Do’s and Don’ts of Injury Recovery

Thursday December 8, 2016 marked one year since I had Arthroscopic knee surgery to fix a pesky meniscus tear I had. I have come so far since that day, and besides being damn proud of the work and results, it has reminded me of the do’s and don’ts of injury recovery.

  1. Do visualize and envision what you want. With injury it is all too easy to be discouraged because of setbacks and pain. I had many moments where I seriously questioned if I would ever get back to doing CrossFit and running and kickboxing and all the other crazy shit I love. I often would be frustrated as all get out and found myself thinking perhaps I ought to trade it it all in for knitting and bring back step aerobics. It sounds ridiculous ;and once I realized that, I started picturing myself hitting my goals. (I even had a dream once of doing CrossFit. Ok maybe two dreams. Who am I kidding? I lost count).  I stopped resigning to what I could not do, and allowed myself to fantasize about what was yet to come. And guess what, over time, those dreams and fantasies became reality.
  2. Do not do too much too soon. All injuries are different and recovery times vary. Regardless, it is important to recognize that one good day does not mean throw caution to the wind and go all out. Recovery requires a whole lot of patience and self restraint. I learned this when I started squatting too soon. I had maybe a week or so where all felt great. Then, before I knew. it, the knee pain came back , and I was frustrated once again. I am by no means a doctor or physical therapist or even someone who is proficient in anatomy. I just know that recovery means we need to ease our bodies back into things. Surgery in particular (as in my case) is essentially trauma to the body. We need to be kind to our bodies and respect the healing process.
  3. Do celebrate the small wins along the way. As mentioned above, you can’t do too much too soon. You can’t be frustrated that you aren’t lifting the same weight you used to. Give yourself time, and celebrate all the milestones along the way. Granted these milestones are things you may have scoffed at back in your hay day, but you don’t get somewhere in one leap and bound. It takes many. I never thought I would smile ear to ear just from doing a little old air squat, but guess what? I did. It’s a big deal.
  4. Do not expect big wins overnight . Small wins lead to big wins. Here is an example of my reconciliation and reunion with squats.
  • I had knee surgery on December 8th.
  • On March 10th I was doing  air squats at about a quarter of full depth.
  • On May 20th I did my first full depth back squats at lighter weight (75 pounds and to put that into perspective, my 1 rep max prior to surgery was 200 pounds).
  • On July 15th following a squat cycle, I hit a certifiable full depth back squat at 190 pounds (only 10 pounds shy of my PR).
  • On October 31, after another squat cycle, I  hit a 195 pound back squat (only 5 pounds shy of my PR).

You can see by this timeline, it took me months and intervals to make strides. I did not regain my abilities a month or even two months after surgery.  You also are safe to assume that to my point above this, every one of these milestones was just as rewarding to me as those first air squats I took. I also have faith and trust that one day i will hit a 200 pound back squat again, but I am not focused or worried as to when. As long as I get there safely, that is all that matters.

squat lifecycle.jpg

  1. Do reevaluate the way you had been training prior to injury. For me, as my surgery was (knock on wood) the last of a string of injuries, I was over injuries. (That is putting it mildly. I was actually heart broken-sick and tired-ready to disown my body-kind of over it).  I had to really take a long hard look at the way I trained to find out WHY was I getting injured consistently. I found that I was not always smart about the way I trained. I would do a 280 stair climb three  consecutive times (for those in LA, Baldwin Hills was my spot) and then go to CrossFit and do a WOD where I had to use a lot of leg muscles that were already fatigued and beat up. I often sacrificed form to hit a heavier weight. I knew I had to train differently as I recovered that was also sustainable long term. Which leads me to the next “Do”.
  2. Do put programming as your first priority. In reevaluating my injury history, I concluded that smart programming was my absolute #1 priority in how I should train.  This lead me (actually prior to surgery as I had knee pain for months before I sought medical help for it) to making the tough decision to switch CrossFit boxes. I chose to go where the programming was insanely good, and where I knew people to have made some ridiculously impressive gains. It also lead me after surgery to stay with Physical Therapy longer than perhaps most people would. I feared going back into the real world on my own and falling back into my old habits. So by switching where I trained and with different coaches/trainers, I enrolled myself on a healthy journey. *Shout out to both Adan and BJ, my coach and trainer respectively, that I do not know how you do what you do with programming,but I am forever grateful for it.
  3. Do put in the time smartly and the results will come.  This is not even necessarily specific to injury recovery but is worth mentioning. With learning to squat again, I did not just attempt squats and do squats all live long day. I had to do many other things to get there, like balancing exercises and strength work (and mobility! Oh how I heart mobility.) There is a tendency to JUST practice the one lift or one skill in order to hit our self imposed goals. Take pull-ups for another example. You can’t expect to just walk up to the bar every day until that one magical day that you can achieve a pull- up. You have to put in time working on engaging the right muscles (note earlier comment, I  am not anatomy expert.  I am inclined to say engage lats and scapula) and shoulder strength to slowly build up to a pull-up. 

