The Recovering Athlete: Rehabilitation for a Blown Back

Yesterday marked the beginning of my 10th week since my injury, and it also marked my new hopeful 6 week countdown to full recovery.  On exactly this date last year, I was just two weeks into starting my Facebook fitness page The All-Natural Athlete, and was celebrating Week 9 of being a clean eater trying to figure my way through the tangled web of losing weight and gaining muscle (click here to see that post).  Revisiting that blog post brought back such fantastic memories, since week 9 was when I was finally starting to see serious results -- the running shorts I had been wearing for almost a full decade were now too big for me to wear!  That sentiment ironically is identical to how I feel now; I finally am beginning to not only feel better, but feel strong again.  I continue to struggle with a stiff back in my sacral region at the end of a busy day, but nothing a little ice and 30 minutes of rest can't do away with.  Each week my Physical Therapy team gives me new work to do (this week we've added unweighted back hyper-extensions, and next week reverse lunges will be thrown into the mix) and I'm starting to see the light.  In both cases - first changing my whole lifestyle last year, and now this year repairing a variety of sports injuries that were, sadly, inevitable -- the first months were an enormous and often times disheartening struggle.  They were a vicious game of patience, and required a lot of trust in the process.  Physically, psychologically, and emotionally, there was not one easy thing about making it through the first 2 - 3 months of harsh reality.  But in both cases, the strength and lessons learned in keeping focused and determined to change and be better for it have paid back to me more than I ever could have imagined.  It was the greatest thing I ever achieved in my life last year to become a clean eater, and I know that healing my body now so that I can come back to be a kick-ass athlete later this year will be one of the greatest stories I'll have to tell for the rest of my life.  I am already grateful for the challenges dealt to me :)

With that said, several of my friends and volleyball/fitness acquaintances have been asking me what my PT guys have been doing and teaching me to rehab my back, both in the acute stages as well as in the strength/preventative care stages.   I've been meaning to share everything, so here goes! 

I would like to start this by saying I have absolutely NO formal education in any of this.  I am merely regurgitating everything I understand as being taught to me by my PT guys based on my own individual situation.  For more details on my own situation and the cause of my back injury, please read my blog post here (about halfway through the post I discuss my anatomical maladies).  In short, I deeply sprained my L4/L5 and L5/S1 discs as a result of my quadriceps completely overpowering my hamstrings and gluteal muscles, causing my pelvis to be pulled forward, which then created a tug-o-war effect between my quads and my spinal erectors since my hams and glutes couldn't do the job.  Thus, my therapy has been geared toward stretching out my quads, opening up my hips, and aggressively strengthening my hamstrings, glutes, abs and lower back muscles in order to rebalance the torque being placed on my pelvis, and to stabilize the whole region to protect my lower lumbar from unnatural strain.

THE ACUTE PHASE (First 3 weeks):  The first 3 weeks were rough.  I was in terrible spasms and my discs were slightly slipped and pressing on nerves, causing nerve pain in my hips, glutes, and down my left leg.  Physical therapy consisted of ART (Active Release) treatments.  Chiropractors and physical therapists actually have to be certified in this type of therapy; it should not be done by a street masseuse.  I was placed on a table the bent back and forth at the waist, creating movement in the spine, and had ART therapy done to me in my lower lumbar region along my spinal erectors to help break up pre-existing scar tissue from previous injury, and to help release the spasms in my back.  At home, I was told to take 800mg of Advil twice a day (morning and night, 12 hours apart, with food).  I was to walk for 15-30 minutes in the morning and the evening on flat paved ground with proper footwear; even if it hurt, I was to walk.  Walking helps loosen the muscles and open the hips to help release tension.  I was to heat my back in the mornings and the evenings, particularly before I went walking.  Otherwise, I was to ice several times for 10-20 minutes, particularly when my back started to hurt.  I was to avoid sitting as much as possible since it compressed and pinched my spine.  Ideally, I was either standing, or laying in the only position I was allowed to sleep in - with my back flat on an egg crate mattress, a thin pillow under my head, and my knees up and bent at near a 90*-angle, similar to the photo above (I would just stack 3 pillows under my knees).  This position helped TREMENDOUSLY.  

After 2 weeks of the above routine, I was taught to do 2-5 sets of "Prone Hip Extensions", holding the position for 20-30 seconds each.  Lying face down, knees touching the floor, toes pointed and heels slightly pointing outward, I was to squeeze my glutes and "tuck my tailbone underneath me".  This action activated the glutes and hamstrings to pull my pelvis back and into alignment.  Here is a video of that action.  Please note:  In the beginning, I did the first version of this video.  As I progressed, I now do the second version demonstrated in this video:

In addition to this, I did 5 - 10 very gentle "cobra" movements (Here is an image of cobra pose - only held for 2 seconds each time)

THE RECOVERY PHASE:  In weeks 4-6, I was more or less taken away from "therapy", and shifted to active recovery.  I was still heating, icing and "Advil'ing" during this period.  In addition to doing the Prone Hip Extensions shown earlier by video (with bent knees), my PT guy did some brutal (but of course, highly effectively!) therapy to my hip flexors near my abdomen and groin, and discovered my quads were full of scar tissue so we did some deep ART massage there. 

