"Don't go to the doctor!" But the shoulder pain has become unbearable. "Just don't go to the doctor!" my skating coach insisted again. I always know he has my best interests in mind.
"Why not?" I asked.
"Because he will just tell you to stop skating."
"Well what if he's right? I have to feel better. It's just too much now."
"He's not right. Pain is just part of life now. You are older, you will have pain. You can still skate."
Whoa, he played the age card. No fair. Still, I know I have endured numerous minor aches and pains regularly for years, figuring they will likely be with me for the remainder of my "older" adult life. But this pain has become unbearable. It wakes me in the middle of the night, begging for attention. I have invented a hundred "workarounds" to help me dress, open the car door, put my hair up, even hug my kids without pain.
I decided to ignore my coach's pleas, and made an appointment with renowned shoulder expert, Dr. B. After a series of x-rays and an office visit filled with excruciating movement study ("do you have pain when I do this?"), my diagnosis was shoulder impingement and rotator cuff tendonitis. Basically a ton of inflammation and parts rubbing rudely against other parts that have no business being rubbed. His prescription for now is anti-inflammatories and some physical therapy. Day 2 and so far not much has changed, pain-wise. I will start the physical therapy on Monday, which will be Day 6, so hopefully the meds will enable me to do some exercises with much less pain.
OK so that is the back story. Now for the lesson. It's a lesson for me. It's my job, my passion, to help injured athletes successfully navigate the sport injury rehabilitation process and come out confident and ready to return to play. All the knowledge in the world does not compare to knowledge plus experience. I am ready to experience, ready to practice what I so fervently preach. Thought I would share with you as I go.
It's not going to be easy, as you can see from my coach's reaction. In the past, I have had sports injuries. Of course I have. Any athlete can point to any number of dings, sprains or breaks they have had. When training for the Marine Corps Marathon one year, my spirit was willing, but my achilles was weak. Had I continued to train it would surely have ruptured. I endured rehab and came back, though I did miss the marathon. Poor timing. So I have past experience to tell me that I will get through this, I will return. At that time, however, I did not yet know about the mental tools I could have used to help me. I struggled instead of taking control and thus did not fully regain confidence in my ability to run long distance.
Another difference between then and now was that I was an individual, training on my own and not with a coach or team. I did not need to please anyone with my progress but myself. There was no timetable beyond my control for my return. Now, I have a coach. And the pressure he exerts is far more than I imagined it would be. It's not like I am training for the Olympics, but I must say I have made significant progress in my skating this year, and who knows what the future holds. To my coach, though, Olympian or not, train through the pain is the mantra.
Granted, Dr. B did not specifically say "don't skate." He did say quite obviously, "If something you're doing when you skate causes pain, it might be a good idea not to do it for a few weeks to let the medication and therapy do their job."
Like many of my clients who hear these words or face the cessation, albeit temporary, of a loved activity so integrated with life, I immediately began to figure a workaround. I can still skate, sure, but I just won't use that arm. Sure, that will affect my balance, my ability to use my shoulders to guide my turns and edges. But is that so bad?
Practice what I preach. I need to do this right, if for no other reason than to prove to my clients I get it. And that the tools we use during their rehab do indeed work. So here I go.
Even though my injury was not due to a trauma but was gradual in onset, there still came the moment when I knew enough was enough. Yet I was still unprepared to consider taking a break from skating. I did not understand exactly what was happening to my shoulder. There was a feeling that my shoulder was betraying me. As athletes we are very in tune with our bodies. We know how they move, know how to direct them to perform. We know what feels right and what feels wrong. We have the sense that we are in control of our bodies. So when an injury occurs, we may feel we are losing control over our bodies. So first things first, I set out to understand from Dr. B what exactly was happening without me. He is an amazing doctor, very patient and knowledgeable. He showed me a model of a shoulder, demonstrated over and over what was going on in my shoulder, and what needs to happen in order for the pain to go away. I plan to take this information into the next phase, when imagery will really come in handy.
Did you catch Washington Redskins quarterback Robert Griffin III's press conference yesterday? If so, you may have noticed he alluded several times to mental aspects of his rehabilitation. He talked about "mental reps," mindset, goals and imagery. He sure seems to have a good head on his shoulders, and knows how important it is to engage his mind as he heals his knee.
RGIII said that at yesterday's practice he and a few other injured players went through "mental reps," rather than taking actual snaps and running full-speed plays. He said doing the mental reps kept him engaged in the practice, rather than just sitting there, watching. "Practice can get a little boring when you aren't taking those mental reps, but as long as you get at least a little bit of work in, we don't feel like we're completely separated from the team." This involvement is vital when you find yourself on injured reserve. In addition to helping you to still feel a part of the team, the activity that you do engage in, even mentally, continues to strengthen the neural pathways involved in the physical movement of play. RGIII held the ball, dropped back, surveyed the field and threw the ball. He did not do any sprinting or cutting like he might have if he were in perfect health. Since there was no pressure to actually complete the pass or avoid a blindside hit, he was able to focus more on the process of decision making in the plays. He explains, "The mental rep is...basically just paying attention...It helps you by looking at it from a different perspective, so that when you get out there on the field you understand that you only need to look at this guy on this play, this guy on this play, and you go about it that way."
RGIII also knows the importance of setting goals when embarking on the seemingly endless road back to full activity. He said as soon as the surgery was over, he thought about the date of the first game of next season. He made that his goal for returning to play. He even set that date as his pass code on his phone!
Finally, he talked about his mindset as a player. While many may criticize some of the play calling decisions made in the past, we all need to remember we are dealing with a "high-caliber athlete," as RGIII referred to himself. More may be expected, but more will likely be achieved as well. He said he wasn't going to change his mindset, his will to win, but he would do a better job of making more appropriate decisions for the situation. He also talked about his emotional mindset upon his return to play. Many athletes have a nagging doubt that their injury is truly healed, or they fear that they will suffer another injury. RGIII said, "It's all about having that confidence. If you put the work in, you'll have that confidence when you get back out there on the field. It's about playing like you were never hurt." He said when he returns to play he will not play afraid. He will believe that he is invincible. His fans are way ahead of him on that one.
"Even if you are on the right track, you will get run over if you just sit there."
Personal Best Sports
The sports world is filled with stories of perseverance, failure and success, personal struggles and public triumph. Each story provides insight into the mental side of sport and activity.