What I’ve learnt from being Injured (and it’s not what you think)

Mountain biking in New Zealand about 6 months post-op. Probably wishing I was mountain running instead, but not a bad option B….!

We rarely come away from life’s challenges having learnt nothing. How we propel in the aftermath of major setbacks can be the major shapeshifter in our lives, and indeed in who we become as people thereafter.

I am finally at the point where I’m fairly comfortably through the trauma of what we shall call the “Everest” of my injury history. If I were to sketch a visual of my colourful history, it would look like a scattered flow of 13 stress fractures, starting at age 12 in relatively non-important locations and then escalating into some more heavy terrain as my eating disorder and distance running career progressed, finally reaching the peak at doing an Ironman with a stress fracture in my foot at age 29 and subsequently ending up needing major reconstructive foot surgery and a total of over 12 months off running. I can confidently say that that will be my peak, as I have finally, definitively, learnt how to respect my body. Which brings me to the 2 (yes, only two, but they’re BIG ones) things that this last 18 months has taught me:

1) Respect your body – you only have one (Yep That Old Chestnut)

Love it or hate it, your body is the only one you’re going to get. Sure, a surgeon can plate and drill you back together, but ultimately the bones and healing capacity that you have is still dependent on just that one body; you don’t get a new one just because you treated the old one like a rental car.

During the worst of an eating disorder it’s near impossible to comprehend or love your body, such a minefield is your brain at the time. And certainly, it’s something that I have really struggled with well into recovery – which is going on over 5 years now. It’s funny how it sometimes takes something so huge as threatening my ability to run and race – the loves of my life – to really “get it”. I guess in the aftermath of your eating disorder, those early months and years are spent just trying to survive the new life that you’re supposed to embrace – the daily climb of having to face food and weight gain, doctors, dieticians, psychologists….it’s all so much to cope with at the time. It’s often only years later that you can look back with some perspective and truly see what your body went through, and indeed how blessed you are to now still be standing here. Able to run. Able to love, and laugh. Able to grow a baby from scratch. It’s truly remarkable, what the body can come back from.

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Eventually the trauma ends, the memories get softer and we get back into our routines….and then along comes a “choice point” in life. I had one of those a fortnight ago. After having a good few months of pain-free and enjoyable running, I started feeling an all-too-familiar pain in the butt….well, my right sacrum (tailbone) to be technical about it. I’ve had two stress fractures there in the past, so I know what it feels like. The fact that I’ve had two, indicates I failed to learn from the first one, as with most of my injuries up to this point. However this time was different: I was able to use my “logical” (Physio) brain, take a step back and assess the pros and cons of continuing to run on this. For the first time ever, I was able to take a week off running, knowing that it was the best thing for me because I want to be able to run not only after the baby arrives in a few months, but also when I’m 60, or 70 years old. And my poor sacrum has already been beaten up enough. So even though I hated having a week off running now, in the long term, it was the best thing for me. And sure enough – my efforts were rewarded: I was able to go back to my 5km run yesterday morning with minimal butt pain. Seems so trivial, but such a huge step for me – in all my years of life, I’ve never yet been able to not just keep “pushing through”. I am finally confident that going forwards with training and racing, I will be capable of making the right decisions, rather than living in fear of what I know I can do to myself. The thought of training and racing injury-free seriously excites me. I have a plan, devised together with my “moral compass” aka my husband, on how I will approach training and racing coming back from this surgery and after the baby arrives in March. I know I have posted some awesome results in the past being tired, injured and generally unbalanced, so I am itching to see what the future brings. Bring on the post-baby running and Ironmans!

Hamilton Island - hiking up that hill at 7 months pregnant was totally worth this view!

Hamilton Island – hiking up that hill at 7 months pregnant was totally worth this view!

2) Enjoy the mundane routine of life – it is truly a blessing.

This is the big one. The surprise I got out of going through this surgery and the months of healing and rehab after was how much we take for granted the routines of our lives. Never before have I appreciated so much the simple acts of being able to walk, sleep, work, drive, cook dinner, do the washing up, hang out clothes washing, water the garden, and not to mention walking my dogs in the sunshine – that’s like ecstasy! The “daily routines” that I used to think got in my way of being…well…busy/productive/important/useful, I now see with a completely different light. Being in plaster and unable to do much of anything independently gives you a fair amount of time to think about these matters. The thing is, what we fail to realise while we get tied up in our own “busy-ness” and in seeming important all the time, is that the majority of our lives are, in fact, made up of us doing the daily routines. They are life. And if we can truly learn to appreciate how blessed we are to be able to have the health and the homes to do those ‘chores’ every day, then the daily grind suddenly becomes more magical.

As a pleasant secondary offshoot to this, this new appreciation for the simple things in life has translated into being able to be still, and just be with “me”, for the first time in my life. A big factor in eating disorders is that inability to relax and enjoy the quieter moments in life – for so long, I was fearful of weekends or holidays, and always had to plan every moment. I’m still not great at it, but I am much, much better. And it’s just so lovely to be able to take a big sigh of relief and know that everything will be OK with the world if I am just still for a little while.

Every experience in life – good or bad – can be a blessing in disguise if we can learn from our experiences. Sometimes this takes time, so be forgiving and gentle on yourself, especially in those early stages of recovery. You are a champion just for embracing the fight of a lifetime and let me promise you, it will all be worth it in time. Life truly can be a beautiful thing.

