Achilles Update - tying shoelaces

It’s the simple things in life that are often so good. Tying shoe laces is one of those, especially when it marks a milestone…in my case, getting out of the CAM boot and being able to put a shoe on my left foot and tie the laces up…for the first time in 6 weeks!!! Hooray!!!

The first few steps were a little tentative, and my whole leg and calf, in particular, are really weak. But nonetheless, they were steps in the right direction and as long as I don’t walk too fast (or too far, for a little while), I can walk OK. The Achilles feels good albeit still a little stiff.

This morning I went to the gym and looked like a normal gym person without the freaky boot on. Funnily enough, apart from two friends I’ve bumped into there, no one has actually asked about the boot and why it was on.

So from here on it’s all forward progress. Just try and stop me now!!

The scar is looking really good without too much scar tissue build-up.

Simple things like wearing a shoe for the first time in 6 weeks!!

Achilles update - feels like Christmas week!!!

Do you remember when you were a kid in the lead-up to Christmas, and the excitement you felt for what was coming up. Do you remember the anticipation for the surprises were in store, almost as if it was like a new life was waiting for you. Do you remember how much you just couldn't wait, and counted the days...and how many sleeps??

I feel just like an excited kid at the moment, except it's not Christmas I'm looking forward to (although it could be Christmas in July!!). You see, Friday is my last day in the CAM walker, moon boot, which will have lived on my left foot for 4.5 weeks. Saturday will be my first time on my own two feet in 6 weeks, since before the operation. I'm soooo looking forward to it.

There's not much else to update on. The heel feels fine...probably because the boot stops me from using it. The scar looks OK. The range of movement is improving slowly. And each week I see Rosie the physio who gives the heel and ankle a good working over.

4 sleeps to go...

Coping with being injured

"I get knocked down

But I get up again

You're never going to keep me down"

(Chumbawamba)

Injuries...yeah, I've had a few. Strains, sprains, bruises, inflammation, tendinopathy, tears, fractures and not to mention burst appendix and a case of "man cold"(!!). As for treatments, I've tried rest, physio, massage, rest, dry needling, ulatrasound, rest, taping, cortisone injections and just recently (June), some more surgery. Nothing like some good scars to show-off...

I write that to simply illustrate that injuries and ill-health are a fact of life, perhaps moreso when you play sports. There's no good time to be injured - or sick - but how you respond makes a big difference to how soon you return to the game. It's not how hard you hit the ground, but how well you rebound that's important.

I'm not a medical professional, and you should always consult one to assess your condition. However, what I will try to describe is how to approach the situation of being injured and what kind of things to do.

The biggest obstacle athletes have in relation to injuries is denial. When you're fit and healthy it seems inconceivable that you could break down or get sick. Besides, as athletes we're used to pushing through fatigue, pain and more so you rarely feel 100%. However there's pain and there's pain, and the sooner you can acknowledge that the pain you're feeling is not normal the better off you'll be. Early intervention is the key, even if it means swallowing your pride. Be honest with yourself, because the only person you're fooling in denying an injury is you.

While there are a range of common and frequent injuries sustained by athletes from the same sports you should consider your injury as unique, and not necessarily be complacent because of someone else's 'miracle' recovery. Sure, you can learn a lot from people who've been in those situations but you are still best served seeing a medical professional about YOUR injury. The theme is to be honest with yourself and get it checked out.

Should your injury be something that requires rest - full (all sports) or partial (just one sport) - then you're faced with the reality of the situation, and often it's hard to accept and swallow. Sympathy is cheap when you can't join in. But action is the antidote to despair, which means you should focus on what you CAN do, not what you can't.

There are lots of things you CAN do...remember, doing your chosen sport is and was just one of a million options for spending your time and energy. So that leaves one millon-minus-one things you can still do...and many of them can be constructive to your development as an athlete. These things will inevitably be different and less than you're used to do doing, but at least you're being proactive about rehab and maintenance. Understand and respect the limitations of your injury, and then work with them and not against them.

Here's some practical suggestions (clear these with your medical professional):

• As a triathlete, have a focus period on the sports you can still do...as long as it's not detrimental to your injury.
• Do a modified version of the sport you're injured in. Eg, Deep water running, stationary bike trainer, swimming with pool buoy.
• If you're a single-sport athlete...take up a new sport. Pick on that uses the same half of your body - upper/lower. Eg, A runner takes up cycling. A swimmer takes up kayaking.
• Core and general strength work...almost EVERY athlete can benefit from more core strength training.

Once you know the things you can do this should be your training goal, to treat with the same dedication and determination as normal training. Your mindset should be as an athlete.

Athletic performance is part physical and part mental so there's also a great opportunity to shift the weighting of your preparation, and boost your overall performance. An educated athlete will beat a less-educated athlete of similar ability every time. Education covers everything from knowledge of your body, training techniques and nutrition to tactics and psychology. Spending time on the outside looking in gives you new perspective, understanding and appreciation for sports performance...and even some valuable insights. But only if you're looking for them.

