Aw S**t!!

A Diary of Injury Recovery

It’s been eight weeks since I went THUD and cracked a rib.  The rib only “twinges” a little bit when I exert.  Good progress indeed.  In the past week I’ve added a good  bit of harder work, more stretching, more core strength work, and some harder climbing intervals on the bike.  That last bit is both rewarding and frustrating.  The rewarding part has to do with being able to tolerate doing it at all.  The frustration derives from realizing how much I’ve lost in the last eight weeks.  On any climb worthy of the name, either my legs catch fire, or I run out of air.  (Sometimes both at once!)  It’s all very much to be expected after such a long enforced lay-off.

In fact, in a perverse way, it felt good to feel so bad.  Not that I have ever enjoyed being out of condition, but rather because I was starting to move forward again.

On Saturday, I did  “full commute.”  By that I mean I didn’t “cheat” and truck clothing and stuff to work the day before.  I did the ride on the heavy commuter, with a full load of clothing, cleanup stuff, foods, rain gear, lighting, and all the other paraphernalia.  Carrying that load was tough going, but I did manage it.  The rib didn’t protest.  I had the thought that I was now doing it again, “for real.”

And then…

Saturday was one frantically busy day in the bikeshop.  The weather was great.  People were coming in for repairs, or to pick up their club clothing orders, or to chat, or to look at bikes and gear.  It was hopping.  That wasn’t enough.  Thanks to a an odd artifact of the vacation schedule, we were short-handed.  So we were all just dashing about the place.

It was in the midst of that dashing that I tripped over something in the Tech Department.  I started to fall, and I was moving forward at a good clip.  In the floundering attempt to catch myself, I managed to kick something.  Kicked it hard.  The instantaneous breathtaking pain radiating from my left big toe, told me I’d done something not good.

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I’ve been around for a while.  In a busy and active life, I’ve sustained a fair number of injuries, some quite spectacular.  Over the years 58 years since I first broke a bone, I’ve developed a personal scale of pain.

1 = Background irritation, bee stings, mosquito bites, paper cuts

2 = “The Ouch Threshold”  It hurts,  but it won’t hurt for long.  Keep going.  This category includes things like inadvertent cuts, barked knuckles, fingers pinched in doors, blisters, and minor sunburn.

3 = Better stop and attend to that.  Deep cuts.  Hard hits.  More serious sunburn.  Plant toxin irritation.  Big wasp stings.  Things that require first aid and/or prompt minor medical attention.

4 =  GASP-YOWCH!!  Hard fall.s.  Big cuts.  Serious burns.

5 =  Stop right now and go to the ER!  This level of pain usually indicates a serious injury, a broken bone, something that must be attended to and/or stitched promptly.

6 =  Don’t ask, you don’t want to know.  Gunshot wounds.  Knife stabbings.  Falls from 20 feet or higher.  Dropping a motorcycle at speed.  Hitting a tree whilst riding a motorcycle.

If there is a pain level 7, I wouldn’t know, as I’m sure I’d be unconscious.

Unavoidable Digression Ends>>

My Saturday toe-kick injury was somewhere around a 4.5 on my personal scale.  Sharp enough to make me believe I just might have broken my toe.

I hobbled my way through the rest of the day, and then prepared to ride home.

I have good coworkers.  They were concerned about me.  I was offered a ride home.  I want to thank them now.  (Thanks you two!)  I told them, “Usually, if I can make it into the saddle, I’ll be alright.”

I made it into the saddle.  (Although pulling my shoe off, and then shoving my foot into a riding shoe took me up the the gasping 4.75 on the pain scale.)  Oddly, once into the stiff riding shoe, my toe felt a bit better.  I did ride home.  All the way I was thinking,  “Please don’t be broken!  Please!  I do not want to extend my layoff any longer!”

Given the level of pain, there was a very real possibility that I had broken at least one bone in there.  I was as close to depression as I ever come.  The thought of prolonging recuperation and further deconditioning was just miserable.

I’m happy to report that the toe is not broken.  No broken bones at all.  The swelling has gone down, and the toe has turned some really impressive colors, but it’s getting better by the hour.  (Sweet relief!)  I’m good to go again.  So this will be the last post in the injury recovery series.  Time to move on, and get stronger!

Bon Chance, et Bon Route!

I Hate following my own advice!