K xoxo

Even looking at this photo is hard....early days post-op.  Never again!

Even looking at this photo is hard….early days post-op. Never again!

Sesamoid Update – 1 year on

oct c 2014

“At some point you need to stop making a comeback and start running towards who you are meant to be next” – Lauren Fleshman #womanup

Hoorah for beating the odds – once again!

Sesamoid fractures have a pretty serious reputation for not going well. There is little evidence-based research available for treating practitioners on best standard of care, and even when that has managed to be achieved, they tend to be slow to heal and long to recover from.

Being a Physiotherapist and knowing all of this information, I was shaking in my boots a little at what I was staring down the barrel of just over a year ago now. Compound that fear with the knowledge of what I had done to my foot (doing an Ironman on a stress fracture is not something I will ever do again…), along with my history of poor-ish bone density thanks to a decade of Anorexia, and I was pretty much crawling with my tail between my knees into that surgeon’s office and pleading with him to save my life. Ok, dramatic…but running IS my life, my first love, my sanity and makes my soul happy. So NOT running again was simply not an option.

I am happy to say that even with the odds seriously stacked against you, with a great medical team and some serious dedication to a long and conservative rehabilitation process one can come out the other side flying. Once I got to the point where surgery was the only option left – 8 months of conservative treatment already tried and failed – I had to make a choice. I had to put my big-girl panties on and suck up the situation; there was zero time for feeling sorry for myself and about 24 hours a day to dedicate to doing an awesome job of this rehab process. As discussed in previous posts this included everything from sleep to nutrition to Physio – and most importantly, a great medical team: a brilliant sports physician who understands my passion for running as well as my medical history; the best foot and ankle surgeon in Australia; and a sexy Physiotherapist (OK that was my husband so I may be biased….but it probably helped the treatment come along….!!).

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Which brings me to the now. My surgeon was clear and stern with me from the start that it would be a 9-month rehab process before running would even begin, and 12 months before my foot would be adapted to what we had done to it: bone grafting the sesamoid plus breaking, elevating and plating the 1st metatarsal (dorsiflexion osteotomy) to take load off the sesamoid underneath it. 8 weeks in plaster non-weight-bearing was followed by another 8 weeks partial weight-bearing in a boot; then a very gradual increase in walking and loading the area. When I was in plaster I was doing a lot of Pilates, strength work and all-importantly, resting and eating well. My arms got pretty buff at this point – crutches plus strength work= guns!! As soon as I was out of plaster I was into the pool. Initially not allowed to deep water run, but I was allowed to swim if I used a pull-bouy and didn’t push off the wall with my right foot. This made me feel about 100% more human just being back in the sun and in the water again, even if it was limited. Towards the end of that 8 weeks in the boot, I was able to start deep water running and freestlye swimming (kicking). Then came the fun part.

The “real” rehab began once I was walking more and out of the boot. My right calf muscle was over 3cm smaller than my left at this point…I had a lot of work to do. Not to mention adapting to my new biomechanics – the first time I stood on my right foot, I felt like I had a marble under my 2nd metatarsal! Now a lot more of my weight would go through that bone rather than the 1st metatarsal/sesamoid complex, and so I had to go slow to allow the bone to adapt – it’s common at this stage to get stress fractures in the 2nd metatarsal if rehab is too aggressive, due to the increased load. I was allowed to start cycling (using carbon-soled bike shoes so the toe doesn’t bend) at this stage.

Due to my job being so physical – Physios are pretty much on their feet for 8+ hours a day – it would be another month or two before I could introduce any extra walking outside of work, which was frustrating. This was (mentally) probably the hardest part – not being ‘disabled’ any more, but feeling like you’re not actually working towards running either. My patience paid off and once I was able to walk for exercise, things moved quickly – at 7 months post-op, I was walking 30mins every other day with minimal swelling and less than 2/10 pain (ie. Acceptable pain levels given the surgery I had)….which meant I was allowed to jump on an Alter G treadmill and start running, 2 months ahead of schedule!

My surgeon was very strict with the Alter G protocol to follow. I started with 50% body weight for 20mins at just 10km/hr. This felt easy as my fitness was pretty good by now from the swim/bike/deep water running routine; that was a key part of this stage going so well. Over the next month I built the AlterG sessions up to 40 mins at 70% body weight including intervals, allowing me to build some speed and rhythm in. I had the luxury of having my husband and Physio accompany me and give me feedback on biomechanics and technique – it was like getting used to running on someone else’s foot! It felt very strange. I will be forever grateful to my sports physician for making access to an Alter G so available to me; not everyone has the luxury or the joy of this.

At 8 months I was given the green light to start my road running return program, which was also very conservative…it started with 30 minutes walking with 8 x 1 minute run throughout. But I was the happiest person on the planet! I kept up the Alter G sessions for a few more weeks just for my sanity more than anything else – it was still a novelty and better than drugs being able to push myself again (from a cardiovascular perspective), plus the fitness boost it gave me was invaluable and transferred beautifully onto road running.

I was slowly building week by week and up to running 5-10km, 3-4 times a week when we got pregnant this time around….and so I have maintained that level of running over the last 5 months, and will continue to for as long as I can into the pregnancy (I’m now 5 months along and 4kg up). Ironically, the extra relaxin hormone boost from the pregnancy has allowed me to get my full flexibility back in the foot post-op and so running feels better than ever! This could have taken a year or more to achieve without relaxin. I can honestly say now that I don’t even think about my foot anymore – it feels “normal”, strong and functional.

