14/11/2020

Forward, always – my lessons from 2019-20

If you think 2020 has been tough, let me tell you about my 2019 for a second. I realise it’s all about you, of course, but just for a second it’s going to be about me, although ultimately, my story is hugely beneficial to you.

That’s not my ego talking there, quite the opposite in fact. You see, I had some fairly life-changing moments in 2019, with a little spill-over into 2020. Actually, a pretty significant spill-over, but more on that later.

They say ‘what doesn’t kill you makes you stronger’, a saying I make light of in my more advanced training sessions – ‘I’m going to try to kill you, but if I don’t it means you’ve moved forwards’, kind of remark. An experience, good or bad, is an opportunity to learn, and I personally think the bad ones teach us more.

So, my 2019. In a nutshell, I decided to look into a few longstanding joint issues, namely:

  • Osteoarthritis in my right knee, making walking for more than 2 minutes really painful. Medial section of meniscus (shock absorbing cartilaginous tissue) removed in 1981 after a football injury, further keyhole op in 2012. Lack of extension and flexion range (ability to straighten and bend), varus (bowed out), knock-on effect to hip, lower back, and foot.
  • Sore left elbow, and unable to fully straighten left arm – wear and tear from previous heavy manual labour.
  • Unable to fully straighten right arm – as above.
  • Painful and stiff right shoulder, severe lack of mobility stemming from a total dislocation in 1976, which was never properly rehabbed, then compounded by 12 years of heavy manual labour. Right arm mechanics severely impaired through imbalance of 2 joints.

That’s a grand total of 4 procedures, in fairly close succession so as to get them out of the way and give me a clear run at recovery and rehab in 2020.

Without going into masses of detail the ops went really well, apart from a minor hiccup (post-op MRSA infection) with the leg op. I had 2 top consultants looking after me and was physically in really good shape to withstand the stress on the body. You’ll see the aftermath in the pictures, the leg especially was pretty arduous; a high tibial osteotomy (surgical leg break to move the angle of the knee joint and create space between articulating surfaces, held in place with plates and screws), but the biggest surprise is the amount of bone that was removed from my elbows and shoulder. I awoke from the first op to a nurse holding something. I said to him, ‘why are you showing me someone’s teeth?’ There was enough bone to make another small human.

Bone fragments removed from elbowThese bone spurs had grown (the body’s response to joint stress) and broken off and these fragments were just sitting around the joint preventing full range movement. On the left elbow one had moved and got between the humerus (upper arm bone) and the triceps muscle that runs up the back of the upper arm, causing the soreness. A 15mm spherical bony mass was removed from my shoulder, which had been restricting movement for probably 20-30 years.

My knee op went well; ‘textbook alighnment’, my consultant told me. I was discharged mid-December and went on my merry way after a couple of days, then 3 weeks later my leg started to itch, and then become swollen and very painful indeed. I checked in with my consultant and ended up back in hospital, diagnosed with an MRSA infection in the bone. Life and limb at risk, it was not a great start to 2020. Look away now if you don’t like gory pics. My leg was a mess, and I left hospital having been trashed with intravenous big-gun antibiotics non-stop, with more to be had as an outpatient over the next month or so. A few months later, I got the all clear.

Once repaired and healing underway, I was placed into the hands of 2 different physiotherapists, one for the upper limbs, and one for the knee.

So, what did I take from all this and what does it all mean for you?

Last resort

An orthopedic procedure should always be a last resort, not a go-to option. In my case I had little option to improve my condition, it’s pretty clear from the pics that I had some physical obstructions that need to be shifted. Very often, a joint imbalance can be fixed using corrective exercise techniques, physiotherapy, or osteopathy, so try one or all of these first.

Osteotomy X-ray

Whilst modern surgical procedures convey a huge benefit to wider society, there are risks too: it may not work, it may not get rehabbed well, or you may end up with an infection as 1% of people do. MRSA is actually quite rare these days, one case a year in London Bridge Hospital where I was.

How things work

It’s all very well learning from a text book or video stream, but there’s nothing like first-hand experience. I’ve always been a self-experimenter, so my previous 18 months has been most welcome from an educational perspective. I’ve become pretty good with shoulders especially and have had some great results with clients and myself this year. For example, overhead pressing can cause problems for many people, but they carry on and exacerbate problems. The shoulder joint and shoulder girdle is a complicated system and one misalignment can quickly become a chronic problem elsewhere if not recognised and jumped on.

I have always understood the importance of detailed assessment before prescribing an exercise programme, but more than ever I realise this is not an option – all compensations and imbalances MUST be uncovered and dealt with if the client is to progress to their fullest capability.

Not all physiotherapists are equal

Let’s just say that I had mixed experienced here. One physio left me in exactly the same situation as when I went to him, so I found another who sorted me out in 4 sessions. I have ‘on the level’ conversations with physios and have a pretty decent idea of the effectiveness of their treatment, but ultimately, we have to trust we are in good hands in these situations. I work closely with a couple on the corrective exercise part of my business, and whilst my understanding is not as deep, I know when someone is barking up the wrong tree. Most ley people do not, and I hear mixed opinions on physiotherapists all the time. When getting a second opinion it’s frustrating when 2 physios give 2 different opinions. The best I can suggest anyone does in this area is find the best specific injury specialist they can afford, on recommendation if possible.

Patience

There will be people who know me that will say I don’t possess much of this, and they would have a point! The past 18 months has been a real lesson for me. At first, being of a mindset of youthful indestructibility and determination I thought I would recover instantly from the arm ops and be back to previous levels of strength and mobility in no time, despite what my esteemed consultant told me. Well, I was wrong, and he was right, of course. These things take time to repair, and especially where joints have not been moving properly for some time, restoring balance in the human movement system is a process. Happy to say this is now even more deeply ingrained in my brain.

Ultimately, my experiences have stood me in really good stead. I have learned more about how the body works, and gained the patience and understanding that things don’t necessarily snap back to normal easily. As a result I am in a better position now than I was before this, personally and professionally. My mobility is almost back to 100% and strength is not far behind. Equally importantly, I am pain free! Professionally, I am a better teacher, and better equipped to help clients navigate more testing situations. Most injuries, thankfully, are relatively minor setbacks in the great scheme of things. If you can’t train upper body, you can train lower body, and if you can’t do strength work then do some mobility training. There is always plenty to go at, don’t get despondent if you hit a bump in the road. Keep going, keep open-minded, as my logo says; ‘Forward, always’.

I’ll add more thoughts on this in the coming weeks.

Happy training!

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