December 4, 2014 by Ana To Athlete

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.

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!

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!

April 22, 2014 by Ana To Athlete

From Rehab to Racing

8 weeks post-foot surgery, happy to be out of plaster and trying to stay positive…

I flew today.

Well, it felt like it. 6km run at good pace with minimal foot discomfort, able to find my rhythm for the first time since July 2013. Excited much?! I was smiling from ear to ear for the rest of the day!

It’s been a huge challenge, a very long 9 months, and the biggest mountain I’ve had to climb in my post-ED life. But I can finally see the light at the end of the tunnel. Today I entered two 5km fun runs, and an Olympic Distance Triathlon which I will do as a team (as my surgeon is not giving me the green light to run 10km at race pace just yet!).

Still a long road to another Ironman finish line but every day is a step forwards

So what have I learned along the way? Patience. Something I never had a lot of before. I’ve learned how to apply my discipline to my rehab like nobody’s business. That applied effort has allowed me to return to running 2 months ahead of the schedule my surgeon set out for me post-op. In fact, when my psychologist was warning me about the danger zone I am currently in (given my raging exercise addiction, it was a fair concern!) – I reassured him “don’t worry. I am treating my rehab program just like I once did Ana – I am aiming to be the “perfect” patient, which includes following the program to a tee, eating every nutritious food I can get my hands on, and doing every recovery strategy that is validated in the research – compression, ice, physio, you name it.” I’m not sure he 100% approved of my approach but was nonetheless impressed by my creativity and my insight into my personality characteristics (well, they weren’t going to go away just because my foot got cut in half and I couldn’t run for a while, let’s face it. May as well make use of them).

Full steam ahead: back on the bike and loving the training!

So, as my coach would tell me, it’s “onwards and upwards”. Every day is another opportunity to “practice perfection” – every stroke on the bike, arm turnover in the pool, step on the run, and weight in the gym, all tiny building blocks that will one day form the strongest Ironman body I’ve had yet. Every new day is another chance to be thankful for my health and my happiness. To breathe in the fresh air and feel alive.

I don’t believe in luck, but I do believe in Karma. And I am grateful for the chance to rebuild my body and to live life to the fullest.

Happy training everyone!

K xoxo

August 8, 2013 by Ana To Athlete

Sesamoid Fractures

Day 13 post-Op

“Your journey has moulded you for your greater good, and it was exactly what it needed to be. Don’t think that you’ve lost time. It took each and every situation you have encountered to bring you to the now. And now is right on time.”

So it will be two weeks tomorrow since my foot surgery, what a whirlwind of a fortnight. This is going to sound like stating the obvious but I just cannot wrap my head around how much it has taken out of me – I mean, I can do an Ironman and run 3 days later, but this surgery thing is in a whole different ball park! Even as a physio, I am constantly amazed at how exhausted I am and how little it takes to get fatigued or to swell up the foot…..but I am learning, often the hard way, and trying to be very patient with myself (doesn’t come easily!). I guess I figured that I was super fit going into the surgery and I had done so much “pre-hab” that I would just breeze through it – ah, close but no cigar! As promised, for the medical nerds out there I’ll go into the juicy details; if you’re not into it then feel free to let your eyes glaze over momentarily while you fast-forward past this section.

The fracture to the medial sesamoid happened 8 months ago; because of the difficulty in diagnosing this injury and because it was literally Christmas time there was a 2 week delay in getting the MRI results and a definitive diagnosis, then getting into a boot to offload the bone. Sesamoids are well known for being very difficult to treat and even with 8-12 weeks in a boot, your chances of it healing are statistically about 50%. This is mainly due to the location of the bone (under the forefoot so it gets your full body weight with every single step), and the poor blood flow to it – which is usually only one small artery for supplying all the nutrients needed for healing. Often when it fractures, you either break the artery or the swelling compresses it, further limiting the blood flow. I’m sure the delay in diagnosis would not have helped nor – I’m sure in retrospect – would me working 40 hours a week on my feet while in the boot; lesson learnt and I would never let a patient of mine do that. (Got to love the benefit of hindsight) So long story short, 4 months after this I had another MRI that showed no healing through the bone despite the mandatory time the boot, and I found myself sitting in the very swish office of a well-known sports surgeon in a big city far away from home.
He explained that we had a few options, and after a lengthy chat and a lot of questions from me, we both decided that the best shot I had at competing in Ironmans in the long term was to operate. He planned to do a bone graft from the hip and screw it into the sesamoid, but also do a dorsiflexion osteotomy of the 1st metatarsal at the same time, which would effectively offload the sesamoid and hopefully prevent me from having this problem again in the future.
So far so good, but here’s the kicker: it was fairly major surgery. Two hours under the knife, overnight stay in hospital, 10 days in a backslab, 6 weeks in a cast non-weight-bearing, then a further 6-8 weeks in a boot partial weight-bearing and a grand total of 9-12 months before I start a return-to-run program. Gulp. I asked him how long we could put off the surgery – I needed time to think! – and he gave me a couple of months. I needed every bit of that time to process how I was going to handle the situation (mentally and physically, not to mention the logistics of work etc) and to most importantly psychologically prepare myself so that I would be able to maintain good nutrition for healing and not revert to old habits throughout this challenging time.