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Of course, I am missing racing immensely – between the surgery and pregnancy, it’s been almost 2 years since I’ve raced an Ironman and I cannot wait to get back to it. I am hoping to do an Ironman about 10-12 months after the baby arrives; it would be nice to go back to Busselton where it all went down in the first place and get some unfinished business out of the way!

What I have learned about Sesamoid Stress/Fractures:

– Get a health care team on board that KNOWS WHAT THEY’RE DOING. Search for someone who has experience with treating sesamoids; if your GP/Sports Doc/Physio/Podiatrist does not, then call around until you find a team that does. Don’t be afraid to ask upfront.
– Use an MRI for diagnosis and follow-up progress scans. XRays are not sensitive enough and bone scans are not specific enough. The cost is worth it to know what you are dealing with.
– You need to be aggressive – from day dot. These are typically not super painful injures (well nowhere near a femur or sacral stress fracture – of which I’ve had both – hence being able to finish an Ironman on it without realising), and so they can be deceiving. But you need to take them very seriously, as hard as this can be early on,
From the moment of diagnosis you should be in a boot; either partial-weight bearing or full weight-bearing if pain allows – needs to be <2/10 pain at all times.
– Use contrast bathing or ice/heat protocols – 20mins of each, 1-3 times a day, to flush swelling and increase blood nutrients to the area.
Give it TIME. Prepare to be in the boot for 8-16 weeks. Yikes! I know….but trust me, this option is much better than having to go through surgery. Sesamoids have poor blood flow and don’t heal well, but if you treat them like gold from the start you will give it your best shot at healing conservatively.
– Statistically, following the above protocol, 50% of sesamoids will heal and 50% will not (at 12-16 weeks). It depends where the break is, what the blood flow is like, and how well you rest it during this time.
– If you are a serious athlete, love your sport, or have a job that requires you to be on your feet, think about getting a referral to a very experienced foot surgeon early in the process. They typically take a couple of months to get into, and it doesn’t mean that you will have to have surgery – but if it’s a slow healing fracture, they will give you an all-important educated opinion on your time frames, options and prognosis. You can always cancel the appointment if you’re going well, but it’s hard to get an urgent appointment if and when you do need it so plan ahead!
– If you do need to go ahead with surgery, ask the surgeon how many sesamoid stress fractures they have treated and how they have gone. You want the most experienced surgeon with good long-term outcomes ie. Return to full sport pain-free.
Avoid removing the bone at all costs. Unless it is completely shattered, a good surgeon should be able to either bone graft, pin or shave off part of the bone to salvage it. A foot without one or both sesamoids is, biomechanically-speaking, a disaster zone for arthritis and injuries and is not very conducive with a future running career!
– Further, if you do need the surgery, plan it well and be prepared for a long haul. Be ready mentally and physically to put in the hard yards from a rehab perspective (exercises, pain and swelling management, and lots of rest…), but even more so be ready to be patient from a psychological perspective. There is no point going through major surgery only to rush it on the other side.
– Be rest assured that with a good surgeon, and an even better rehab protocol (think slow-and-steady), you CAN and WILL return to your old athletic self. It’s possible you may even come back stronger after all the time spent with rehab and core strength work, and in my case, biomechanically improved because he fixed the 1st metatarsal angle at the same time, decreasing my chances of getting the injury again.

Currently sesamoid injuries are highly misunderstood by the medical profession and usually by athletes as well, but over the next decade I believe there will be huge improvements in understanding and treatment from medical professionals. In the meantime, those of us who have walked this path beforehand can hopefully shed some light, advice and much-needed hope that there is indeed light at the end of the tunnel!

Happy Training

K xoxo

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The Broken: A Survival Guide Part III

Right now, I am at the point where my foot is essentially 95% healed, and I’m ramping my running back up.

Cue music: “Highway to the Danger Zone”……

You see, this is the magical moment where the bones are healed enough to need adequate loading in order to reach full strength and function. This means running every other day (yippee!!), but crucially it also means having the discipline to not overdo it. And to listen to my body. And put my pride and perfectionism to the side.

This is, in many ways, the hardest part. It’s the part where I have to test my growth over the past 9 months. Have I really become more patient? Stronger? Less perfectionistic? More realistic? Hell, will my body even remember how to run, let alone with decent pace or technique?! And then the toxic seeds of doubt creep in: what will my fellow runners think of me now? What if I’m not good enough? What if I never get back to where I was before I broke my foot? Will I ever beat my husband in an Ironman again?

Of course, it’s highly likely I will come back stronger than before, will continue to kick my husband’s butt in many an Ironman to come, will have learnt a boatload about myself and my body and most importantly, learnt how to train more efficiently and with less risk (cue Britney Spears: Stronger. Yep, I went there). This is my “logical voice” talking. But we all know, that illogical voice is the one that dominates when we have been out of the loop for some time.

Hiking in NZ with my better half

Hiking in NZ with my better half

Two weeks ago, I readied myself to go to running squad for the first time in over a year. It’s a super friendly bunch of runners who I have trained with throughout all my Ironmans in the last 5 years. Saturday mornings are usually a sociable 8-12km group run, with coffee afterwards. There is a front pack, of which I’m usually a member, and then there’s everything back to a 5km jog/walk group. In all, we have about 50 people turn up, so it’s not like I would be lonely.

