The 7 steps of rehab

lower-back-injuries

Injury. Uch. There is nothing better to show you how amazingly active and wonderful you once were than an injury…you become a horribly restricted and ancient version of the old you, and performing tasks that were once simple can bring you to tears of frustration! It plain old sucks!

And as of about 7 weeks ago I learnt first hand how awful it really can be! So I thought I’d give you the gritty truth about rehab, and with it the reality that we are all breakable, whether our own fault or not, and we need to give ourselves enough time to heal – regardless of how absolutely frustrating that is!

So here we are, my 7 steps of rehab. The true story.

1. PAIN                                                                                                                                                                                  

Oh the pain! Agony! In my case it was a sea rowing incident that involved instant lower back spasm – waking up the day after I felt like I’d aged 60 years and would never walk pain-free again! I could barely put my socks on let alone get out of bed – life stopped – was this what it’d be like forever now? (Please allow for plenty of melodrama during this stage…it will pass)

This is the part you remember for the whole rehab process – the bit that hurt so much you might never return to that sport or specific circumstance for fear of triggering it off again. This excruciatingly painful bit is generally about 1-3 days and known as the ‘acute stage’ – ice can help with the pain and stop any unnecessary swelling – although see my previous article for some thoughts on that. Rest is important though, your body has experienced trauma, as hard as it might be, you have to accept that you need to ease off! Annoying!

2. ANGER

So the pain has subsided to the point where you can begin to forget the incident at least a tiny bit. But its been replaced by fuming, frustrating, all-consuming anger.

‘Its the beginning of the season and THIS happens!!?!?!?’

‘I am NEVER getting back in a BLOODY boat…’

‘GRRRRRRRRAARRRGHHHHHHHHHH…’

Thats right, fight it out with yourself! You can hate yourself and the circumstances that led to your injury as much as you like! Remember – it will make NO difference. This bit is THE WORST!

Officially you’re in the ‘sub-acute’ stage that can last about 3 days to 14 days, depending on your injury – in my case I was starting some pretty painful stretching around my sacroiliac joint where the damage lay – very gentle, focused movements – accompanied by plenty of soaking in a warm bath to loosen up those muscles. My right lower back was holding on hard, trying to protect me from the threat that I might do something equally stupid again! Believe me, all your body is trying to do is protect you the whole time, so anger is a fairly pointless emotion right now. But I completely understand!

3. DENIAL

‘Right, it has to be better now doesn’t it, I’ve been healing for AAAAAAAAAAAGES?’

You’re about 2/3 weeks in – moving into the ‘Early Rehab’ stage, and quite frankly you’ve had enough. It should definitely be better by now…shouldn’t it? I was at the point where if I was walking I could easily forget that I had been injured – but as soon as I’d go to sit down or bend to pick something up – OWW! – there it was again. Sitting was definitely an issue.

At this point, you’re a bit vulnerable. Its easy to think your body is super-human and that maybe you’re almost 100% back to better especially if you’re part of a team who are mad keen to have you back – so you’ll go for that quick run/short time trial and see how it goes. Believe me…the way it quite often goes is sending you right on back to stage 2.Hello anger and frustration!

See this as an opportunity to begin rebuilding your body, stretch out the tight bits and strengthen up the vulnerable bits. If you approach this with the right attitude you’ll be in an amazing place in a few weeks time…

Although it actually feels like you’ve been out of action for at least a year, have put on about 3 stone and will never again be that amazing, flexible (rose-tinted?) former version of you that existed only a few weeks ago…

4. ACCEPTANCE

By this point you may have flickered between stages 3 and 2 numerous times, depending on how serious your injury was and other factors. None of us are able to completely shut off from ‘normal life’ for a period of 6-8 weeks so we will all at some point ‘ping’ back a stage – my trigger was as mundane as going to mow the lawn. It needed doing, I didn’t think twice, but instantly I triggered the old injury and ‘BOOM’, back a stage. But thats rehab – 2 steps forwards and 1 step back. Frustrating? Yes. Necessary? Unfortunately.

By this point, you’re in the later stages of rehab, about week 4/5, and able to accept that this process is needed, if not a complete pain in the arse! You can probably start stepping up your strengthening and begin to feel almost back to normal – but be warned – if you jump right back on in you might find yourself sliding back on down the snake to stage 2…or even 1! Listen to your body, have some relaxing baths, stretch it out and take enough rest days. Full health is tantalisingly close! Don’t mess it up now!

5. HOPE

Now we’re looking at the ‘functional rehab stage’ – 5 weeks and up! This all depends on your injury of course, but you could be working back up to your old work out levels – make sure to get some serious proprioception activities in there! Balance is mega important in rehab and will have you back to best ,and even better – yes, its easy to focus on your big, bad muscles but don’t forget the smaller, less impressive ones that will subtly give you the support you need.

This is also the bit where you’re tempted to enter that race and pretend like nothing ever happened – just proceed with caution. We all have different recovery times, and rather than be stuck in an eternal stage 5 where you’re almost-but-not-quite-back-to-normal, and constantly struggling against unresolved nagging injuries, try and power through to stage 7…its worth it!

6. KICKING ASS…AGAIN…MAYBE…

This can be a pretty difficult bit. You know when you injured yourself all those weeks ago? The excruciatingly painful thing that knocked you off kilter for what feels like a lifetime? Its time to go back there, and do it again. Thats right…time to face your fears!

Admittedly, if that thing you did involved falling off your chair at work, being hit by a car or something equally unfortunate then maybe don’t go back and do it again. But, if like me, it involved a tough day taking part in your favourite sport, then you have to go back there. I’ve met so many people who have given up something they’ve been passionate about because they just can’t face going back! And it makes me sad, because with the right rehab and support you shouldn’t be scared, you should be excited, maybe a bit apprehensive, but still confident in your body and returned strength.

This is about the stage I’m at right now – last week I went out in a boat for the first time in a while as Cox and this week I’m back out there rowing…wish me luck!

7. INJURY? WHAT INJURY?

10421309_10153329861143799_8173042120090426436_nTa-dahhhh! Finally! Sweet normality is resumed, in fact, if you’ve done this whole thing right you could even be fitter and more bullet-proof than ever! Its been about 6-8 weeks of thinking about nothing other than your injury but now its all but forgotten & you’re back and fighting fit and probably boring the ears off people about how awesome you’re feeling! Hurray!

Yes, our bodies our brilliant at healing themselves, but this whole rehabilitation process feels uncomfortable and unnaturally long – which is why so many of us end up in that frustrating cycle of never quite reaching our former fitness. We’re an impatient bunch!

If I could give you one piece of advice it would be to take that extra week, allow yourself time to recover and tune into what your body NEEDS! Listen to your physio or sports therapist, do those tedious rehab exercises, strengthen up in all the right places and when you’re back to full health get out there and make the most of it! X

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