Try, also, being a supporter on the sidelines for a while by investing time and energy in supporting your friends, encouraging them and helping them. They'll appreciate it and it keeps you as part of the team/group. Pay it foward for a while and in the long-term you'll be far better off for the experience.

Finally, when it's time for your comeback - to get up again - you'll have greater wisdom and will treasure the opportunity to actually be fit and active again. It's a gift and not a right, because there's millions of people who'd love to be in your shoes.

So when you're injured look on the bright side at what you CAN do, for both you and others around you. Put back in. It's good for karma.

Achilles update - more tortoise than hare

You might remember the children's fable about the Tortoise and the Hare.

The story concerns a hare who ridicules a slow-moving tortoise and is challenged by him to a race. The hare soon leaves the tortoise behind and, confident of winning, decides to take a nap midway through the course. When he awakes, however, he finds that his competitor, crawling slowly but steadily, has arrived before him. The moral of the story could be that slow and steady is more effective in the long run.

I'm taking the tortoise approach with my heel, and basically there's not a lot to report on it. Just slow and steady progress, and I'm really just biding my time until I get out of the CAM walker boot in 2 weeks and 1 day...yes, I'm counting every hour...

Since the last update I've recovered from the "man cold" I had, started applying Vitamin E oil to the scar and started taking fish oil capsules and Nurofen tablets, these last two things to address the inflammation in the heel. I've never taken fish oil before and not sure of the side effects, but geez, I've never farted so much in my life since I started on them!!!

The scar seems to have recovered well although in the last couple of days the scar area has kind of bunched up. It's not sore but there is a whole lot of scar tissue building up.

I have a weekly appointment with my ace physio, Rosie, who works her fingers into my heel, scar, foot and more to loosen it all up. There's no pain from it in the area, and over time the swelling will come down. We have some good chats - she's a triathlete and we swim in the same squad so there's plenty to talk about.

The next milestone is to get out of the boot, when I can start to do some gym exercises and slowly get into walking. I've already joined a gym to start some exercises - plus swimming regularly - but I'm a bit limited in what I can do. These last couple of weeks in the boot are taking forever...can't wait to get out of it.

Warming up

What do you do at the start of every training session? You warm-up. The first part of any session is all about warming-up your body, getting into the right mind frame, and pre-paring for the session ahead. It's pretty basic stuff and something most people do without even thinking about it. Nonetheless it's worthwhile understanding some basics about warming-up and what kind of warm-up to do in various situations - training and racing.

There's volumes of information around about warming-up, and what happens both physiologically (eg, increased blood flow, increased muscle temperature, improved range of motion) and mentally (eg, clearing the mind, reviewing skills and strategy). Each explanation inevitably includes examples of warm-up exercises to do - all equally beneficial in various circumstances - and provide a great basis for looking at specific warm-ups for triathlons.

It's worth noting at this point that not every session needs a structured warm-up, as such, for things like easy runs, easy rides and the like. While there is a still a warming-up stage you go through in the early part of the session, the following explanation is more suited to the times you're doing an "interval" type session or race.

The basic structure for a warm-up is as follows:

1. Aerobic Start-Up
2. Drills and Skills
3. Pace Preparation
4. Good to Go

Additionally is equipment and clothing preparation, hydration considerations, nature calls, etc. Ideally, these stages follow-on from each other in close succession or else you'll cool-down and need to go back a stage or two to adequately warm-up.

Aerobic Start-Up

This stage is common to every session we ever do. You head out the door and ease your way down the street. It doesn't matter how fast or slow you go, just get going and take your time for the blood to start flowing, heart rate to pick up, the rhythm and feel for the movement to develop, and your mind to start focusing on what you're doing. This will take a varying amount of time for each person, depending on the weather, your level of fatigue, arousal and other factors. It's important not to rush into this stage too fast, or force yourself too hard. Just relax and ease your way into exercise over the course of 5-20mins and you'll be well on the way to being ready for your session.

I don’t recommend static stretching once you’ve completed this stage – it stalls your warm-up plus and is far better being done once you’ve finish the whole session or race.

An important role of this stage is listen to the things your body is telling you. The early minutes are an important time to pick-up on messages about how you're actually feeling, any little injury niggles, your health and more. However the messages may be confusing, and may take some time to become clear. It takes a lot of experience and understanding of your body to be able to interpret it reliably and accurately. Nonetheless, the signals during the Aerobic Start-Up are invaluable and can have a bearing on your session or race.

Drills and Skills

Following the Aerobic Start-Up stage is the time where you click your mind and muscles into the desired movement patterns for what's ahead. Drills and skills could be a routine part of every session - up to 5mins each time - because when they're repeated often enough they help to develop and refine your technique in an on-going manner. This stage applies equally to every sport.

There's a myriad of drills and skills for each sport, where you should select 2-3 different ones which have a different focus from one another, and run through each one for 1-2 mins. As with all drills, the important things to remember are to relax, concentrate on executing good technique, and to use the drill to focus your mind on the session ahead. Keep the drills and skills continuous - they should not send you into oxygen debt(!) but nor should they be a stroll. They should maintain a similar of slightly higher heart rate than the Aerobic Start-Up. Dynamic stretching can be incorporated into the drills and skills stage, also.