Only I chickened out. Why? Because according to my return to run program from my Ortho, I still have to walk 2 minutes for every 8 minutes of running. And, I knew I wouldn’t be able to stop and have the discipline to walk when everyone else was still running. And my pride didn’t want the slower runners to catch up (there I said it. I may be the world’s most competitive person). A week later and I decided to try again. I took off at decent pace with a largish pack, and I did manage to stop and walk when I was supposed to. It was harder than getting through an airport on crutches, I’ll tell you that much. My heart and soul just wanted to keep on running!!

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Whether you are getting back into training after an injury or after an eating disorder (or both), the hardest part is often sticking to the plan. I know from coaching beginner run groups that the three aspects of training that “normal” people struggle with most are 1) motivation; 2) fitness; and 3) being able to mentally push themselves. This is not the case for athletes or those of us with the ED birdy on our shoulder. These are some strategies that have helped me over the last couple of months:

1) Front and Centre: How Far You’ve Come (and how quickly it could go wrong). Its human nature to compare yourself to others, and even moreso for uber-competitive athletes like myself. There’s a bunch of people you used to be faster than lapping you around the park. But that’s OK, because they don’t have a metal plate in their reconstructed foot. They haven’t walked every step of that hard road to recovery. When the temptation to push yourself overwhelms you, it’s important to remember how broken you were and how quickly you could return there (ie another stress fracture or overuse injury). Sometimes fear can be a very good motivator! Write it on your hand, stick a photo in your wallet – whatever it takes, a not-so-subtle reminder is key.

2) Plan Ahead: The Insecurity Factor. As a flip side to point 1, remember that we are all humans and we do all have our own story and our own journey. When that little evil voice starts sprouting doubts in your mind, squash the insecurity by fighting back with basic logic. Those runners know what you’ve been through, know what kind of an athlete you are, and really couldn’t care less that you are running slower than you used to. They’re more than likely impressed by your motivation and determination, not judging you for your pace. They’re likely happy just to see you back at squad. Or they may not have even noticed that you’re not as fit as you were (you’d be surprised how remarkably un-observative “normal” people can be, really….you’d be shocked….not everyone can recite what the whole table ate at lunchtime and what times they ran on the track for the last 4 years….that’s a very unique trait!).

3) No Negotiations. Even if you feel like Paula Radcliffe today. Any changes to the plan MUST be pre-approved by your Physio/sports doc ahead of time. As with any rehab program, you have days where you just float like a butterfly….and days you feel like an elephant. Just enjoy the fact that you feel great, cherish every step, and know that if you stick to the plan, it’ll be that much sooner before you get to have another great training session. If that fails, revert to point 1.

4) Focus on how Amazing Your Achievements Are. And celebrate them. Who cares if your old training buddies smashed out 10km in sub-40min pace? YOU just did 36 minutes of quality running, and you had the discipline to stop and walk, and your technique was great, and you are coming back from major foot surgery, and you get to be outdoors in the fresh air running…you get the picture. Gratitude is the best emotion on the planet. Use it to your advantage. Write it in your training diary. You’re doing awesome. Repeat.

5) Enlist a Training Buddy who is on board. Does not have to be of the human breed. If you are going to squad, suss out who is about your pace at the moment or perhaps also coming back from injury. Or grab a friend who is willing to do walk breaks with you. My favourites for this are my husband and my dogs, the three of them are always whinging that I run too fast normally so they are happy for the walk breaks – much happier than I am!

6) Nutrition: ensure that you are adjusting your eating plan for the increased exercise load. You need to be eating for training, recovery AND healing – the triple threat. Bones have a lag time of about 3-4 weeks with increased load, so when increasing run kilometres it is best to have a training week that is about 50% of your normal current load for that week, to let your bones catch up and get stronger. Push over that and you may find another stress fracture. So if you are up to running say 40km a week, on the fourth week, stick to 20km and you can add some walking or cross training. It’s an annoying but foolproof investment, and any running coach on the planet worth their salt will stick to this plan for injury prevention. You’ll actually come out the other side feeling fitter, as your body will have “absorbed” your training up to that point and feel fresh again. Bonus!

7) Get a Hero or Two. Professional Triathlete Jesse Thomas actually broke his foot during Wildflower triathlon 2013 and subsequently had surgery about a month before I did the exact same thing. He has blogged about his rehab, the highs and lows, and I have found it hugely helpful following his progress along the way. His wife Lauren Fleshman is also a great role model and her blogs are highly entertaining for any athlete who has faced injury or childbirth and beyond. As a side note – be wary of Ironman athletes claiming to be recovered from their eating disorders. There are a lot of them around who hide behind “Ironman/triathlon” as their excuse to continue with disordered eating patterns. Chrissie Wellington’s book “A Life Without Limits” is probably one of the worst so don’t go there if you are still recovering. Same goes for any running or ultraendurance bio if you are recovering from a running injury – it’s like motivation on steroids to go do something really stupid!

I hope that helps! The journey back to health can be a long and lonely one, especially once you get towards the end and on the surface everything looks fine. Stay strong and remember how far you have come. Most importantly, reward your body for the amazing job it has done by nourishing it and letting it bloom into its full potential. It will serve you very well if you treat it right.

Happy Training xo

Racing Weight

So yesterday I had a revelation. It’s only been, hhmmm, 18 years coming.