     

    A year after surgery, I do admittedly find my life to be of two eras: pre-surgery and post-surgery.  It really is because of all the changes to my training and mindset that I differentiate “then” with “now”. Because of these do’ and don’ts that I do religiously live by, they serve as both a reality check as well as a benchmark. I never want to take for granted being healthy nor do I want to ever minimize all the work I do every time I train. I am undoubtedly at my all time strongest (and getting stronger). I am doing workouts now (even many at RX) that I would not have been capable of prior to being injured. I say this not to be a braggard but rather it truly is my wish for all of you to adopt them so you can continue to train smart and to continue showcasing everything great about fitness (particularly CrossFit).

Working My Way Back

I never thought I would hope a doctor tells me I need surgery until I had a tear in my meniscus. My MRI came back inconclusive.  After trying a PRP shot, physical therapy and cutting out a lot of movements, I was pretty much just over being restricted and in pain all the time. I was seriously relieved when my doctor and I decided I should have arthroscopic surgery. A week later, he went in there, got rid of the tear (yup there was a tear despite that it wasn’t visible in the MRI) and cleaned up some other cartilage damage under my femur bone. After a few days on my couch, I was feeling mentally ready to get the healing show on the road.

It’s now been two months since surgery and my knee is progressively improving. My mindset with this injury compared to others is different. I used to be all gung ho on CrossFit and my goal with any injury was to get that shit fixed ASAP so I could get back to CrossFit 5 times a week like a nut. This time around, I took a step back and started really thinking about how do I have a healthier balance of CrossFit with other areas of fitness? I have hit a lot of PR’s and milestones and am damn proud of them. But I am also ok that I am not at that level right now. I am not dissing CrossFit by any means. I am just reevaluating my former obsession with it. There are aspects of it that I do thrive off of (like the varied workouts, being pushed hard, gymnastics stuff and lifting).  The main distinction I have this time around is that I absolutely never want to get injured again. I have said that before  without actually being smart about making that realistic. Like with tendinitis in my shoulder,  while I essentially rehabbed that body part, I fucked up my knee in the process. I am over the days of swapping injuries.

So it is a shift in my mindset. I have accepted that 5 days of CrossFit right now would not be the smartest move for me.  I have too many imbalances as a result of my knee injury that I need to focus on. I favor my right side and have to consciously engage muscles on my left side. For example when I do a back squat, I literally have a conversation in my head of ‘ok, slowly go down, stay in heels, don’t rush coming back up and don’t lean to the right.” Over time I will get these habits down without even having to think about it but my muscle memory is not there… yet.

I do seriously love love LOVE lifting. I would be lying if I said I did not miss lifting heavy. I do get somewhat humbled and bummed when I back squat weight that used to be my warm up weight. I get over that pretty quickly as I am honestly just grateful to be able to have an almost fully functional knee again. I will never take for granted that I can do things again like squatting and jumping. I am on a path to do them at optimal form so I can be consistent and safe.

I can’t benchmark off of my previous PR’s to gauge percentages for lifts. My new benchmark is my knee and how much pain things cause it (it will take many more months for my knee to be fully functional and pain free… and that is ok as it is giving me the opportunity to focus on doing things the right way).

I am fortunate to have the best Physical Therapist and aide (who is now my personal trainer) as they support me in healing and helping me reach my goals. I often question if I should really ever do high impact stuff and I share those thoughts with them expecting them to tell me I should never squat again or run or do anything that I enjoy. That never happens. They tell me I will get there and they will help me in that journey. My physical therapy has now become full on workouts where they program specifically for me. I still have goals as that is what will forever motivate me. I have said it before and I will say it again. I LOVE WORKING OUT! Even when it’s fucking miserable or I feel like I may puke. I am extremely ecstatic that my workouts once again make me sweat my ass off and leave me winded.

Ok so I am sure you are wondering what exactly are my goals? Here they are in an email I sent my PT team:

1. Stay injury free
2. Lose some weight and get leaner/more toned (I want to get back to
where I was before I had tendinitis in my shoulder)
3. I don’t care about things like snatches or overhead squats. All other movements
are fair game for me. I don’t necessarily expect or care (ok maybe a
little) about squatting as heavy as I have before. I do want to work
my way back though to it. Same thing with cleans and deadlifts and
other movements.
4. Improve on gymnastics stuff! One day I’d like a muscle up. And I
want to learn butterfly pull ups.

So basically I want to be a bad ass 😉
But seriously though, obviously not at the expense of being injured again.

There you have it. I am practicing patience right now in my workouts and putting my ego aside as much as I can.  It’s ok if I sacrifice shaving a few minutes off a workout time as that’s less important that compromising form or risking injury. It’s ok if I scale my workouts to what seem to be a beginner level. It’s ok because I honestly get a feeling of euphoria when I can actually do a workout in its entirety without having to swap out movements.

Life is good. I cannot complain. I am fortunate I am back to working out frequently, only now with a different routine. I have 2 days a week of Crossfit, 2 days of personal training (aka physical therapy) and spin class twice a week. I rest when I need to without the guilt I used to have of missing a day. My body isn’t where it was before fitness level wise and while  I know I will get there, I recognize I have to pace myself. Overall, I am on the road to recovery and to safely get back to being the bad ass that I once was.