Don't overdo drills and skills before a session or race, and if you're new to them, introduce them gradually...especially running drills.

Pace Preparation

Along with the Aerobic Start-Up, the Pace Preparation stage is the most important part of the warm-up. This stage is what really tunes you up for the intensity and effort of the session or race ahead. The aim is to replicate the pace and speed of movement that you'll experience, but over a short distance so that this stage is not a training session, as such.

Pace preparation consists of reps over a duration of 15-30 seconds, with a recovery of about x 2-3 of the duration of the rep. Typically you’d do about 5-10 such reps. Within each rep use the first 3-5 seconds to build your pace to about 90-95% of max (this is NOT a sprint), and hold that pace for the duration of the rep. Each successive rep will feel slightly faster than the previous one as your body adapts to the pace, your range of motion increases and your neurological system develops it’s ideal rhythm.

It’s really important not to race these reps – they are at your own effort level. Relax and concentrate on feeling rhythm, feel and movement for the sport you’re doing. Don’t force it…just work your way into and through the reps so that by the end you feel ready for the session or race ahead.

Good to Go

This stage is marked by not really doing much physically at all!! It’s more of a time to mentally prepare for the session or race ahead, to make sure you understand the workout details, race strategy, or similar. It’s important to keep moving to maintain the looseness you’ve already achieved during the warm-up, which may be by repeating some drills, short pace reps, or just staying loose. Cover up and keep warm, if necessary.

A small problem with this stage is that it can allow you to think too much about what’s ahead, which may “do your head in” via analysis paralysis. This is a mental skill to practice in training racing, so you maintain optimal arousal until you start the session or race. Repeating a mantra can help, one like “loose as a goose” can relax you. Ideally this stage will be little more than a pause in proceedings and flow-on from the preceding warm-up.

A good warm-up is the entry point to a good training session, which in turn is an entry point to good race performances. It’s something you can practice over and over, and learn how to adapt it to various scenarios to help you manage your body to get the most from it when it counts.

The only way is up

Don't be afraid if things seem difficult in the beginning. That's only the initial impression. The important thing is not to retreat; you have to master yourself."

Olga Korbut, Gymnast - Four Time Olympic Gold Medallist

This post is more of a personal record for me, to mark this point in time so I can look back in months to come and reflect back on it and see how far I've progressed. Things are already looking up since after 5 days with a bad head cold - 2 days where I literally lost my voice - I can almost talk today. That coincides with managing to go swimming today and do some exercise which has been sorely absent for weeks and weeks.

So from feeling about the weakest, un-fittest and un-healthiest that I can ever remember, the only way is up...and I can't wait.

I feel a little ungracious writing all that...and I'm certainly not whinging or complaining...since I'm actually in a really great position and what's happened over the last month or so is setting me up for many more years of exciting living, sports, events, good times and more. This is just a little bumpy section and serves to remind me just how fortunate I am in many ways, not least of which is that it's only temporary.

So here goes. From this point onwards the only way is up.

Achilles Update - Tentative steps forward

It was only a week ago that I was taking my first few, tentative steps after getting off crutches. They were tentative because they hurt so damn much because my ankle was so stiff and stuck in a toes pointed position so that I literally couldn’t put my foot flat on the ground. It felt like two steps forwards, one step back. For the first couple of days officially off crutches, I actually needed them to be able to get around!!

It was hard to explain what was limiting my movement – it wasn’t specifically the Achilles, just the whole ankle – and this has became the first challenge of the recovery, to get my range of motion back.

The scar has healed really well, and is a lot less gruesome than it was. It took a few days to “seal” up fully but now it has I’m up to applying Vitamin E cream on it to help it recover. Additionally, there’s minimal general swelling of the foot and ankle, which is a big relief, although the area around the operation site is puffy, which is to be expected.

One week after having stitches out, it's looking good.

I saw a physio last Friday for the first of many future appointments. Rosie is really on the ball and was great in being able to explain what will occur over time, what I can expect and the check-points we’re aiming to achieve along the way. She’s good friends with my original, referring doctor (Dr. Karen Holzer) so in effect I’ll benefit from their combined knowledge and expertise. I’m fully expecting her to inflict some pain along the way…physios have a way of finding pain where you thought there was none!!

Day-to-day I’m getting around in CAM (Controlled Ankle Motion) walker boot, which helps to immobilise the joint and prevent me from making any sudden – and damaging – movements. It’s relatively comfortable but is a little higher than my shoe which gives a funny feeling of being unbalanced!! I don’t wear it at home much but walk very carefully to continue the process of getting range of motion back.

 The CAM walker boot. Straps go around to hold my leg immobile.

Overall it’s all going well – the scar, the swelling, range of motion and more – and although it’s slow I can see progress almost from day to day. The next big milestone will be getting out of the boot, but that’s still a few weeks away. For the moment I’m enjoying being able to do some exercise again – swimming – and slowly getting some fitness back. Everything is going in the right direction.