I was looking through some race results from a recent track meet and they had accompanying photos. One photo in particular really set me off – I felt a deep pang of ?yearning? to suddenly stop eating and to run a really long way. To look like that. ASAP.

I won't put the triggering photo up for obvious reasons.  Instead, here's a bunch of awesome, fit healthy chicks at the New Balance Games.

I won’t put the triggering photo up for obvious reasons. Instead, here’s a bunch of awesome, fit healthy chicks at the New Balance Games.

Ever since I started restricting calories at age 12, I have always been very easily triggered by certain people – for me, mainly athletes of the very lean, tanned, blonde and hot description. I most definitely have a “type”. For the longest time it was Anna Kournikova. I remember as a 12 year old looking up her height (same as mine – I was tall at 12. Incidentally, I never grew after that….amazing what starvation can do to the human skeleton) and weight. That was ground zero. Only, once I got to her weight, of course the ED/Ana was in full flight and I couldn’t stop there. I may have had the long blonde hair, the sports trophies, the tan….but I didn’t look like Anna Kournikova, because, well….she looks healthy. She glows. I had some grey death staring out my eyes to match the grey shades under them, and a bony back to boot.

Anna Kournikova in full flight.

Anna Kournikova in full flight.

Over the years the role models have evolved, and as I’ve talked about in previous posts, I now tend to look up to healthier athletes as a matter of requirement. I am simply too easily set off by the former. And of course a swap to a sport that suits my genetic make-up to a tee has helped as well: as a distance runner, being lean and super light was always an uphill battle, whereas I build the endurance and strength needed for long course triathlon almost by mistake, it happens so easily.

Anyway back to the point. To give you some context, my body at the moment is not at racing fitness and after being “Ironman fit” for the preceding 3 years straight, that’s a hard thing to get used to. I was as fit as I’ve ever been going into my foot surgery in July last year. But 3 months in a cast and non-weight bearing on crutches, when all I could do was core and upper body gym work and then after that, swimming….well for someone who builds muscle easily, I suddenly developed upper body muscles. Throw into the mix a couple of pregnancies then miscarriages in that period and well, needless to say, my body has changed. So I’m in the prime target zone of being affected by such triggers and constantly fighting the urge to overexercise and undereat, when in reality my body needs to be loved in every way in order to repair right now.

Only yesterday, for the first time ever, a shocking thing happened. I’m not even sure it was my brain producing the thought process, so foreign was that thought process. I suspect perhaps my psychologist or dietician found a way of tapping into my brain waves and altering them. For when I saw the picture, I yearned to starve and go run 35km. But then the next thought that followed was astounding: “yeah, if you want to be skinny-fat and unhealthy. If you want to get back to that level of fitness, you know what you need to do. You need to commit to training hard, and eating. A lot. Of really high quality food.” Sigh. Wait – whoah!! What just happened?!!!! Was that my head talking?

New, healthier role models: Caroline Steffen aka "Xena", 2nd fastest female Ironman athlete in the world.  Machine.

New, healthier role models: Caroline Steffen aka “Xena”, 2nd fastest female Ironman athlete in the world. Machine.

After deep consideration, I’m fairly certain it was me. I’m impressed. And when I analyse it, it’s true – the only times in my life I have been super race-fit, lean, healthy and glowing (and incidentally injury-free) have been when I’ve been able to train well and at a high intensity, and when I’ve been able to eat a lot of food to support that. For many of the other times, I may have been clocking in at my desired “racing weight” – for distance running, not triathlon – but I was far from glowing, and the fake tan and smiles were barely hiding a very frail skeleton with 10+ stress fractures in their short history.

As we all know a little too well, it’s far easier for us to undereat and overexercise. It’s comfy, predictable, safe, not scary. Eating like an athlete is frightening, uncomfortable, requires planning, and a lot of mental strength – and not just for a day, but for months. But when all is said and done, it’s always more rewarding doing something challenging than sticking to the same well-worn path. I don’t want to be a skinny-fat distance runner anymore; I will stand proud as an athlete. Glowing, too.

Bring it.

xoxo

My hand-made Easter chocolates for the family.  Happy Easter everyone! xoxo

My hand-made Easter chocolates for the family. Happy Easter everyone! xoxo

Our Body Responds to the Messages We Give It

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I have a friend in Brisbane who has just taken up Ironmans, which I am over the moon about. At first glance, she has all the right ingredients to make a solid long course athlete: she’s tall, muscular, mentally pretty tough and she has the support of her family – her husband also does Ironman triathlons. And boy does she like to train.

Before her first Ironman she was understandably nervous, and wanted to skype with me to pick my brains about a few things; I was more than happy to help out. I had a lot of fellow Ironman athletes take me under their wing when I first started out, and along with my coach I felt extremely well prepared going into my first race and subsequently had a great time. I was excited to be able to do the same for her, and so I wrote down some key nutrition, pacing and training concepts that work well for me (mainly female-specific things).
So you can understand my shock when no more than 5 minutes into said skype date, she blurts out “well of course I’m only doing Ironman to keep my weight under control – for the same reason you and every other girl does it!” she laughed. I was not laughing. I was actually trying not to choke on my espresso.

SAY WHAAAAATT??!!

