Mental recovery from a major injury

crutchesI often chat to elite athletes to learn what makes them tick, to understand more about their mentality towards their sport and to steal some of their tips to help amateur athletes improve. Here however is an amateur athlete (Find them on twitter @sime0nstylites) who, after spending many years in a tough, long hours job, took some time out to train properly for an ironman. And then had a major injury. The approach they took to confronting that barrier, the mentality they have shown towards dealing with it and the actions they took to overcome it have been exceptional and provides great lessons for amateurs and elites alike. So, sit back and read about how, even with a broken hip, some athletes are able to find a silver lining.

Breaking my hip was not at the top of my list of things to do in 2016. I had been a keen triathlete for many years — numerous Olympic distance and a few Half Ironman races. I had never been keen on entering a full Ironman, partly due to the training time required and partly because I was unsure that I could complete the race. Earlier in the year, I had stopped working and subsequently ran a credible London Marathon. Now that I had more time and confidence, I signed up for the Weymouth Ironman in September.

I love training. I’m much more keen on the training than the racing. I ran for miles and miles, up and down canal paths in East London and winding coastal routes in Suffolk. My faithful bike and I became regular passengers on the Overground line from Liverpool to Chingford. I developed an encyclopaedic (pun intended) knowledge of cycle routes in and around Epping Forest. And I swam, swam, and swam some more. In fact, I swam so much that I developed an unhealthy liking for butterfly (the swim stroke obviously).  

A cursory examination of my school and university sporting career would lead even the kindest of observers to conclude that I have not been blessed with an abundance of sporting talent. Much to my surprise the training went very well. I had the usual niggles but no Achilles strains, no hamstring knacks, no shoulder pulls, no real problems of any sort. I ate like a horse and slept like a baby. All in all, I took to it like a middle aged fish to water.  

On that fateful August Sunday, I set off on a long, slow run. I spent an enjoyable couple of hours practicing running within a moderate heart beat range. The weather was great, sunshine, clouds and a gentle coastal breeze. As I ran downhill, by the side of a B road, my foot suddenly slipped on some loose gravel. I fell, head over heels and landed heavily on a stone kerb. In the split second that you have to alter your impact point — front, back, shoulder, elbow — I selected the right hip option.

I lay spread-eagled in the gutter by the side of the road. Getting back up again was not a priority. Meanwhile, cars stopped and a small crowd gathered. After a short while, the local GP appeared. She carried me into her house, lay me on her dining room table and fed me codeine. She then drove me back to my partner and our dog. The fracture itself wasn’t obvious and I was given strict instructions to go to A&E if the pain didn’t start to improve quickly

We drove back to London and it would be fair to say that I was not in good shape. When we arrived at home, I couldn’t get out of the car. Walking upstairs was an ordeal of Himalayan proportions. My teeth were permanently gritted and I couldn’t sleep. For a while I made the argument to myself that I had badly bruised the hip. Perhaps a little tendon damage? After a couple of days of feeling sorry for myself, I had lost faith in my amateur misdiagnosis and my lovely partner insisted that I see an orthopaedic surgeon.

I had broken the femoral neck in my right hip (the femoral neck is the bone that attaches the hip ball to the femur). The surgeon calmly explained that I needed emergency surgery as soon as possible. He also said that there was a worryingly high probability of further major issues. Oh, and I really, really should stop moving. It would be an understatement to say that I was upset. I was devastated. Not because of the now forgotten race but because I couldn’t believe I had hurt myself so badly.

The next few days were a blur of pills, needles, straps and crutches, surgeons and nurses. I was very stressed. I’m afraid that I don’t have much advice for this part of my small saga. Fortunately, the hospital had great wifi so I watched a large amount of psyche numbingly bad TV. More strangely, I wrote limericks. Some combination of stress and pain killers triggered poetry synapses in my addled brain.

The operation went well and I was discharged. The recovery phase was 6 weeks of crutches with no weight bearing and then a further 6 week transition from crutches to walking unassisted.

I thought it might be helpful to provide some of my reflections about the recovery phase — needless to say, none of this is medical advice. I’m also conscious that many people have medical issues much more serious than my own. Who knew that the surgery itself was the part of the process that required the least personal effort.

Managing the Physical Recovery 

This, of course, depends on the type of injury. In all circumstances, follow your doctor’s advice to the letter. Overdoing it in any way is a bad idea. Also, don’t underestimate how physical exhaustion impact of the operation. It took me at least three weeks to get over the post surgery tiredness.

I was very fortunate to see an excellent osteopath about 2 weeks after the operation. He prescribed gentle static strength sets, gave me an ultra-sound kit to aid the knitting of the broken bone and an electric stimulation device to help prevent muscle wastage.

Most importantly, he gave me a plan and a sense of purpose for the recovery period. This was a key moment — the actual process of actively managing the recovery was both physically and psychologically beneficial.

Another aspect of the recovery process is nutrition, feeding that healing bone. My partner excels in this area and the highlights of my post operation diet were bone broth, grilled mackerel and many, many vitamins and supplements. 

Establishing a Routine

As you look ahead during those initial weeks, many long and apparently empty days seem to stretch in front of you. From both morale and recovery perspectives, finding a routine is very important. 

Mine was straightforward: wake in the morning and have breakfast; do my physical exercises; head out for a very local coffee; spend the afternoon writing and then yet more exercises; dinner, bed. Repeat.  

Establishing a routine is also important to making sure you complete the physical recovery exercises. One of the points that my osteopath made was that many people don’t do their physio “homework”. I suspect you are much less likely to skip or forget exercises if they are diarised.

Being Looked After

I’m not much good at being looked after but you don’t have much choice for the period of time at the hospital and those long first weeks at home. You are going to need some looking after and being kept well fed and relatively stress free are important.

I was very fortunate to have a wonderful partner who put up with everything without complaint and was unstintingly kind and generous. I also stayed with my mother for a week.

Looking after an injured son or daughter, friend or partner, is not straightforward. Always be mindful of the people around you. It’s not easy for them either. 

Not Being Miserable

I would challenge even the most optimistic and resilient of people not too feel at least a little miserable in this situation. I would strongly people to be honest with themselves and talk it through with friends, family or a professional, if needed. 

Two friend stories come to mind. A day or so after I returned from the hospital one of my oldest friends appeared with a crumpled plastic bag filled with cans of lager. He stayed for hours. I became friends with someone who lives locally, who I hadn’t known well before. He insisted on walking me home after my morning coffee to make sure I was ok.

These acts of kindness were very important for me. An unlocked for positive of being a little helpless, is seeing the quality of your friends shine through.  

Being Scared and Being Challenged 

Parts of this experience were frightening and pretty much all of it was challenging. Apart from the obviously scary part, the operation itself, pretty much everything post surgery is difficult.

In those early days, lifting the injured leg, taking a shower or navigating a kerb were real challenges. In the later stages, getting back on a static cycle for the first time or going to a crowded pub to watch the football were daunting events.

Unfortunately, this is the reality of the situation. My advice is to be ready for it and accept that for a while even the small things will be challenging. Scrupulously follow the medics’ advice and take everything in your own time. Don’t be concerned about saying no if you don’t feel up to it.  

Silver Linings

Silver linings can seem very well hidden in all of those dark grey clouds. In fact, they can seem so well hidden in the gloom that you may think they are not there at all. But of course they are. You just need to go and find them.

I’m always reluctant to say anything like “stay positive” — it can sound so meaningless. But in this situation it was true for me.

Use all that time to do something life enhancing: read; write; reflect; catch up properly with friends and family; think long and hard about what you want to do next.

Get better and do better.