Pain…We all have it at one time or another. We all tolerate it differently. Hopefully, the pain we experience is relatively short in length. But, eventually most of us will start dealing with chronic pain. It doesn’t really matter who you are, or what kind of pain you are suffering from. Pain is debilitating. Both mentally and physically. I wrote this blog and asked my husband to read it. He said “Yeah… What’s your point?” Well… I don’t exactly know. I may not really have a point. But what is clear to me is that others can relate to your pain. Sometimes you need to hear about other peoples’ journey to inspire you and keep you moving forward. And really, it just helps to know you’re not alone.
For years, I’ve dealt with pain. Lots of pain. Pick the pain…good pain, bad pain, general suffering till you think your chest and head will explode in a race. I think it is easier to name the parts of my body that have never incurred an injury than list all that have. Yep! I’m a mountain biker! I ride and race downhill! I suck my way through cross country races. Heck, we haven’t even mentioned the gym! Its the name of the game. Right? Ride, race, crash, ride, race, crash… I mean, I live with a foam roller next to my bed. Doesn’t everyone?
As a personal trainer I am very aware of the pain dysfunctional movement patterns and overactive muscles can cause. I won’t lie – up until 5 or 6 years ago I naively thought as long as I kept moving, working out correctly and being aware of proper motion, I wouldn’t experience arthritis and pain the way I see so many people do as they age. I always thought, “We ALL have pain…get over it. just keep moving and go WORK.” Bahahahaha! I won’t say that I was a horrible person or trainer for feeling that way. I won’t say other trainers or doctors for that matter are horrible people for feeling that way. Young? Maybe. Currently uninjured? Maybe. Definitely lucky enough to not be living with chronic pain.
I guess from here, we could go into how differently people experience and manage pain. Rather than talk about the general population, (not that I don’t think addressing pain in ALL people is important and life changing) I think its easier to understand why so many mountain bikers, downhillers in particular are pretty tolerant of pain. It’s the same reason we find it essential to sometimes keep riding when we are in pain. Adrenaline…. Some of us need that shit in our bodies on a regular basis.
Now my point, that really has no point, is how we in the fitness and healthcare industries deal with pain. Along with how our bodies and minds deal with it. So, let’s get back on track. I have pain. Chronic, debilitating pain…pretty much everywhere. I have varying degrees of osteoarthritis in nearly every joint in my body. But my knees. Well, the knees are a mess. (remember that keep moving thing…. yeah, right!) I guess when you slam into a rock, even with hard knee pads on…ok…repeatedly slam into many rocks over many years! Dislocate your knee cap, tear the quadriceps tendon, crush the body of the vastus medialis and rip apart the articulating cartilage on the patella, the effects could linger… Or, well… just be permanent.
Lucky for me I have been referred to THE KNEE guy. Head of the department. He is THE BEST! Or so, I have been told… He’ll have the answers! Awesome! It’s simple really. The only movement that causes extreme pain is flexion of the knee. Like the flexion you MUST hit while riding a bike down hill. The doctor’s answer? Stop riding bikes. “Start acting your age.” I shit you not… I was informed, people my age… Oh! sorry, WOMEN my age, don’t do the things I want to do. My answer to that? Stop going to the doctor! Well… get him to give you a cortisone shot before you leave. Then get in your car and scream obscenities at him.
Luckily, cortisone works great. Yay for me! Well…It works great for a little while. Of course, you know I’m a mountain biker and I’m going to ride whether it hurts or not. I’m going to race, whether I should or not. I’m going to crash…. I’m going to tear a rotator cuff tendon. I knew exactly what I had done. (I did 3 tendons in the other should five years earlier) My first thought was “no way am I doing surgery”. Recovery from that one is a bitch. Right about this time that awesome cortisone shot was wearing off. So, shit…Now I’ve got multiple things going down. All I could think was, there was NO way they’d hit me up with a cortisone shot when I had a torn rotator cuff. Plus, I knew I would once again be told it was time to act my age, which would lead me to tell the doctor to fuck off. But, shit that shoulder hurt… I KNEW I wouldn’t do surgery. But, I wanted to know how bad it really was, so I could work around it. After all, summer was coming and I had a lot of riding to do. Plus, I figured it would be a small tear and I knew it was only one tendon. In fact, I knew which one it would be. Supraspinitus. It’s a small muscle, it doesn’t do much, it’ll be fine. I just want to know how big.
