My recovery from nerve injury (part 1)
15 Jun 2021
It’s been almost two years since I wrote on this blog. And for most of those two years, I’ve been struggling with a nerve injury in my hip and groin. I started many a blog post during this time, but always ended up scrapping them because the pain was too fresh, too raw, and what I wrote felt melodramatic or untrue to the experience. Also, there was a pandemic, soooo, that happened.
Anyway, to prevent this post from being 723094092358234809 words long, I’m going to skip over most of 2020 (I mean, seriously, did it happen, anyway? was it real? did we all fall into a collective black hole?), and start this story at the beginning of my recovery — when Macky and I moved to Boulder, Colorado in November of 2020 to work fulltime with REVO PT and Performance. If you want a synopsis on my 2020 and to see how I ended up with a nerve entrapment, you can watch this video from our YT channel. But, otherwise, let’s all pretend it didn’t happen!
For the past seven months, I have had the opportunity to reinvent myself physically, and become a completely different athlete. This was an enormous privilege but the cost of entry was high — although I desperately needed this, I never would have done it if I hadn’t been in pain for almost a year first. By the time I arrived in Boulder in November I had had near constant nerve pain in my left hip and leg for close to a year. I had lost a huge amount of muscle mass on my left side and couldn’t properly activate those muscles. I couldn’t stand on my left leg for more than a few seconds without losing my balance, because my body had almost zero idea where my left side was in space. Mentally, I was depressed, fatigued and seriously doubting whether I would ever ride, much less race, again. To quote T-Swift (which I will unabashedly do), “to make a long story short it was a bad time.”
It is hard to describe the mental toll of chronic pain, but for me in manifested in a sense of permanence. The more pain I felt the harder it was to remember what being pain free felt like, and the more it felt like “forever.”
For the first three weeks we spent in Boulder, I did nothing but hydrants/clamshells, in a bid to get my left glute to wake back up. Every day, I went into Revo, attached EMG sensors to my ass and willed the blue line to come to life.
Eventually, it did. I started to be able to activate my glute while doing hydrants, and then skates, and then even while doing mini squats. For a brief moment, I thought, this is it, I will just stare at this screen and as long as my glutes are doing what they are supposed to, the pain will go away.
Of course, it was not nearly that simple. Activation was only one tiny piece of a very big puzzle. By activating my glute, we had proved that my nerve damage was not so bad as to completely block the pathways between my brain and my butt. So, good news, indeed, but hardly a complete solution. During this time we had also started addressing my “bad posture” which was actually a fairly significant curvature in my thoracic spine. It quickly became clear how connected this was to both my hip/groin pain and the thoracic outlet issues I have dealt with for over a decade.
And problems that have taken decades to create do not unwind themselves easily.
Over the following months we worked on thoracic spine mobility, balance and proprioception, all while trying to slowly increase strength without irritating the nerve. This was a fine balance, and often we exceeded the limits and I spent a week laid up with pain, but I was almost always able to get back to the gym within a week to ten days and pick up close to where I left off. Thus, we made progress despite near constant setbacks.
I had always heard “recovery is not linear” and I probably bandied that line around during previous injuries, which were, in retrospect, incredibly linear. I now have a much better idea of what a nonlinear recovery entails, and to give you some idea, for a long period of time, I felt extremely lucky to be making progress one week of the month, because for most of 2020, I never got more than three good days in a row.
In March, things started to turn around in a more significant way. One or two good weeks a month became three, three and a half. My strength workouts were now harder and heavier than before injury, although still tailored to be cautious of certain problematic movements. Hard workouts plus movement retraining left me exhausted every day. I started going to bed at 8pm most weeknights (sometimes earlier, yes, for real) and tinkering with my diet to increase protein and hopefully gain back muscle mass. It worked. I gained 10 to 15lbs between mid March and mid may. Gaining muscle has never been easy for me — to put that in perspective, I didn’t gain weight after a year of almost complete inactivity, so to put on weight while also exercising was a very conscious effort. In many ways, this has transformed my body into something I am not entirely comfortable with. My pants no longer fit and I feel farther from my goal of being an endurance athlete. At the same time, I know this is a necessary step to gaining the strength I will need to train again.
In May, I started riding again, 20 minutes at first, then working up to an hour of pedaling on the e-bike. While riding for an hour on the e-bike seems very insignificant when I look at the big picture — I want to be able to race 50 to 100 miles on a normal bike! — it is a huge step forward and something I haven’t been able to achieve consistently in 18 months. It also opens up a lot of possibilities for fun. E-bikes are truly awesome. And, if I’ve learned nothing else from this injury, sometimes it’s better to NOT look at the big picture, and just focus on the next step forward.
And, right now, the next step forward is leaving Boulder and continuing my recovery while also living a normal life. To be honest, this step terrified me. Being able to see Dane three times a week and confer every time something felt weird or when the pain started to get out of control, has been instrumental to keeping me on the right path. However, it’s now been several months since I had a significant flare up, and it’s pretty clear what I need to do. Keep building strength. Slowly work in riding. And be really f*cking patient.
Being in Boulder has been both expensive and all consuming. For seven months, I did almost nothing beyond physical therapy, gym work and rest. I did more resting than I would have thought possible and really reevaluated the amount of recovery that I need. (Luckily we have some really amazing friends in Boulder, who made sure we did something fun at least ONCE a week.)
This whole process has been one of slowly removing metaphorical “crutches.” For six weeks, EMG was the crutch. Then careful movement in front of the mirror. As long as I move perfectly, it won’t hurt. Then Dane took away the mirror and I started working on balance exercises with my eyes closed. My body knows how to do this now. The final crutch was being at Revo under Dane’s close supervision. Now I’m stepping back into the driver’s seat of my recovery (with continued guidance from Dane and Mike, obviously). I know how to do this.
The thing about chronic pain is that it destroys your ability to interpret pain signals. Last year, I became terrified of pain in a way that I had never experienced on the bike or with previous injuries. Not because of how painful it was (although it was obviously painful), but because of what that pain meant. Failure. Setback. Permanence. The loss of my career and way of life. Instead of diving into pain the way I would at the end of a bike race, I folded, over and over again, doing anything to avoid the pain, and by the time I arrived in Boulder I no longer knew whether I was fleeing emotional pain or physical. The key to unwinding this was trusting someone else. If Dane said I could do it without making things worse, I would do it. The end. I ceded “listening to my body” to someone else, because I was f*cking done. Obviously this is a dangerous game, and I feel insanely lucky to work with someone like Dane who I trust implicitly and who was 100 percent committed to getting me out of this hole.
Now, however, it’s time to tentatively start to trust my body again. I now know that I am not going to reinjure myself doing normal movements, even when those movements occasionally do cause pain. I now know what I can push through and what means I need to pull the plug.
And the next step is slowly reintegrating my recovery back into normal life. The reality is that nerve injuries often take 12-18 months to heal, so while this recovery time sounds insane to those who haven’t experienced it, I am still within the realm of “normal” and there is no reason to believe I won’t make a full recovery, there is just absolutely no way to say when. And while this injury has been soul-crushing on so many levels, I can confidently say that I am now a stronger, kinder person. As so often happens in life, we don’t get what we want, but we get what we need.
I’m so glad for you! Keep up the good work!,
Hey so nice to see you on here writing again! I also experienced a huge health setback in 2019 and have been learning to deal with and try to come back from it physically and mentally and emotionally ever since. So although I’m sorry for your situation and what you’ve had to go through, it is encouraging to know others are going through similar things and are making a comeback! Here’s to both of us riding strong again in the very near future!
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