When you fracture something, you figure it will take time to heal. Then you figure it will take time to rebuild. And then you figure you will be back to normal, just like before. Break-heal-recover-fixed. But no one ever tells you that sometimes you might have lingering pain.
When I broke my ribs as a result of the impact from a silly bike topple just before the CapTex USA Paratriathlon National Championships, I knew that it would have an impact on my triathlon season. I dropped two races in 2012 (The Blenheim Triathlon and The Paris Triathlon) because of the fractures. I knew I would need to rehab my injury. I was taped, I did some shoulder exercises, and I was patient (kind of).
I started swimming again about three weeks post break, but I didn’t “SWIM” until about six weeks after the break. I waited to feel healed before really hitting training. I naively thought that would be it, I would just get back to normality.
When I finally got back to swimming my times had slowed dramatically, from a steady consistent 1.45 per 100m pre-fracture (and 1.40 wetsuit assisted) to about 2.00 per 100m at best. When Rev3 Old Orchard Beach came around, I was looking forward to racing and was thankful to be out there. I threw my time goals out the window and used the format (middle distance aquabike) just to try something new and to have fun. One of the things I didn’t reflect on in my race report was how OFF my swim felt. I felt like I just couldn’t get any power out of my right arm (the side that I broke my ribs). I thought more time training would right this, and looked forward to testing myself with a hard swim at The London Triathlon. But I still did not feel right in the water by the end of September. My shoulder was clicking a lot, and I just felt weaker and like I was getting slower in the water – no matter how much additional training I was doing.
So finally in I had had enough. I knew something was not right, something left unaddressed post bike topple in May, and I knew I needed to go back to the drawing board to fix things.
Enter Ellis Taylor of Tatami Health. I started seeing Ellis in October to find out the reasons for and to FIX the lingering shoulder issues I had from May’s crash. Essentially with the fracture my shoulder had pulled forward and out of alignment as the muscles tightened to protect the injured ribs. So to bring things back to a more normal state we started with gentle exercises to work on spatial awareness (quite similar to what I did during my Bay Swim training), and then slowly built in weights to work on strengthening around the joint. I had strict orders to stop all weight training and to stop using paddles in the pool until stability and basic strength had returned to my shoulers. Slowly and steadily I rebuilt so that by January I was able to resume training as usual with weights at bootcamp and paddles in the pool. And I was feeling much better.
Not only was I feeling better, but as I have continued to work on shoulder strength and stability I have grown stronger than ever in the pool. I am now consistently clocking less than 1.40 per 100m on my hard sets. With a wetsuit on this is about 1.30 per 100m. I have never swum this fast before. So it is a testament to the power of consistent and constant rehab – so important after an injury, and I think vital for someone like me who is hypermobile.
But one thing that has not gone away is the lingering pain.
Image sourced from google, original source Pain (The Game)
No one ever tells you that you may have pain that continues for a while after chest fractures. Well, okay. Almost no one. If you read the blogs of pro triathletes who have had career changing injuries like Joanna Zeiger you may know that rib fractures can lead to significant and lasting pain. It’s just that my topple was so silly, so “gentle”, I never expected that I would have any kind of post-injury pain.
From what I can understand from Ellis and my sports therapist Michael Collins, my pectoral muscles attach to the area where my ribs were fractured. This area also has a lot of nerves and cartilage. So it is sensitive and can take a while to “feel better”. As I am rebuilding and getting stronger, when the muscles get tight they pull on the same (formerly injured) spot. This causes me to have a dull continual ache – what I imagine a toothache must feel like. I notice it the most after hard swims, yoga and bootcamp – activities where I use my shoulder and chest muscles. And I think I notice the ache now – months after my fracture – because I am finally starting to use my muscles in “the right way”.
So what is my point?
This is not a “woe is me” post. Rather, I just want anyone who is injured to learn from my experiences.
1. You may be treated for the obvious injury (in my case rib fractured) but the longer term issues that require physical therapy may be initially untreated.
Tap into a good trusted physiotherapist as soon as possible in your rehab process so that you can start to work on the “collateral” damage from your injury.
2. Just because you feel better, don’t assume you are fixed.
Again, work with a trusted physio to develop, monitor and assess yourself during the rebuilding process. You may find that you have to address other things that are going on as you rebuild, to avoid ongoing issues. Get a good dialogue and working relationship going with your therapist so that you can address these head on and early in the game.
3. Expect the unexpected and if you want something be prepared to persevere.
I had no idea I’d have a continuing dull ache from my injury 10 months post topple. I know it relates to tight pectoral muscles so I am prepared to continue to work not only on my shoulder strength (because it is helping my swim SO MUCH) but also to figure out how to keep loose and how to stretch out my pecs, to manage the ache. I can completely understand why people give up doing things after injury as the aches can be tough – but persevere and talk with your team to figure out how to best manage things. Don’t quit asking questions and seeking relief. Because the reward of being active is worth it.
4. Keep it all in perspective.
I was swimming yesterday and although it felt uncomfortable, I did hit some good times including my best yet 100m hard effort. I was chatting post-swim with one of the guys in my lane. I knew he was coming back from some sort of injury, but what I hadn’t appreciated was that yesterday was his third swim in about 18 months, after having dislocated his wrist, broken his arm, and suffering related shoulder problems. He was faster than me in the pool so I hadn’t realised the extent of his injuries and type of comeback he was just starting to make.
It’s really easy to forget to consider the people around you when you are focused on your own pain and injuries. Don’t. Because I took an extra 5 minutes post-swim to chat with “the fast guy” I now have a new lane buddy who is dealing with rebuilding post injury too. So when my swimming is hurting I can look to him for an extra bit of inspiration to push through and work hard.
Always make the time to learn about others and what they are up to.