has been going well the past few weeks. I’m starting to fall back into the routine of studying and immersing myself in my course load. While the first few weeks were full of anxiety about falling behind, I’ve found my tempo again and my classes are all covering very inter-relatable material which makes studying much more time-efficient in many ways. Right now, I think my favourite course is rehab- mainly because it involves many ideas that I’ve always been keen about in this profession. Specifically, a key focus of the course is being creative and designing rehab programs suited to a specific client’s goals and sport. It’s a course where there are many right answers to one question, and is very much about being creative with programming.

A close second favourite is Ergonomics/Applied Biomechanics. The course content is pretty heavy, but the ideas the course has inspired is what I love. The prof has also taken an interest in some of my ideas relating to my Equestrian Training programs, and suggested we pursue some research ideas I’ve had. These ideas all focus around the forces a rider’s body experiences while in the saddle (most of the current research is focused on the force a horse’s body goes through). I love that I have people within the Faculty that I can bounce ideas for my class off of and get great feedback.

Speaking of my class, it is also going really well. Tonight we did a HIIT style work out, one that I didn’t have to demo anything for. 20 minute sets of 15 squats, 10 TRX body rows, 5 TRX push-ups, and 5 burpees. It’s great to see the participants improving already even after just 3 weeks, and get good feedback on the home program I designed. They are always full of great questions to ask me, and thankfully my education has backed me up with some good answers to give.

I’m very excited for when I am back in action so I can start teaching some of the more specific exercises I have come up with. One specifically targeting stability for the rider when taking off/landing from jumps. I know I’ve had issues in the past (and still do) of getting ahead of the horse, or falling forward upon landing. The stability needed in the rider’s body to resist the pull of gravity is something often talked about, but not often addressed in training. I’ve come up with a couple exercises (integrating plyometrics and stability) to combat this habit many riders face, and am really excited to see how they work out when put to action!

During my clinic shift a couple weeks ago with Claude, I got the opportunity to do a assessment on a client coming in with knee pain. This is the second full assessment I’ve done this year, and I already had a pre-existing phobia of knees.. plus this is the first assessment I’ve done where Claude chose to pull up a chair and ask me all the questions (examples: “what muscle is that you’re palpating? Why did you do that test? Etc.).

Fantastically nerve wracking.

Anyway. I stumbled my way through my history, and ROM testing. Client was having pain around the patella, and described it as sometimes feeling stuck or blocked if she sat for too long. This all started a few weeks after she had been in a car accident. There was noticeable bruising around the knee, and minimal swelling. During the postural assessment I ran a full squat test (after standing there for a few moments being confused as to what to do next) and noticed that her entire upper body fell forward going into the squat and her heels wanted to lift off. Cue Claude asking “Ooooo so what could be causing this?” and me feeling stupid for the next few minutes. Right, tight hip flexors and calves. Here is where I really started to lose my mind. For special tests I decided to run a Clark’s and a Apley’s, after ligament testing of course. Claude had stepped out for a minute at this point, and I completed the tests once only to realise that I had done them on the wrong side (I had flipped the client over for Apley’s and gone brain dead apparently), #awkward. However, when Claude came back he didn’t realise either- or possibly he was just playing dumb to give me a chance to save myself….Clark’s was okay, as was Apley’s. Sweet.

From here I went into palpation, with a complementary anatomy quiz from the peanut gallery (thankful I aced this). Tender through the calves (achilles on the injured side was a little puffy- something I probably should have noticed during postural observation, quad and IT also were tight. A case of tight muscles pulling the patella out of whack, me thinks. Claude agreed (yayayay) and I got to do the rest of the treatment (quick massage for IT/quads and teaching stretches for the lower body) before she had to run to a vball practice. This was the same client who had come to us for a concussion initially- an assessment I also did- happy to report that she has been symptom free from that over the following weeks and has been able to progress back into her sport. Kinda cool to be able to follow a clients progress over the weeks consistently!

Anywho. Another week starts tomorrow, I am hoping to be back at MORfit working the desk for sure as the resident gimp this week, as well as the Older Adults class and lab demo-ing for P&C. And of course spending many a hour with my favourite AT working out the kinks and bruises in my leg. Ciao!

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