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Nell’s Corner: Gaining Perspective On Athletic Injury

By Nell Stephenson, B.S.
April 16, 2017
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It’s no surprise to say that following an authentic Paleo approach to eating would help support the demands of an athlete’s physical training routine.

Low in sugar, rich in nutrient dense organ meats, abundant in leafy greens, and balanced out with a variety of natural fats, this common sense manner of eating truly does provide all we human animals need to thrive during our day-to-day routines and to achieve our goals as athletes.

But even the most idyllic eating pattern can’t make up for physical wear and tear that the body undergoes when pushed to or past its limits.

Despite my years of racing triathlon, marathons, and Ironman, I’ve been able to remain quite healthy, with the exception of some mild soft tissue injuries, such as a hamstring tear back in 2011. The forced time off resulted in my having to rest, take stock, regain perspective, and then ease back into training stronger than before. That season, I ended up achieving both my marathon as well as Ironman PRs (3:01 and 10:17).

My Paleo approach to eating, combined with increasing fat in my diet over the past two years, plays a key role in keeping healthy.

So too does being mindful about running surfaces, running shoes, and running volume, factoring in more time for sleep, rest, recovery, and meditation, and finally incorporating more stretching, strength training, and yoga.

Yet, it still wasn’t enough to prevent the wear and tear on my feet and just a few short weeks prior to when I’d planned to break my PR on my home course of the LA Marathon, something went awry.

I had completed my last longish tempo run (two hours at sub race pace,) felt great, and finished up with a cool down walk and some stretching.

About an hour later, I felt an odd twinge somewhere I’d never had an issue - in my left ankle. Later that day, it moved to the inside of my ankle and by the next morning it was a distant memory.

After Monday’s dog walk and Tuesday’s Master’s swim, I forgotten about it.

Wednesday, I headed out for a 90-minute easy run on the trails…and when I was finished, I couldn’t walk properly. Each step hurt if I walked any other way than on my toe!

The race was less than 3 weeks out, but I decided that I was doing the race until I wasn’t doing the race. I channeled Deena Kastor and thought about a story I’d read in which she’d had to take 6 weeks off prior to the Olympics and ended up setting her PR!

A few days off from running never hurt anyone!

I had a growing suspicion something wasn’t right, but I decided to go for a test run anyway, which lasted all of three minutes.

More time off running.

Another test run. No go.

A few PT sessions. A couple of massages… another test run. Nope.

Finally, the Friday before the race, I called a podiatrist from my health insurance network, who did an X-ray, (which I later learned only shows a stress fracture after it is healing), told me I should be fine with some Aleve and heel lifts and to plan to come in the next week to get orthotics made.

Wanting to believe him, I headed down to the expo to pick up my bib. Have I mentioned my number? A1111. Didn’t help much thinking it was some kind of a sign that I was surely meant to race and win my age group!

Even though the chance of racing was getting slimmer and slimmer, I still wanted to believe I could do it, but on the very last test run, Saturday afternoon, I knew it wasn't happening.

I had a pity party with my husband and we decided we’d head out the next day for a bike ride, which was indeed quite helpful, and I must add- pain free as cycling had been all along.

I was disappointed about the race, of course, but accepted it; it is only a race, after all, and the potential long-term consequences would have made it nothing less than foolish to have raced.

So, on Monday, I called that same doctor and filled him in. He sent me for an MRI which showed a stress fracture in the calcaneous which meant 6 weeks in a walking boot, no swimming (apparently too risky to push off the wall,) no cycling, and only upper body exercise.

I was in a stupor after I received his call.

How could I do zero activity for 6 weeks?

I was frightened, to say the least.

I went into his office the next day to get my boot. The nurse who helped me made no mention of how to walk properly, how to avoid other injuries due to compensations and how to prevent uneven hips which would cause back, shoulder and knee problems.

I called in later to ask the doctor about these issues. He chuckled and told me he’d give me the name of a good chiropractor when I needed it!

Fortunately, by then, I’d connected with a few friends who'd also had various foot injuries and had the chance to see another doctor who happened to be an athlete himself.

The new doctor was kind, patient and thoughtful. He said I didn’t need a boot that was suitable for a tall man and he gave me one half the size. He said I could spin on my bike on the trainer if it didn’t cause pain. And of course I could swim.

He also ordered another MRI, this time to see both my feet looked. He even gave me his cell phone number and said to please call to let him know how I was doing!

I was so relieved, I cannot even put it into words.

BUT, and this is a big but, I still hadn’t realized that just backing off exercise doesn’t equal rest.

I was still going 24/7!

Leaving the house to swim before sunrise, out to teach a cooking immersion class, then stopping at the farmer’s market to head up to a client’s home to help her with her weekly prep. Then out to meet another client, home to pick up one of our dogs who needed to go to the vet … and on and on and on.

It took my husband, and several friends reprimanding me that I needed to slow down. So, after a week, I finally did.

I felt broken. And fragile. Weak! And worried. It took all the mental fortitude I could muster combined with my meditation to first let myself sit in that space and then begin to realize the truth (as opposed to the worse case scenarios I had begun making up in my mind. I would heal, I would come back stronger and this is only temporary.

I took inventory.

I was finally resting; why not do calls from home so I could put my feet up? How about not booking my calendar from morning to night? And, here’s a thought- how about being grateful for the role the foods I choose to eat would play in the healing process?

I even reached out to my mentor, Dr Cordain, to ask for his two cents.

Turns out, he’d had the same injury:

“I had a similar injury (calcaneus fracture) when I was in my 20s, but at the time I knew nothing about Paleo diets as the concept was still about 10 years in the future. My only recommendation would be to eliminate any dietary salt (it causes increased calciuresis) and to focus upon calcium rich veggies (kale, spinach, watercress etc). Drink fresh kale juice (via a juicer) mixed with juiced apple, lemon etc. Keep protein high (eggs, fish, seafood, grassfed meats) as protein increases IGF-1 which acts as a bone growth promoter. Stay off your feet for a few weeks and concentrate on swimming, water exercises, etc.”

I finally began to feel calm, focused and balanced.

The race was just a day. Not being able to take my dogs on their walks was now the real bummer!

I had gained perspective.

Not just for myself, but for what an injured patient with limited knowledge of the body might have to deal with when they go through the common channels of the typical healthcare model.

While this injury was only temporary, it’s a true reality check to learn what it’s like to have to ask for help or to have to tell someone I can’t walk very far.

I visited my doctor just two weeks post MRI and he took an Xray which showed the beautiful, thick white bone already being laid down.

Thank you bone broth, leafy greens and grass fed meat!

Lesson learned (still learning, to be truthful), new outlook and a better overall balanced approach to what I choose to put my body through day in and day out!

I wanted to share this because I learned so much from friends who’ve had a similar injury and shared how they coped with it.

Perhaps this will help someone, too!

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