Lucky for me I have a fantastic primary care doctor who ordered the MRI before he sent me to the surgeon. I decided no more “knee guy” for me… Going back to the “shoulder guy” who did my other shoulder. I think he kinda laughed when I walked through the door. Once again, I can pass all the tests and they’d never believe it was torn without that MRI. Oh, and that little tear? Yes! It was Supraspinitus. (and yes, I’m a personal trainer who knows anatomy and every muscles movement and function) Only that little tear, was a full thickness, 9mm long tear…. That’s considered massive. Pretty much go dig for what’s left and what’s kinda sorta still attached. How are you lifting your arm? I’m a mountain biker…remember. So, surgery it is. BUT! Not till fall! Cuz I’m riding my bike all damn summer whether it hurts or not! Worth it? Hell, yeah!
Boy, that summer hurt…I’d ride my bike or work for a few hours and be trashed. I felt 85. I wondered how people got through their days. Was everyone this worked from just living? No amount of pain relievers did a thing. Some other time I’ll tell you what happens to your kidneys when you take ibuprophen in mass quantities for long periods. I was ready for surgery. It went great. I knew what to do. First PT session, I had nearly full range of motion! Assisted of course! it would be a long time before I could use this arm freely again. But, pain for the most part was under control. Too bad by the time I was ready to ride again that wasn’t the case for my knees. My first ride back I’m not sure which hurt more, that fresh cut shoulder or the knees. Whatever… The shoulder progressed nicely. Can’t complain! It took a while to ride without pain though. When I had my first ride where the shoulder felt, umm, nothing… YEAH! nothing! soft, flexible, easy and just plain good, I knew the time had come to address those knees again. Sure, the shoulder surgery went well, but I didn’t have much faith that I’d get the help I wanted in regards to that knee issue.
I dumped the “the knee guy” and asked my “shoulder guy” to take a look. I was ready to start shopping if I had to. But, I had to start somewhere. Remember when I said arthritis in every joint? Well, lets just say this doctor looked like a truck hit him when he pulled up the fresh set of x-rays. Stage 4 arthritis? Yeah, right… No. Way beyond that. So far beyond that, that they BOTH need to be replaced. Like, yesterday. My right knee is in such a constant state of grinding injury that I cannot even develop bone spurs or cupping because it is constantly grinding bone away and NEVER healing. No replacements though. Not yet, anyway. I’m too young. 47. He says “lets try to get a little closer to 60.” Umm, my head thinks I’m 27 not 47, so 60 sounds scary old. (Sorry if I just offended anyone.)
Plus, my specific injuries are not what normally goes on when someone needs a knee replacement. I have great spacing between femur and tibia. But not between the patella, femur and tibia. Which means I can go run 6 miles. But 6 miles on the bike puts me out. So, here we go again… STOP riding bikes. Right? NO! This doctor actually took the time to learn what exactly it is I do! And WHY it hurts so much when I ride. Ok…. He can’t REALLY help. Because, there is nothing to do but replace them. But, he didn’t tell me to stop riding. Score one for the Doc! Well, he did say it would be best if I stopped riding, but he knew it wouldn’t happen. Uh…Yeah. That’s true. You’ll have to pry my cold dead hands off those bars. So, let’s get through as long as we can, as pain free as we can. WHAT?! Not what I expected. But, totally relieved! Shoot BOTH of ’em up this time.
The first couple days were was rough this time around. I was worried. But then? RELIEF!!! It was amazing. Awesome. Liberating! I noticed some things happening. Trust me… I still kept amazing, awesome, totally happy and excited as feelings. But then I added irritated, kinda pissy and also dumbfounded. Why? Because one of those amazing things? An anti-inflammatory effect in not only the joint that was shot up, but everywhere. Yeah… EVERYWHERE! within 3 days of the shot I had lost 7 lbs. Within a week a total of 10. What’s that say about inflammation? What does that say about stress? What I know is, when the pain left, the stress left. Why is this aspect ignored? So, from here I could get into things like cortisol levels, ability to handle inflammation caused by pain. Stress caused by pain and many other issues along these lines. But, I’ll be writing and you’ll be reading for hours. So, lets just say I was happy again and we can discuss that all that some other time. Anyway, I could finish a 2 hour ride, go to work, teach a couple classes, clean the house AND still make dinner. I could get shit done again! It was truly amazing. I had been thinking I was just getting old and lazy and that was just what happens. However, when the pain went away it became crystal clear as to how much pain I had truly been in. Also, for how LONG it had been. I am feeling calmer and happier than I have in a very long time.
