Overcoming an Injury
It's been six years since I suffered a serious sports injury. It was completely self-inflicted - in my quest to lose weight, I was exercising 10 to 12 days straight without a break and doing minimal yoga or stretching. I was typically doing two gym classes a day, running 10 kilometres weekly and walking anywhere I could to burn extra calories. My body was constantly sore which I took as a sign I was working hard.
It's little surprise that after increasingly upping the intensity and frequency of my workouts, my body began to protest. I rolled my ankle in a boxing class, I was waking during the night with restless legs and eventually, my right knee buckled. You can read the full story in The Dangers of Overtraining, but essentially I was left limping, depressed and completely depleted. I finally accepted I needed help.
The months that followed were painful, frustrating and expensive. I was in such denial about my injury, it took two attempts to address the problem as I rushed my recovery. The second time round however, I was determined to get stronger and rebuild my fitness. There were several things during my recovery that helped me progress and stay positive. Here's how I overcame my injury:
The first step was booking a physiotherapist appointment. She identified my knee pain as coming from a tight ilitibiol band. The 'IT band' runs along the outside of the thigh, connecting your butt to your knee. IT Band Syndrome is a common injury among runners, especially from overuse. I was actually relieved to get a diagnosis. I had private health cover, so appointments only cost me around $40 or so after rebate. I got massages on my leg every few days and felt relief almost immediately. I also learnt to use a foam roller to loosen my IT band, and the physio even did some acupuncture. She told me to take it easy at the gym, so I kept going daily but just used lighter weights.
I also saw a podiatrist based in the physiotherapy complex, who, identified I had flat feet and overpronated my foot - meaning it rolled inward when I walked and put additional stress on my knee when running. I got custom-made orthotics, which set me back around $400-500. Thankfully, I again got a part rebate through private health insurance. On the podiatrist's recommendation, I also changed my sneakers to Asics' Nimbus range, which is designed for runners and has a neutral sole (so would fit my orthotics). While orthotics felt strange at first, my feet quickly adapted to the new support and cushioning. I even started running again, although I did one minute of jogging and one minute of walking which I could sustain for 7km. Believing I was cured after new shoes and a few weeks of physiotherapy, I quickly increased intensity on everything.
don't rush recovery
My symptoms rapidly returned. I tried running after work one day and couldn't even do 2km before I limped home. The outside of my knee again felt like it had a burning gumball inside it. I was upset, angry and refused to do anything that involved eating or drink because I had no way to burn off the calories. Apart from my morning oatmeal, I wasn't eating any carbs for fear of weight gain. I'd invested so much time and money in trying to fix the issue which made my failure all the more frustrating. At this point, I knew my injury was serious and needed more than massages.
I saw a different physiotherapist, recommended by a friend of my boyfriend's who'd also had knee problems. My new physio (Phil at Energise Physiotherapy) said if he couldn't fix my knee after three appointments, he'd refer me to a specialist. I appreciated the honest and upfront approach. I had more massages, was given some stretches and exercises to try strengthen supporting muscles and felt optimistic but ultimately, I didn't recover as much as either of us would've liked. True to his word, Phil referred me to a specialist sports doctor.
seeing a specialist
The sports doctor didn't mess around. He did a quick assessment, poking my knee and asking how painful it was. He recommended I stop all exercise immediately apart from brisk walking - he was the first professional to ask how I felt about that. I was petrified. If I didn't cry during that appointment, my eyes certainly filled up with tears. He then recommended I get a cortisone injection to help reduce the inflammation and kickstart recovery.
I was warned that cortisone is a semi-serious treatment, with injections limited to three per year. I did research online about the procedure - there was a lot of discussion about side effects, how effective the treatment was and the risks. But I trusted my doctor and having had little results with less invasive options, I went ahead. From memory, it cost around $300 which was almost as painful as the actual injection.
Getting a cortisone injection is like shooting adrenaline directly into your body. I hate needles and having one go into the side of my knee was awful. I was told to limit movement for 24 hours to maximise the drug's effectiveness but I should otherwise feel an improvement within a few days. I went to work, I went to an end-of-year function, I went out for Chinese food after the function and then rested later that night.
Guess what? The injection didn't work. My knee was in agony (a cortisone 'flare up' I later learnt) and when that subsided, the same old pain remained. I had a follow-up appointment with the specialist who arranged for a magnetic resonance imaging (MRI) scan to pinpoint the exact problem area.
If you haven't had an MRI, it resembles something from a 1950s sci-fi movie. Think a tiled room with a tunnel-like machine in the middle of it. You'll lay on a bed, be given headphones and the body part being scanned will be wedged into place with cushions or foam. You'll be gently slid into the machine and then everyone leaves the room. For the next 30 minutes, you'll hear loud, unsettling sounds akin to an electronic jackhammer, but with varying pitches. You absolutely cannot move or the scan will need to be redone. My experience was uncomfortable but overall, not too bad apart from the $700 price tag. I got about half back from Medicare.
Just three weeks after my first cortisone injection, I had a second one. I began crying as soon as I walked into the room, knowing how vital it was this one worked. If not, would surgery help me? The man administering the injection saw how upset I was and asked if I had a competition or event coming up. "No," I told him. "I just really want to exercise again." He was puzzled. The injection was extremely painful and all I could do was wipe away tears.
