• Injured ribs and back – Part III minimizing fitness loss and back to 100% from hurting, timid and fearful

    Hurting, timid and fearful

    Litmus tests

    Breakthrough days

    Minimizing fitness loss

    Patience, persistence, progression

    This is the final post in a three-part series. In the last post I outlined some of the principles I followed for the healing process. In the first post of this series I wrote some about the mental and physical process of healing. For Part III I want revisit those two aspects and how they work together to get back to pain-free, confident and fearless.

    Hurting, timid and fearful

    Anyone suffering an injury expects pain in the area of injury. What we don’t expect is pain in places or with movements seemingly unassociated with the injury. I expected pain in my back, ribs and lower shoulder blade (scapula) area. I did not expect pain in my arm, in the deltoid and triceps area.

    I had the most pain in my arm, back and ribs rolling over in bed, getting up off the sofa, picking something up off of the floor, putting something with a little weight into the cupboard, pulling myself up into the car and restraining the dog. Other movements did cause some pain, but these were the big attention-grabbing ones.

    About a week or so after the crash, I caught a glimpse of myself in the mirror while walking. I noticed my posture was terrible! I was somewhat hunched over and leaning to the right. It looked like a protective stance and I’m sure it was just a natural reaction to injury.  

    Good posture didn’t hurt at all, so I immediately began to focus on good posture and alignment when walking or sitting.

    The thought of planning anything into the future, like a ski day, brought sadness and fear to mind. How could I possibly go skiing if I have the movement pain described above?  

    Litmus tests

    I did want to ski at some point in the season, if possible. What I didn’t want to do is try to ski before the ribs were healed and muscular pain was gone. But when will that be?

    It is common knowledge that bruised or cracked ribs take some four to six weeks to heal. Time goal number one was ski no earlier than four weeks post-injury.

    In order to give myself permission to ski, litmus test number one was pain-free normal activities. I needed to be capable of doing all normal daily movements pain-free. Test number two was the ability to jump, doing my basic plyometric routine, with no pain. I thought if I can jump confidently, I can ski.

    It sounds strange, but in order to ski, I needed to be able to fall and not worry about falling. This was litmus test number three, though it was quite subjective.

    Breakthrough days

    In Part II I mentioned that I received manual Muscle Activation Therapies (MAT.) Seventeen days after the crash, I received my first MAT treatment from Sherri Goering. I explained my crash and the seemingly unrelated pains I was getting with arm movements. She did a resistance evaluation on both legs and both arms. She would ask me to position my leg or arm a particular way and then press against her hand. I could feel that in some positions, I could not resist very well and sometimes one side or the other was weaker.

    She then worked along muscle attachments with just enough pressure and friction to be uncomfortable but not painful. There is a lot of participant work with manual MAT; rolling over, testing, manipulation, repeat. MAT not a relaxing massage.

    The next morning after MAT treatment, my unrelated-to-the-crash pain was gone. Gone! I couldn’t believe it. Of course I still had pain if I pressed directly in the area of my injury, but I was now able to move my arm normally and increase swim time by 15 minutes. I could use the ladder to get out of the pool, with no pain. This was my second breakthrough day. I was able to stop the night time acetaminophen 48 hours after this treatment.

    The following week I had another acupuncture treatment from Ellen Williams  which reduced the pain level in my back and ribs to zero within 24 hours. Specifically, pain associated with any movement. Again, pressing on the area of injury was still uncomfortable, but much better.

    Three days after the second acupuncture treatment, I had another MAT session. The MAT session again improved my ability to move normally, this time movement related to the injury. Along with the manual manipulation, I had assigned daily isometric exercises.

    The end of week three was a big breakthrough in feeling good, but it is still too early to ski.

    Minimizing fitness loss

    I was able to minimize my loss of fitness during the entire process by focusing on good form during any exercise. (The focus was not on higher heart rates or intensity.) Early on I was able to swim, begin strength training with body weight only and ride an indoor trainer. As I mentioned in Part I, my guide was to do only movements and exercise that didn’t generate pain. I was very cautious adding load, particularly in the weight room.

    Slightly more than four weeks out from the injury I am back to swimming an hour and doing a long road ride at 53 miles. I’m not quite back to where I was before the crash in the weight room or running. I’m being conservative in the weight room and cautious running on icy surfaces.

    Closing in on five weeks post-crash, I don’t feel any pain when pressing on my rib and back area. Yay!

    Patience, persistence, progression

    Looking back to the beginning, I can still recall being in pain, very discouraged, sad, timid and fearful. It is no fun mentally. I was fearful of not being able to get back to doing the things I love quickly.

    If you find yourself injured, I suspect you can relate to the last paragraph. Sometimes “quickly” is defined as a few days; but sometimes it means weeks or months. It is difficult to remain optimistic, but if you set realistic goals and look for small successes; it helps mentally and physically. Also look for ways to accelerate the healing process. Of course you can’t “bake a cake in 5 minutes” but you can do things to keep progressing on the fastest realistic timeline and minimize fitness loss.

    I’m planning my first alpine ski day somewhere in the fifth week and I’m confident it will be a great day!


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