Firstly, let me get this off my chest. Ironman is sacred. It is a place where you go to search the depths of your soul, to find out what you’re really made of in a way that daily life just doesn’t allow for. It is a celebration of the human body and mind, of the incredible things it can achieve. It is a magical place with a finish line that feels better than ecstasy. And when all is said and done – the months of discipline, the long, long rides with fellow athletes who become friends, the many memories made, the body chiselled and honed, the mind strengthened and the self-confidence firmly built one brick at a time – you become part of the “Ironman Family”. And THAT is what Ironman is about. Nothing short of a celebration of life in all its glory. Amen to that.

My second thought was “oh boy you are going to crash and burn in a big way, you’re doing it for all the wrong reasons”. (I didn’t say that out loud….). I do Ironman to celebrate my recovery, and to be around a couple of thousand people who don’t make excuses about why they can’t do things, they find a way to do things and be happy and loving and I am addicted to the joy and self-confidence that Ironman has brought to my life. I now respect my body for what it can do, NOT what it looks like or what the number on the scale is. It’s not an exaggeration to say that it has saved my life, by taking me away from Ana and onto richer pastures. I can’t believe how amazing this body now is, and also feel mortified sorry for the things I have done to it in the past.

final Arpil 14

The third thought – and this is where the scientific nerd within kicked in – was “you’re not going to lose weight by doing what you’re doing, if that is your goal….”. She refused to take any nutrition other than water during any training sessions, scared that it would make her gain weight. Then she would try to restrict her calories during the day as well, to try to cut more corners. (Subsequently I am sure) she hated long rides because….well….she probably felt like crap, running on empty! Not surprisingly, she had a few niggles that she couldn’t settle and she wasn’t able to push the training up to the next level.

And sure enough, after her first Ironman, she didn’t enjoy the experience. She was too focused on trying to keep her weight under control, and stressing about not training in the couple of weeks after the race.
Here’s the thing. This may come as a revelation to non-athletes and to Anorexics, but our body responds to the messages we give it. If you starve yourself, it learns that food is scarce out there in the world and it better slow down its metabolism and store fat for the long cold winter (we still have the same DNA as our hunter-gatherer ancestors, remember). It learns that it better prioritise only the essential life-giving functions, like breathing and brain activity – so those niggles don’t heal and the muscles don’t repair from the hours of training. Minimal training adaptations occur, so you don’t really get fitter either, you just keep breaking down. Not to mention hating the training because, well, you never really feel good! In the short-term or if you get extreme about the starvation yes, you will lose weight (hello eating disorders). But eventually that weight loss slows down. And I can tell you from personal experience that after 10 years of it, your metabolism becomes very smart and very thrifty. I could go days on minimal food and not lose any weight. My body just knew it had to conserve to keep me alive.

On the flip side, if you train hard, and fuel your body, it will get the message that you want it to become fitter and stronger, and that since there is plenty of food around, it’s therefore safe to make those adaptations. You’ll lose fat, and gain bone density and muscle. Your mental health, sleep and mood will improve. You will have more energy through the day. And on race day, you will perform well and likely also enjoy yourself and the experience (which is the whole point, right?!).

Matching shoes and nails: check...

Matching shoes and nails: check…

And then the best part of all is the famous post-ironman “afterburn” phase, which lasts between 1-4 weeks depending on your metabolism and fitness and genetics. This is where you pretty much eat whatever you like, do minimal exercise, and lo and behold – you get leaner. It’s hilarious. Your body is working so hard to repair everything, and it’s still zooming from the 12-hour race, that if you feed it with A LOT of food, you will then set it up beautifully for the next phase of training and racing (or just life in general if you so choose). BUT if, like my friend, you decide to hardly eat anything at all after the race, you will actually halt that process and force your metabolism to really, really slow down. Your body is madly trying to repair and recoup, and if you don’t nourish it now, you will set it up for an ever slower metabolism and, unfortunately, you will likely actually lose muscle and gain fat. Which is what happened to my friend. And so the cycle continues, as she has signed up for the next race in order to “control her (now higher) weight”…..

I know it’s hard to get your head around the fact that eating more could result in losing weight. It certainly took me a long time to believe it. I tried it as a one-woman experiment and took all my measures weekly. Sure enough, over the course of 6-8 weeks I got leaner, stronger and my performance and recovery were better than ever (read: I was kicking my husband’s butt in training). The key is to keep the food as nutritious as possible, and to eat most when your body needs it most – before, during and after training. It still feels odd for me to do that, but it’s worth the mental discomfort in order to now feel like an athlete.

As a final disclaimer, I’m not saying that there aren’t people in Ironman who have eating disorders and abuse the system, and I’ve talked about this in previous posts. But they aren’t the ones succeeding in the long term. They’re the ones you see at one race, who look super fit and fast, but who end up walking the marathon because they have no fuel or endurance. They are the ones who, after 1 or if they’re lucky 2 years in the sport, you never see again. Or the ones who are one big chain of injuries one after the other – they never line up on race day 100% healthy. And they certainly aren’t the ones with the sparkle in their eyes, who will still be doing it when they’re 60 years old. Now those guys are the real superstars!

We all have one body in this life, and we all have a choice. We can nourish it and let it flourish to its true potential, or we can cut corners and watch it struggle.

I choose life!
Happy training.