So, here’s where I start to get to my point, that is maybe, not really a point. Even though I had been in horrible pain for quite some time, I had been riding all along. I had been lifting all along. I had been racing. Ok, attempting to race, cuz sometimes that racing part was bad when it hurt so much. Kinda hard to put the hurt on when you already hurting. I’m a personal trainer. I know and teach corrective exercise. I’m doing it right! Right? Maybe not. DOMS….Delayed onset muscle soreness, something that I strived for after most workouts when I was in my 20’s and 30’s. Hadn’t seen those in a while. My first ride after the shots? DOMS in muscles I would have never imagined. In places that I thought I had been working and keeping strong. Yeah, even though riding was horribly painful, I still mentally NEEDED to ride. Plus, I LOVE coaching, I love training. And most of all I love watching someone’s face light up as they succeeded. So, I faked a smile, and my way through clinics and rides and then went home and just about collapsed in a non-functioning state for the rest of the day.
Why is all this important? Because, I work with people everyday who come to me, in the gym or on the bike and they want to get stronger. They want to get faster. They want to ride gnarly stuff or maybe they just want to feel better and be able to work in their garden. So, we go through postural assessments, we work on corrective exercises, we learn to foam roll and stretch. We learn about interval training. Balance on the bike, nutrition and so on and so on… If I, someone who is a trained professional, who thinks about this everyday. Someone who has a pretty extensive knowledge of the skeletal and muscular systems, and biomechanics of the body, is merely going through the motions. What is happening to our clients who really don’t understand joint stability, proper joint movement, core stability, or how to keep tension in a muscle. How do I help these people? Can I ever really help them or make a difference? Are they like me? Where no matter how much corrective work they do they will just NOT be able to repair the damage and fix the problem? When I brought this to other trainers they understood my questions and concerns. But, they had no answers. When I brought it to my doctor, I think he thought I was nuts…. He also thought I was asking for way more than the average person. Yeah, I get that. I want more…. and I’m not ready to give up the things I want to do. And I won’t.
So, I guess I’m finally at my point, that is really not a point because there is no clean conclusion to this. I want to find relief. I want YOU and my clients, athletes and everyone else to experience relief too! I know my days of being pain free or even just limited pain are numbered… I’ll get another shot in each knee next month and hopefully get through this year with the help of a couple more. Then I’ll probably be left trying new things. I know there are a few other procedures that have shown some success. Stem cell therapy. But, few main stream doctors are jumping on board with those procedures and NO insurance company is game to take that one on. Sure, it’s your body, its the only one you get and YES, its the most important thing you have. But I also don’t have 8-10K sitting around to spend on something that has shown some results for only some people. We as fitness professionals and healthcare professionals, HAVE to work better with one another. I really dislike the use of drugs or products like orthotics that cover the pain up rather than address the issue. But, sometimes we have to accept that our issues may not ever be resolved and we have to be willing to tackle them any way possible. You, as the person in pain have to be your own advocate. Yeah, I know most of you already know this. But sometimes we forget or don’t have the money to search out the professionals that can help. When you’re in pain it almost becomes a job to figure it out and for most people you’re probably not going to be able to do it by yourself. I think putting this on paper may have been somewhat selfish… A way to get this all off my chest and get people around me to shut up and quit whining… Or maybe it’s a way to get people talking more. I don’t know. But, I know it inspires me to hear that my friend on the lift or client in my class or on the TRX next to me is not giving up.
As athletes and people in the fitness business, our persona, our self esteem and self worth and our financial well being are somewhat tied up into what we do on the bike or in our given sport. For an athletes’ sanity and well being, we’ve got to get this under control. So, how do you get your doctor to understand that just quitting racing or riding is not really an option. How do you get your doctors to play nice with your fitness professionals? When are doctors going to acknowledge the amount of stress that chronic pain can have on your life? Keep shopping and don’t give up? I’m no sure if those are rhetorical questions or legitimate ones.
Like I said, I’m writing this with no hard point or actual conclusion. I may not have all the answers, but I’m not ready give up! I know there are others in the battle an on the journey with me. Sometimes it just helps knowing we are in it together.