Beyond the Tissue - When Injury and Identity Don't Align


Injury is scary. No matter who you are, or what you do, or what you think you know about the human body, when it is yours...all bets are off. It's funny how the human brain can, in a moment, shift from firm conviction to absolute uncertainty. The amount of times that I've had clients tell me that XYZ medical professional told them "You will never [insert activity of choice] again, if you're smart anyways..." and the number of times my response has been " BULL S*** YOU WON'T" are one and the same. Yet when the same words came directed at me, you may have thought I had never learned a thing about the human body, its resilience, its ability to come back stronger and better after countless insults. As I've learned in this first true run in with personal injury in the past week, it turns out that the entire experience is pretty different when its YOU, when the treatment room is turned and you find yourself on the "patient" end of the spectrum.


It isn't that I've experienced pain before, quite the contrary. I've had my fair share of issues I've had to self-manage. From some cranky knee pain I've had to keep in check for about as long as I can remember, my "wonky" hip that talks back when I forget to do my homework, or the countless falls off a horse that left me with the scrapes and bruises to my body and more often my ego. But, this was certainly what I would consider to be my first true injury. It's interesting to me how blurry the lines can get between the two. Even though we know from the research over the past decade that "injury" and "pain" are NOT one and the same -- that you can certainly have pain in the absence of injury and even vice-verse at times -- the difference in experience is something I had not truly appreciated until this past week.


It was a freak thing-- the type of thing you can think about for days and reason "well if I would have only done this, or changed that, or not done this" -- but at the end of the day, was truly just a "sh*t happens" kinda moment. At the moment it happened, I tried hard to convince myself that maybe I was fine, that it sounded worse than it actually was. In fact, for the next 24 hours, I kept trying to convince myself that it was no big deal, that a dislocated shoulder (visuals below, because if you don't show your gross pictures did it really even happen??) could just be popped back in and then I'd be up and at 'em as usual the next day.



But once I woke up on the day after and the initial denial (and let's face it, residuals of the 'conscious sedation' -- whatever that oxymoron means), the doubt started FLOODING in. "Question cliffs" I had talked clients off MANY times before... "Will I need surgery? Will it happen again? Will I have to WORRY about it happening again, forever? Will I ever be able to do olympic lifts or pull-ups again? Will this impact my work? How much is too much, too soon? Is 50% REALLY an accurate reoccurrence rate? How long until I can reach overhead? Is it normal for my arm to feel so heavy?" Try as I might to quiet my mind from all the questions, the self-sabotaging thoughts kept flooding in. And even though I kept telling myself that this was no big deal, that this really wasn't a big injury, that it could have been way worse, that I'll be back to myself in no time, I couldn't help but think about all the things that I had been working toward, the progress I had been making towards my goals, and the massive step backward all of that would take in the process of recovery. I couldn't help but dwell on all the things I couldn't do that I normally don't even think twice about. And, if I am honest, it was the first time that I truly realized how much of my identity is tied to being healthy, physically strong, and independent. Even though I cognitively knew that a little shoulder injury couldn't take that away from me, sometimes the hardest person to convince is ourselves.


But after my allotted 12 hours of feeling self-pity and a tasteful smattering of what I believe to be very direct signs from 'the Man Upstair', I became aware that there was something that this process would teach me, that it already WAS teaching me, that would help me to be a better PT, a better person. One with a stronger appreciation for how deeply our identity is tied to what we do with our body, and a deeper understanding of how essential exploring-- TRULY exploring-- that with our clients is as a part of the recovery process. That no matter whether the "what we do" is our fitness, or our work, or our hobby, or our family roles, or most likely a combination thereof, that anything that derails this has the power to derail our own identity, our own sense of self.