A Diary of Injury Recovery

Seven weeks ago, I went THUD and cracked a rib.  I’m “happy” to report that things are on track for recovery.

I am pretty sure I turned the corner in this last week.  Here’s a review.  I have gained some unwanted weight, thanks to the reduced activity levels.  I’ve lost a surprising amount of aerobic condition.  On the other hand, the rib is healing nicely, and I find I am capable of accepting increased training loads.  Not increased over previous norms, mind you, but definitely an improvement.

In the past week I reduced overall volume somewhat, from the “maintenance level” I had worked up.  At the same time I added a bit of increased effort.  How much?  Not much at all, but it’s a start. 

Here’s what I did:

• Increased stretching routine to about 2/3 of pre-crash levels.
• Began limited core/abs strength training, 10 minutes per day, 4 days per week
• Added two short hill drill interval sessions, of about 15 minutes each
• Used the fixed gear bike for two hours on one day.
• Rode 10 hours at low cardio levels, distributed over 6 days.

Folks, I’m here to tell you, by early Sunday afternoon, I had the thought that I just might have overcooked it a bit!  By the end of a very modest two hours of riding, I was feeling cooked.  I am happy to say that the feeling did not last.  Recovery and rest took me back to a happy state.

That sketch of the effort doesn’t look like much, does it?  But it’s a good start.  I’ll increase this coming week.  It’s time to reduce the unwanted weight, and increase the aerobic capacity again.  But gently.  Very gently.

I Hate following my own advice!

A Diary of Injury Recovery

I’m posting this series in the hope that it will be helpful and instructive for others.

Note the title of this post.  The advice I dispense is the best that I know.  Much (most) of this advice concerns things that I do on a regular basis.  Frankly, some of these things are not always pleasant.  We do them because they yield desirable results.  That last is highly applicable to recovery from an injury.  Many cyclists, and other athletes, are so constituted and motivated that the very idea of slowing down, backing off, or decreasing training is repugnant.

We tend to be goal-driven folks.  But sometimes we suffer a set-back.  When this occurs, it gives rise to an internal conflict.  Almost all of us know that injury requires treatment and recovery.  However, if that recovery process interferes with training, and there is a goal involved, we agonize.  It’s hard to stop, and it’s extremely difficult to let go of a goal.

The proper course of action is to make the healing, and recovery into the goal.  After all, failure to do so may jeopardize more than just an event.  Attempts to continue training, and vigorous intensity activity, can retard recovery, or even increase the severity of an injury.  So the job of recovering, in a healthy and correct fashion becomes the goal.

I’m not all that different from the athletes I mention above.  There are things that I use as goals and training-motivators.  I absolutely hate to postpone, cancel, or fail in achievement of those things.  I know that the advice I dispense regarding injury recovery is correct, but that doesn’t mean I have to like it!  Nor does it mean that I enjoy following it.

Progress to Date:

It has now been six weeks since I injured a rib and a fair amount of soft tissue, and connective tissue around it.  The healing process is not complete, but it is advancing well and in a normal fashion.  (I have been told I am recovering at an exceptional rate for one of my age.  YAY!)

For the past two weeks I’ve gradually (and most carefully) increased the amount of physical activity, primarily riding.  That’s in increase in volume, but emphatically not in intensity.  This has not been the time for stress exercise.  Also please note, that volume increase was not over my “norm” but rather from a very low level.  I am a long way from returning to “normal” volume levels.  This has brought me to a milestone of sorts.

This is the point where I should be able to stop the gradual decline in fitness.  If I can hold steady at this level for a week, I should then be able to start the long process of regaining previous fitness levels.

Next Phase:

For the next week I will decrease volume, while adding a carefully measured, and very nominal increase in effort level.  In the week follow that, if all goes well, I can bring the volume back up slightly.

That’s the balancing act.  First extend volume, the amount of exercise, watching for any signs that the body will not tolerate the increase.  Then, if successful, reduce volume slightly and bring effort levels up.  With luck and care, I should be pretty much back to “normal” levels of activity by the end of June.  Then I will be able to really train again.

Fingers crossed.  I’ll keep you posted.

Injury Recovery: “How’s the rib?”

I’ve had that question a lot lately.  It’s touching.  Folks are concerned.  It’s now been five weeks since I took a spill and cracked a rib.  I’m happy to report that I’m well, and recovering nicely.