I was determined this second injection would be the last. I'd stocked my fridge, my sister drove me to and from the appointment, and for the next 48 hours I didn't move. When I did get up from the couch to go to the bathroom or make some food, I winced. At the time, I described my knee as feeling like a burning hot chopstick had been driven into the side of it. Every time I moved, it burned. I discovered insomnia was a side effect of cortisone too. But eventually, the pain subsided and even better - my knee finally felt relief.
support & strengthen
I wasn't going to mess up my recovery the second time. I followed everything the doctor recommended and returned to physio, diligently doing every exercise he'd prescribed to strengthen supporting muscles. I'd been so worried about gaining weight by not exercising - but I actually found I wasn't constantly hungry like I was when training. I was surprised how little food my body needed when I was only going to the bus stop and my desk job.
I'd already changed my footwear and gotten custom made orthotics which had made a huge difference. I bought a foam roller and used it almost daily to massage my IT band at home, which was extremely painful but effective. I hadn't worn heels in months, but I bought some semi-wedge shoes I hoped to wear for special occasions.
My permitted exercises were walking and light activities that didn't involve my knee. That didn't leave me with a lot of options, but I developed a newfound love for power-walking on flat ground. In my supportive sneakers, I'd walk as fast as I could around a lake for an hour. Just months before, I would've deemed the exercise wasn't worth my time - burning a measly 200 calories. But now, it felt like liberation and victory. I was out of the house, I could wear my gym gear and I could get my heart rate up without pain. I was also doing basic exercises such as clam shells and squats against a wall to try strengthen my glutes. It wasn't much, but it was a start.
While I was grateful to be pain-free, my newfound passion for walking and at-home exercises quickly waned. I wanted to do more and felt my body could handle it - but I was too afraid to try anything else on my own. By chance, I met a personal trainer who'd had the same injury as me (although her's wasn't from overtraining). I had PT sessions with Sharon from Uplifting Wellness once a week, and I was surprised how much I could do at a gym without using my knee. She showed me low-impact options such as the cross-trainer (elliptical machine) and seated leg press machine, which would help strengthen my glutes. I did body weight exercises, used free weights and other equipment like kettlebells, fitballs and TRX suspension.
I really encourage anyone with an injury to consider a personal trainer. On top of the physical benefits, having a positive, qualified professional guide my recovery was invaluable. Sharon helped me focus on what I could do, referring to my 'stronger leg' rather than my 'injured' leg. It was empowering to learn new things at the gym and while my lower body activity was limited, my upper body became the strongest it had ever been! Having a coach truly helped me develop and maintain a positive mindset.
slowly increase intensity
It felt agonisingly slow, but in coming months I increased the intensity of my workouts. For example, I returned to BodyPump but did the squat and lunge tracks without any weights. I didn't care I wasn't working out as hard before - I was simply grateful to be back in group fitness classes. Around this time, I rediscovered my passion for the indoor cycling class RPM. I was able to get a cardio fix with far less impact than running.
I started doing one of my all time favourite classes BodyAttack again, although initially I marched instead of jogging and I did slow, body-weight lunges instead of the plyometric kind. I even returned to running, but with extreme caution. I would alternate between jogging and walking, and slowly increased the distance I ran. My first non-stop, one-kilometre jog felt like a bigger achievement than the 12K City to Surf I'd done two years prior. My boyfriend was extremely patient and supportive throughout this time, and I recall how happy I was when we ran 4K non-stop together (of course, he could've run much further). Little by little, I slowly returned to where I'd been been when I was forced to stop exercising. It probably took me around 18 months to fully recover from my injury, whereby I could comfortably run 7K - although this probably would've been quicker if I could've afforded more coaching.
Six years on, I still see my physio every couple of months - not because I'm in pain, but to prevent it. I've fully returned to my fitness routine and feel even stronger than before. I lift heavier weights, incorporate functional training like CXWorx, and I do a lot more yoga to loosen my muscles - especially my hips. I force myself to rest one day a week (even though I still don't usually want to). I still hate walking downstairs as this one of the main triggers of pain when I had my injury. This is still true of recent hiking trips in Italy and China, when despite the exertion, I preferred going upstairs!
I still push myself physically almost daily but the difference is I no longer work through pain. If I set off for a 10K run and feel a tinge in my knee at 6K, I'll stretch, try again, but stop if the pain persists. Particularly if I'm tired, my form slackens and my IT band inevitably gets a little tight. I massage it, stretch it and most importantly - I don't push it. I've accepted there'll be times in my life where I won't be in peak form (illness, holidays or shiftwork) and that's okay.
The lessons learnt from my injury will be particularly relevant in about two months' time when I have surgery on my little finger. I'm told recovery should only take two weeks - and while the prospect of a fortnight without the gym would've previously been petrifying, I now know to focus on the movements I can do and show my body some sympathy. My attitude now days? When I'm at my best, I'll give my best - and when I'm not, I'll give it what I've got.
QUESTION: What did you do to manage an injury?