I believe that strength doesn’t really come from what we can do. I think it comes from overcoming the things we once thought we could not do. Many years ago when I first imagined having to perform 100 snatches in under five minutes with a 24KG kettlebell to pass the SFG Instructor test, it seemed impossible. I wasn’t sure if I could ever do it. I had just recently recovered from a serious illness that wrecked my liver function and was still very much on the rebound.
The journey to accomplish that seemingly unimaginable task made me stronger in new and surprising ways. It made me realize that the challenges that we voluntarily take on and face down while simply trying to improve ourselves a little bit more each day are already daunting enough most of the time, but then there are the challenges that we don’t choose; the injuries or illnesses that arise unforeseen and unbidden to thwart our hard-earned progress. Scary thoughts, I know, but here’s an amusing quote from strength coach, Mark Rippetoe, to put a more lighthearted spin on it:
“Injuries are the price we pay for the thrill of not having sat around on our asses.”
Or to state the case a bit more like a yogi might state it, how about this:
“The wound is the place where the Light enters you.” - Rumi
December 1st is an important anniversary for me. It will mark the end of seven months of recovery from a combined Scapholunate Ligament Reconstruction and Carpal Tunnel Release surgery on my left wrist. For those wondering why someone might need this procedure, here’s a quick backstory. A bad fall on my hockey skates over 20 years ago had caused some broken bones to need pinning back together and likely partially shredded a ligament that gradually stretched itself to the snapping point just last year. Hey, it was a good run, all things considered.
With a partially torn ligament, during those 20+ years after the fall, I have been able to train in several martial arts with full contact sparring, played ice hockey, and competed in several Tactical Strength Challenges and powerlifting meets. But... on May 1st I came out of surgery wondering if I would ever be able to withstand the rigors of hard training again.
With that said, on December 1st I’ll be entering the final week of training for our inaugural Winter Warrior Challenge with minimal modifications made to the program due to my wrist injury! I’ve discovered that I’m able to get stronger in ways I once hoped I wouldn’t ever have to be. If this all sounds like something you’ve ever had to go through, I want you to know that you’re not alone. Unless you are somehow living a charmed life benefiting from otherworldly protection, you probably can relate to this experience of being somewhere on the comeback trail. Well, from one weary traveler to another, if you’ve ever felt daunted by the difficulties of the dark road ahead, take heart and keep going! Movement is life, and moving well is living well. So, you may ask, Is there a secret to an expedient and successful recovery? There might be. In my experience there might be two, actually: Strength training and community.
"Reject your sense of injury and the injury itself disappears.” - Marcus Aurelius
Research suggests that we can lose up to about 10% of our muscle tissue and experience a reduction of 30% of muscle protein synthesis for every 2 weeks we are immobilized after a surgery. This means that the stronger we are and the more lean muscle we carry before going into surgery, the less this inevitable period of immobilization will impact us. Think of it this way, if a body has a very low proportion of lean muscle tissue before being laid up by a procedure, then the loss of any of it is going to mean a lot; effectively taking a body from weak to feeble. But if that body carries a high proportion of muscle mass, it can more easily afford to lose a little without being seriously compromised; going from very strong to maybe just somewhat strong. Sounds a lot better, doesn’t it? Pre-habilitation can make the recovery hole we have to climb out of a lot less deep! I like to think that my recovery actually began before my surgery took place by making sure I was as strong as possible beforehand. Then I had that good ole' humbling experience of being stuck in a bandage for two weeks and a hard cast for four weeks.
It was very tempting during this period to eschew all forms of exercise. While tissues are in the first two phases of healing, we can experience a lot of pain and discomfort. These consist of the Inflammatory Phase, where there's lots of bleeding, swelling and our dead tissues are being consumed, and then the Proliferation Phase, where new immature tissues are formed using type III collagen. Had I avoided all forms of movement training for that entire period of my recovery, I would have experienced almost two months of straight muscle loss while all my joints stiffened up! Recent medical research also indicates that early mobilization after surgery lowers the risk of complications, swelling and loss of cardiovascular endurance. As such, getting moving again, even while feeling sore, sluggish and wearing a cast, was essential for me to begin within days of my ordeal. But how does one avoid getting it all wrong, taking too many risks with resistance training and sabotaging one’s own recovery? This is where community really comes in.
“We don’t heal in isolation, but in community.” S. Kelley Harrell
With a solid support system of family, friends (many of whom also happen to be expert coaches and great training partners!) and excellent occupational therapists, recovery from surgery actually feels like steady progress in the right direction. Although challenging, it can be an experience filled with failsafes, encouragement and just the right dose of accountability. Going it alone just isn’t as successful.
Of course, it does help to have a basic understanding of the phases of healing that our tissues have to go through in order to take confident ownership of the process and not put all the responsibility on the rest of the team. As I mentioned earlier, the first two phases, Inflammatory and Proliferative, are fairly delicate and unpleasant. The most gentle of mobility work, with an absolute minimum of pain and discomfort, helps to facilitate blood flow, reduce stiffness and allows the weaker type III collagen layers to form. During this phase of my recovery I maximized progress by putting the non-injured body parts through some fairly normal looking, vigorous, but bodyweight-only drills and kept the movement in the injured area barely perceptible (I wiggled my fingers a lot). Injury recovery, and not training recovery, must remain the priority for the body’s limited adaptive resources throughout this period.
When we enter the Maturation or Remodeling phase (which starts about when the cast comes off and can last up to two years) the immature type III collagen layers start converting into more robust type I's. This is the phase where a return to function begins to take shape because of, and not in spite of, closely monitored optimal loading and controlled manipulation of the injured area. An appropriate level of stress, applied in a creeping, incremental, progression must be diligently followed throughout this long period of healing in order to get as close as possible to our prior level of performance. Unfortunately, this is often the time when we have exhausted our available physical therapy sessions and can become bored and disillusioned with the whole process; settling for a level of recuperation which is far from our true potential! Consistency over time (much longer that we think) is the only sure method to maximize results.
Although my recovery has come a long way in the past seven months, I plan to be working on targeted improvements for range of motion, strength and the resilience of my post-operative wrist for another year and a half at least. With periodized resistance training and the support of our Breakthrough community, I’m sure I will be able to achieve what once seemed impossible. If you’re a fellow traveller out there on on the long comeback trail, don't underestimate the power of community. I believe that guided strength training with a group of powerful people might be the closest thing to a panacea that we could hope for.