I’ve now spent a week of gently testing and probing.  I’ve done a bit more on the bike, and have (cautiously!) increased my stretching drills.  I’ve also started to add just a very few core and abs strengthening exercises.  I find that I’m not yet ready to do much in the way of core/abs work.

The high point of my last week was the Bike to Work Day commute.  It was successful.  I took the long way home, without undue strain.  I did feel it a bit on Saturday morning, just a residual stiffness.

In short I’m doing about half of my “normal” ride volume, and the intensity is much lower than I’m used to.  This seems to be about right for now.  The idea is to do enough exercise to promote more rapid healing, without doing so much as to aggravate the injury.  It’s good to be moving, but I must confess, it’s also frustrating to be hampered.

I do look forward to better days ahead.

I Hate following my own advice! (Week 4)

A Diary of Injury Recovery IV

Make a Plan

Act on it

Test and Measure

Correct and Adjust

Those four steps outline a good method for accomplishing almost anything.  In this case, we’re talking about the process of planning and executing a recovery from injury.

Today marks the fourth week since I fell and cracked a rib.  I’ve already mentioned that the healing process seems to be going well, that it was time to start planning my recovery work.  In doing so, I will be adhering to the four step method outlined above.

It’s not possible to do a complete, long-term plan for an injury recovery.  To do so is to invite trouble.  The problem is that injuries don’t always follow a smooth and linear path to full restoration.  There can be setbacks.  It is possible to miscalculate and over, or under work the recovery.  So part of the Plan has regular periods of assessment and evaluation built into it.  The idea is to apply calculated loads, and then observe and measure the result.  If the body is responding well, good.  If the body shows a negative response, or a setback, the Plan must be adjusted.

I’ve made my initial plan.  It consists of the three week periods.  At the end of each week, I will be evaluating.  Is it working?  Are there symptoms of having gone to far, too hard, too fast?  At the end of each three week period, I’ll be doing some testing.  Will the body take a slightly increased performance load without undue pain or other symptoms.  If so, then the next three week period can be implemented.

If, at any time I experience a setback, then the Plan must be altered and reset to allow for it.  The idea is to recover and heal, not to conform blindly to a schedule.

The Plan

1)   Stretching and flexibility:  I’m adding a bit more stretching exercise, and doing so cautiously.

2)   Core Strength:  After the third week (Injury + 7 weeks) I will begin to add some core and abs strengthening work.

3)   Bike Work:  Increase cycling activity, focusing on volume first.  No more than a 5% increase per week, and no more than a 10% increase on any given day.  (Intensity and interval training will have to wait until after the first of the three week periods.)

This post marks a milestone of sorts.  I won’t be doing these on a daily basis now.  I will keep you updated on progress, but only on a weekly basis.

BTW, two features of this first week of active recovery include The Ride of Silence on Wednesday of this week, and a planned Commute on this coming Friday.

For all of you who have contacted me with notes of concern and support, please accept my heartfelt and humble thanks.

Timeline

Wed 8 May:  Did a light (and short) morning spin.  Time to begin developing a fitness recovery plan. 

Thurs 9 May:  Mowed the front lawn.  I led the beginner group on the Novie Road Ride for 17.1 miles.  This was the first fully “NSAID-Free” day!  (Not pain free)

Fri 10 May:  An easy and needed gentle post work ride of 11.2 miles.  Continued “NSAID-Free”

Sat 11 May:  Did 19.5 miles of easy riding on the Saturday Morning Path Rides.  Still a bit stiff and sore, but still “NSAID-Free”

Sun 12 May:  Did household chores and a 21.1 mile pleasant afternoon ride.  Wanted to do more!

Mon 13 May:  Rest and recovery.  No training or exercise.  

Tues 14 May:  Begin light recovery training.

I Hate following my own advice! (Week 3)

A Diary of Injury Recovery III

I’m posting this series in the hope that it will be helpful and instructive for others.

Below you’ll see the “Diary” continuing.  The idea here is that I’m constantly evaluating the state of healing.  I want to stay active enough to promote faster healing, without do enough to aggravate the injury.  There’s nothing big here, but a lot of smaller milestones.

Note the entry for Monday.  Things are looking up, and it is time to begin to plan a bit more active recovery.  That will be the topic of the next post.