The next day I got up and worked out. It wasn't the best workout, I was awkward with my arm in a sling and I was moving pretty slow. I maybe lasted 10 minutes. But I instantly felt refreshed. I felt "me". I realized that my identity is higher than my circumstances and that at the core of my identity is grit, always has been and always will be. I made the conscious decision to start measuring my progress across a few simple metrics, which I will post below along with my exercise progression, and to actually trust the process like I say others should. I am also going to share notes of encouragement sent from people in my life and from different motivational & spiritual sources (note- NOT pushing any type of spiritual agenda here AT ALL, but in my desire for authenticity I want to share the little nuggets that helped shape my perspective along the way). My goal is to share this process not because I think what I have to say is really all that novel, or that I think I will have some profound perspective that hundreds of people haven't had before, or because I think my injury is really even all that unique or complicated. But my hope is that deeply and authentically exploring the actual process of recovery from a first person point of view for the first time in my life will not only help deepen my own learning process and catch all the lessons I know this experience was designed to teach me, but maybe even help someone else that has gone through/is going through the process too. If you're joining along for the ride, welcome! Happy to have you alongside me on this journey and I eagerly await the lessons that are packed within.

OBJECTIVE MEASURES & EXERCISE LOG


Day 1 post-injury (12/6)

  • Active Range of Motion (AROM), L shoulder: Flexion: 46 deg; flexion w/ elbow at 90 deg: 82 deg; Active ABD w/ elbow at 90 deg: 34 deg

  • Recovery Exercise: 4 way isometrics 3 x :30s @ ~10% effort


Day 2 (12/7)

  • Active Range of Motion (AROM), L shoulder: Flexion: 56 deg; flexion w/ elbow at 90 deg: 82 deg; Active ABD w/ elbow at 90 deg: 40 deg

  • Recovery Exercise: 4 way isometrics 3 x :30s @ ~20% effort

  • Workout: 20 minute AMRAP- 50 banded squats, 50 lunges, 20 lateral step downs, 200 m jog (all in sling)

  • Verse that came up in my devotion:


Day 3 (12/8)


  • Active Range of Motion (AROM), L shoulder: Flexion: 105 deg; flexion w/ elbow at 90 deg: 115 deg; Active ABD w/ elbow at 90 deg: 59 deg

  • Exercise: 4 way isometrics 3 x :30s @ ~25% effort

  • Workout: 5 rounds for time: 5 push press R (35#), 5 steps ups ea (35#), 5 DB hang clean and jerks R (35#), Rest 1 minute. (In sling)


Day 4 (12/9)

Back to the gym! Thankful for awesome coaches at the gym (CrossFit D5) for custom programming me workouts to still get the stimulus and make me feel the same.

  • Active Range of Motion (AROM), L shoulder: Flexion: 120 deg; flexion w/ elbow at 90 deg: 130 deg; Active ABD w/ elbow at 90 deg: 66 deg

  • Exercise: 4 way isometrics 3 x :30s @ ~30-40% effort / 2 x 10 gentle banded rows to tolerance, 2 x 10 bent over scap sets

  • Workout: Belted box squats 53# 6 x 20 / hollow body hold between sets. // 10 min AMRAP 16 cals assault bike no L arm, 20 tuck ups (in sling)


Day 5 (12/10)

  • Active Range of Motion (AROM), L shoulder: Flexion: 138 deg; flexion w/ elbow at 90 deg: 134 deg; Active ABD w/ elbow at 90 deg: 75 deg

  • Exercise (thanks Abby McDowell for the additions): 4 way isometrics 3 x :30s, AAROM PVC, scap sets 2 x 10

  • Workout: A myriad of fun involving lateral step downs, banded good mornings, reverse sled drags, Sorensen holds, leg drops (no more sling!)


Day 8 (12/13)

  • Active Range of Motion (AROM), L shoulder: Flexion: 140 deg; flexion w/ elbow at 90 deg: 140 deg; Active ABD w/ elbow at 90 deg: 75 deg

  • Exercise (thanks Abby McDowell for the additions): 4 way isometrics 3 x :30s, AAROM table slides

  • Workout: 2 mile run limited ROM left arm, 30 - 20 - 10 of DB push press, rearfoot elevated split squats, goblet squats, bent over row R arm only




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