K xo

Insecurities

“Step out the front door like a ghost into the fog
Where no one notices the contrast of white on white

And in between the moon and you, angels get a better view
Of the crumbling difference between wrong and right

Well, I walk in the air between the rain
Through myself and back again
Where? I don’t know”

– Round Here, Counting Crows

Please read the following scenarios and choose the most correct answer:

1) You are an elite female triathlete with the following stats to your name: two sub-9hour Ironman finishes, <12% body fat and arguably one of the fittest bodies on the planet. When asked your weight in an interview, would you:

a. Tell the truth – your body is a weapon, your job, and a beautiful machine and you are proud of it!
b. Take off 5kgs from the true amount; you think you are ‘heavy’ with the muscle on your frame and your height.
c. Refuse to answer.

2) You are an athlete who has had an eating disorder in the past, you are now recovered but do not know your weight. You haven’t been able to run for 6 months due to injury, but have the chance to run on an Alter G treadmill that your sports doctor has arranged. In order to use it, you and your doctor will find out your weight. Do you:

a. Get on it – to hell with my weight I am desperate to run!
b. Agree to use it as long as you don’t need to find out the weight, then proceed to have a meltdown about it anyway, fearing that your doctor will think you’re the most obese athlete on the planet;
c. Gracefully decline. You are desperate to run, but the trauma of going through being weighed is just too much.

What would you do?

WA Ironman 2009

WA Ironman 2009

Impossible scenarios like this face us day in, day out, when we have the tracks of a previous ED in our scar tissue. We may be doing well for the majority of life’s intricacies, but there will always be situations like the above that will either get our blood boiling, or mentally challenge us more than is desirable (I don’t think it’s considered “normal” to have a panic attack at the thought of someone else knowing your weight….).
The first scenario makes me so furious that it sends me searching for my soapbox – in fact, I did send a huge ranting email to my good friend and doctor about the exact situation. I have been in the fortunate scenario to be on a squad alongside professional Ironman athletes for the last few years, and some of the best female triathletes on the planet to that end. Our head coach boasted more sub-9hour females on his squad than any other coach worldwide. It has been incredibly insightful and for the most part beneficial for me to be able to access their wealth of experience and knowledge and to apply that to my own racing and training.

But it doesn’t come without some serious eye-opening of the bad kind. Over the years, as you get more “well”, your triggers become so much more obvious. Racing has always been one of my biggest triggers – lining up on the start line in little more than some loud flimsy lycra is one thing; having that then photographed and marketed back to you in the eschewing weeks is truly disconcerting. No-one looks good in lycra, just putting it out there. The males who don’t have eating disorders love the race photos because they look so buff and muscly; the females – ED or otherwise – hate the photos for the same reason. I continue to race because for the most part it heals my soul. I’m good at it, and so it builds my self-esteem and creates an identity other than “anorexic”; in short, the risk-reward ratio is in the right place for me.

What I have learnt, however, is that disordered eating is rife among these professional women. They are not immune to the pressures; in fact, they feel it more than most.

Which disgusts me. Here you have 5 of the fastest, fittest, most incredible female athletes on the planet, all with bodies which would make any human proud. Their bodies are their livelihood, and to that end are serving them very well. Their self-confidence should be oozing; success is practically their middle name. And yet, they feel the need to lie about their weights, ashamed by the number on the scale.

What does that mean for the rest of us?

What message does that send?

Fast forward to scenario II, where I get this amazing opportunity to start my return to run training 3 months ahead of schedule following my foot surgery, thanks to the Alter G treadmill purchased my sports doc…..and yet I baulk. Frozen. Panic sets in. I know it means being weighed, and for someone who has just had 6 months off normal training, that is paralyzing.

But why should it be? I weigh 5kg more than the average of those 5 elite females put together – their real weight, not the one they put down on our team bio page. I am healthy, lean, fit and carry as much muscle as a good Ironman athlete should. Yes, I’m a few kgs up from my race weight, but that is OK too – because I am not race-fit right now. My body is as it should be right now, and I would like to be able to “own” that.

In the end, I guess you could call me a hypocrite. It upsets me that those women feel the need to lie about their weights, and it saddens me that that will send a very wrong message to young impressionable athletes coming through. It’s as if we are expected to achieve the impossible: to have muscle and minimal fat, and good bone density, and yet to weigh in at featherweight. Consider who is setting these expectations, and whether it is a sad modern extension of the female bullying epidemic, insisting we be perfect and able to do-it-all and yet so ruthlessly judging one another for how we all look/dress/work/live/parent…..the list goes on. I can tell you that my doctor, who is a male, didn’t give two hoots about my weight. And you rarely hear males bitching about their fellow mates, judging how they live their lives. Food for thought.

My plea is for female athletes to start “owning” their beautiful bodies. Be proud that you weigh a little more than your unfit skinny counterparts because you actually have muscle tone. Be proud of what your body can do, and how far it has come. For those of us who have climbed from the dark depths of an eating disorder, also be kind and forgiving – for your body has been through so much more than you will ever know, and every day it wakes ready to heal a little more and to help you to keep fighting the good fight.

Never forget that. Own what you are, and be proud. Starting a revolution starts with one tiny step, and you just never know who you’re inspiring by how you live your life.

insecurity blog

K xoxo

The broken. A Survival Guide.

Part II:

So you’re fractured – body and brain. You want to scream at the world and pull your hair out and cry, simultaneously. I get it.