Time Line:

Wed 1 May:  Did my day at work and then led the Wednesday Evening Path Ride.  The ride was 10.7 miles at a recreational and easy pace.  I felt just it.  I wasn’t in great pain, but I wasn’t happy either.  It was good to be on the bike, but…

Thurs 2 May:  My day off.  I took it easy, rested, and continued popping anti-inflammatory pain relievers.  I was only feeling slight stiff, so I went out and led the Novice Road Ride.  I chose a somewhat hilly route, but kept he effort level down.  Ached a bit while riding, but the 16.8 miles went okay.  Only aches after

Fri 3 May:  Rode an easy, post work 11.8 miles in a relaxed hour, on the road.  It was good to be able to breath (but not deeply).

Sat 4 May:  The morning rides were rained out, and I was kinda glad.  No other riding or workouts.  I was restless, but I slept okay.

Sun 5 May:  Decided to stretch out a tiny bit.  Rode an easy 18.9 miles in just under two hours.  It was good to be out in the sun, and I needed  it!

Mon 6 May:  No exercise except beginning modified and light stretching.  That went okay.  It’s time to start thinking and developing a “Recovery Training Plan.”

Tues 7 May:  Very light and short spin before work in the morning, followed by light stretching.  Then a one hour easy road ride, post-work.  All went well.

I Hate following my own advice! (week 2)

A Diary of Injury Recovery II

I’m posting this series in the hope that it will be helpful and instructive for others.

So, the first two weeks of this weren’t a lot of fun.  I didn’t need to work too hard at not overdoing it.  Just about any time I tried to do much of anything, it turned around and bit me.

I wasn’t doing any training.  My usual routine includes morning stretching and core strengthening and toning exercises.  Those were just out of the question.  Yes I did ride, but at a very easy pace, and for much shorter intervals.  My morning spins or rides were dropped from my schedule too.

None of this took a lot of discipline.  Frankly, things just hurt too stinkin’ much to allow for more.

Basically, in this, the second week post-injury, I was kind of probing at the edges of the thing.  I was testing.  I know that exercise promotes healing, but…  too much, or too soon and the effect is to aggravate the injury, prolong the recovery period, possibly even do more damage.

I was testing, attempting that third step in the injury recovery process

“During the healing period, maintain light, healthy, non-aggravating exercise.”

I was trying to determine if I was ready for step three, and just how much was “light” and “non-aggravating.”

Below is the timeline continued.  This is the second week of the whole thing:

 Wed 24 April:  No riding.  The usual evening Path Ride was rained out, and I was Thankful!  Not doing much more than going to work and hurting.

Thurs 25 April: I led the easy part of this year’s first weekly Novice Road Ride.  It was a pleasant ride of about 17 miles, but I was being nagged by low level back and rib pain throughout.  I caught a ride home.  By the time I got home my back was on fire.  By this point I was getting really tired of taking NSAIDs.  My stomach wasn’t liking t much either.

Fri 26 April:  NO RIDING!!  I can take a hint already.  Took the day as easy as I could, and did nothing that was not absolutely necessary.

Sat 27 April:  I slept a bit later and drove down to Peachtree City.  I was able to ake the Saturday Morning Path Ride out.  It’s a very mellow, recreational paced, short ride.  It didn’t seem to trigger any kind of bad result.  This was my Saturday off for the month, so I didn’t need to work.  I spent the day resting, with the occasional NSAID dosage to reduce pain.

Sun 28 April:  I was feeling better for the rest day on Saturday.  I wanted to get out and move around a bit.  Of course the weather was pretty awful.  So I geared up for the rain, waited out one strong thunderstorm, and went.  It rained.  A lot.  I got soaked and a bit cold.  The ride was only 19.5 miles, and I took it easy, spending one hour and forty minutes.  I felt “okay” while out ther, but after I got home and cleaned up my rib and back went into extreme pain again.  Okay.  A bit much right then.  Clearly I needed to back off more.

Mon 29 April:  I went to work, was careful about lifting and moving, and went home.  I wasn’t comfortable, but things were showing an incremental improvement.  No riding and no training of any kind.

Tues 30 April:  After work I went out for a gentle and short road ride.  It felt goo to get out, and the short duration, low effort ride of 11.9 miles in just over an hour  didn’t trigger any unpleasant side effects.  Good!