Which brings us to the now, 13 days post-op.

The surgery itself did not go to plan in that when he got in there, the fractured bone literally “fell apart like an eggshell” and so he set about salvaging what he could of it. No bone graft was done but he re-attached the ligaments to the new smoothed out bone and the outcome should remain as favourable as if the bone graft was done. The osteotomy went well, and when the backslab came off it felt like unwrapping a present to see two relatively big but very neat incision scars and everything coming along well. Surgeon’s happy means I’m happy. He didn’t let me leave without a 15 minute lecture on training and not overdoing it, but then he does work exclusively with athletes so I am thinking I was not alone on the receiving end of that spiel! My next review is in 5 weeks to get an XRay done and hopefully we can remove the cast and get into a boot shortly after. I am allowed to do upper body weights and Pilates as long as I do not put my right foot on the ground, but nothing else. I will hopefully get back into swimming and deep water running, plus cycling in the boot on the turbo trainer, once the cast is removed.

The things I have handled well include preparing work and home so that I can still be keeping my mind occupied – that is, running the business from home and still overseeing my junior staff treating my patients etc. That has been huge for me, because without running AND my work I go mad. Take away running – and Physio becomes my main crutch, excuse the pun. So the surgeon was happy to work with me on that one, I was upfront from the beginning and he has been brilliant with setting clear guidelines. As of next week I will go back to the clinic and see selected patients during half-days so that will be even better – the worst thing you can do in this situation is have only yourself to focus on! I was also lucky to have my closest friends around me throughout the whole process, as well as my husband’s family who I am closer to than my own. They all knew in advance that I would be in need of lots of laughs, some sense of “normality” and zero sympathy (I am NOT a good patient! Business as usual….well, as much as possible!). Anyone in my life that I thought would not be able to abide by those guidelines I haven’t spent much time with (yet). I need to make sure I have a strong support network around me and it has been worth its weight in gold; I would do the same for any of my friends. (Don’t be afraid to tell people what you need – your true friends will actually feel more comfortable as they will likely be upset seeing you so busted up as well! This was a lesson in life that took me a long time to learn but that has been invaluable). And of course, there has been plenty of baking coming from my kitchen (therapy for me and a great “thank you” gesture for said friends). Equally as important as anything else has been making sure I eat great quality food, regularly, and getting enough sleep – not as easy as it sounds with zero appetite after all that my body has been through. Of course, this is hard for me when I can’t train as the two remain inextricably linked for me (ironically I am healthiest food-wise when I am in full Ironman training mode), but having prepared mentally for it beforehand was very important. I have no intentions of gaining any weight during the next few months, but by the same token now is not the time to be depriving my body of any vital nutrients – the success of this surgery depends on it. My long-term running depends on it. And that, my friends, is non-negotiable!!
What I have found most challenging has been pacing myself – I am so used to going 100 miles an hour every waking moment of the day; obviously being in plaster non-weight bearing slows you down but having to stop and REST every hour or two is a HUGE ask for this little duck! The other complications couldn’t have really been predicted – I have low blood pressure normally (110/70) and a low resting HR (55) which I put down to being fit and possibly a bit of after-effects from the ED; but my body really struggled with the anaesthetic – the night after my BP went down to 70/40 and things got a bit hairy for a while there. But all is well now, onwards and upwards, time to rebuild this body!

Anyone wanting more info about sesamoids and stress fractures can head to this brilliant site:
and of course I am happy to answer any questions on this tricky topic or with coping with injuries.
Happy training!
K xo