In the previous post I introduced the concept that perhaps it is essentially the mind that causes stress fractures in the large majority of athletes, moreso than just the body failing, as modern medicine would have us believe. Specifically, the sheer force of power that is that voice in your head that will not allow the body to stop, even when presented with increasing physical pain. We are a smart bunch; it’s not like we don’t know that something’s wrong and it’s getting worse. It’s just that stopping is infinitely harder than pushing through a little physical pain. Hell, sometimes the physical pain feels good – euphoric even – like you are fighting the beast in a different way. And yes, the pain of a stress fracture is “little” in comparison to running 35km after not eating much for a few days….there’s levels of relativity and most of you here have an abnormal sense of ‘perspective’ when it comes to matters of human suffering. I wish it wasn’t so, I really do.

Sometimes the beast wins, and you find yourself in the doctor’s or physio’s office with a full-blown stress fracture or major overuse injury, which essentially you did to yourself. Yet another kick in the guts. Facing down the barrel of 6-12 weeks off your beloved sport, you feel the red rush of hot panic bubbling up from the fracture site and seeping into your heart. Staring at the image of a clear break on a clear scan, suddenly the pain feels so much worse.

What now?

Sesamoid IV

There are hundreds of well researched and accessible texts on gold standard treatment protocols for stress fractures, ranging from stopping running right through to the extreme of surgery, depending on the site and severity of your injury. But there are very few resources written on coping with the emotional and psychological backlash of injuries, much less if you also have an eating disorder or disordered eating and you are now faced with the removal of one crutch – running (emotional) and the replacement by another crutch (literal).

1) Take time to digest the news and go through the stages of grieving, so that you can recognise what you are dealing with. If possible, have a close friend or loved one with you to help with the support and to remember information. The average patient only retains 30% of what is said to them during a medical consultation. Even better – write it down. The doc won’t mind.

2) Embrace the “Athlete Mindset”. The fact that you are in this situation means that you are dedicated enough to your pursuit of excellence that you are already in the top minority of athletes. BUT….you need to learn when that line is approaching and how to not cross it in the future. Allow yourself to recognise your best traits (discipline, commitment, passion), but also to define what you would like to work on in the future (the strategies in part I – prevention; listening to your body; allowing yourself to rest and letting go of some of that perfectionism….). Your “training” now is recovery. That is no.1.

3) Get some Sun. It’ll help with the bone healing thanks to its Vitamin-D inducing properties. It will also assist with depression, appetite and most importantly it will get you outside into the fresh air.

IMAG0496

4) Ensure Social Contacts. It’s more important now than ever to make sure that you stay involved somehow – whether that be with group catch-ups after training, going to training or dance class and assisting the coach or teacher, keeping up with dance or running magazines. While it seems counterintuitive, this can actually help you to keep the “athlete mindset” and to help with staying on track in order to achieve bigger goals in the future.

5) Create a different outlet. Use your emotions as a guide. Do what makes you feel good; steer away from things or people that make you feel more down or frustrated. Be aware of being pulled towards bad habits – they can be strong and start sneakily. Tune into your emotional radar early when it’s slightly easier to resist.

6) Develop a nutrition plan. And stick to it. Most notably:

a. Avoid regular and diet sodas due to the bone-leeching phosphoric acid contained in these liquids.

b. Reduce caffeine intake, ideally to less than 2 cups a day. Caffeine also leeches the skeleton of calcium, critical when the bones are in healing mode.

c. Avoid alcohol, which can induce a pro-inflammatory environment and affect absorption of important nutrients in your food. Aside from this, it is a depressant so probably not helpful on the brain given the current situation.

d. Maximise sleep, as this is where your largest surge of growth hormone occurs – crucial for healing and mental health as well. Talk to your doctor about this if you are struggling, which is common when you are used to expending so much energy on a daily basis.

e. Most challenging of all….keep the focus on nourishing the body with high quality foods, now is not the time to diet or restrict food groups. Keep in mind that healing takes up a huge amount of energy. Accredited Sports Dieticians are very experienced in this field thanks to the high injury rate in elite athletes – and yes, you can totally book an appointment and request a meal plan to maintain your current weight while injured, whatever that weight may be. Even if they suspect you have a phobia of certain foods or a controlling personality, they will respect that and all information shared is legally confidential.

7) Most importantly, give yourself permission to rest and heal. If you cannot give it to yourself, ask your health professional – whether it be your dietician, psychologist, physio, doctor or even a friend or loved one. The most weighted words you can hear are “you are not allowed to exercise with this”. You have permission, to just heal. That is your number 1 job. There will be plenty of time once you’re back on your feet to concentrate on training; for now, the more you rest, the faster you will heal.

Of course, it all sounds so practical and easy when it’s neatly typed out on a page. It won’t be – it’s going to be hard, much harder than the physical pain of the initial injury or the discipline of full training. But if there’s one thing that’s certain, it’s that with no plan at all, things will likely slip downhill fast on the sliperyslope to ED-land. You will have a much harder fight on your hands in the mental department during your down time, but it is worth fighting for and you will come through the other side a stronger, better, more passionate athlete. In my younger (Ana) darker days I had a tibia stress fracture which I couldn’t (mentally) stop running on, eventually I ended up in a cast. When the repeat XRays were done at 8 weeks there was zero evidence of healing, mainly because I had been stressing and severely restricting food during that time and had consequently lost a significant amount of weight. Yes, that can happen. Don’t muck around with it – the psychological setback is so much worse the longer it goes on.

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Stay strong, fight the good fight, and learn from your experience so that you can come out fighting.

K xo