I was also given my first homework to start doing.  First it was the Prone Hip Extenions and cobras, but now we added "Hip Openers with a Stability Ball".  I did 4 sets of the Hip Openers per each leg, holding the pose for 30-45 seconds.  Follow this link to the video; for some reason, Blogger can't locate the video for me to upload: "Kneeling Hip Openers" (link redirect: http://www.youtube.com/watch?v=FAolljf8vps) In this movement, for various weeks I did this stretch staying erect or leaning back a little bit, before my quads were loose enough for me to then proceed with the exercise and lean forward.

Next, I had to foam roll my IT bands like crazy.  They were so painful in the beginning, it brought me to tears!

I was also taught "Pelvic Tilts with Tidal Breathing".  Tidal breathing is breathing slowly in through your nose and letting your belly extend outward (instead of breathing "upward" into your lungs), and then breathing slowly outward through pursed lips.  Pelvic Tilts had me laying on my back with my knees bent.  Breathing in and letting my belly rise, it would lift my lower lumbar off of the table.  When I breathed out, I was to tuck my pelvis underneath me so that my lower lumbar touched the table.  This creates movement in the spine and is good for it (although I cannot site specifically why..the video explains :D).  Here is a video showing this exercise:

I would do 25 sets of the above exercise once a daily, sometimes twice later on.

THE REBUILDING PHASE: PART 1:

Between weeks 6 to present, I have continued to gain new exercises each week I receive therapy. I was assigned to do forward planks and to do 4 sets of 20-60 seconds each.  The proper way to do a forward plank is here (again, Blogger cannot locate this video.  Ugh!):  Forward Planks Video (link redirect: http://www.youtube.com/watch?v=uQtvkzhg-Ls)

I was also taught to do lateral planks with a foam roller between my knees.  As this video explains, that is to keep a neutral alignment of the spine and pelvis.  Blogger won't let me updload the video, so here it is:  Lateral Bridge (Link Redirect: http://www.youtube.com/watch?v=001_lfX1rjM)

I was also prescribed to do 4-6 sets of 10 reps at 70% strength of two separate hamstring curl exercises:  The first was the seated one, the second was the prone (laying down) one.  In both instances, I was to have my toes slightly pointed inward, to target my medial hamstring which is very weak. Here is a seated leg curl tutorial:

And here is a prone leg curl tutorial:

In addition to these exercises, I was allowed to start walking hills for 30-45 minutes each day, which I progressed to hour-long hikes eventually.

THE REBUILDING PHASE: PART 2:

2 weeks ago, the "T Exercise" was added to my repertoire.  This, to build my glutes, low back, and also my thoracic region which has also been in flexion.  Again - SHOCKER - Blogger won't let me upload the video.  So here are the links: Y's and T's (link redirect: http://www.youtube.com/watch?v=zoi2KmtNHaY) *Please note, I have not graduated to Y's yet*

I was also given Floor Bridge exercises to do.  I was taught two of them:  One using a stability ball, and one just lying on the floor.  I only do the floor one (don't tell my therapist!) :)  Floor Bridge (link redirect: http://www.youtube.com/watch?v=sSQhcG-aqYQ)

And last week, the back hyper extension exercise was added to my routine.  I was told to do this 4 sets of 10 reps but I've only been able to do 3 sets of 8 reps.

I do all of these exercises in conjunction with all the ones previously assigned me. I'm 2.5 months into this process and I now only take Advil when needed, I ice each evening and anytime after I work out, and I heat every morning when I wake up, every time BEFORE I work out, and I also place the setting on low and sleep on the heating pad each night.

I know that soon, I will be adding reverse lunges and stuff, and will post those when I cross that bridge. The goal in all of this, as mentioned before, is to train the back of my legs and get them strong enough to pull back against the force of my quads so that my Pelvis comes into a neutral position.  Also, to continue to stretch out and massage scar tissues away from my quads so that they will loosen up on their pull on my pelvis.

My back still cracks a lot, I have a standing desk at work to avoid much sitting, and I still sleep in the same position each night (or on my side with a pillow between my knees). I have good days and bad days, but I more or less am in a position to move about freely without pain.  I don't lift heavy things or do anything not prescribed by my physical therapist though.  I do, after all, intend to make a full recovery and train to run a half marathon in November, not to mention still train to do maybe a figure competition at some point :)  More updates to come soon!

The Recovering Athlete: 孫子兵法 ("The Art of War")

"兵之形, 避實而擊虛."  

("So in war, the way is to avoid what is strong and strike at what is weak.")

--Sun Tzu, The Art of War

If my last blog post wasn't evidence enough, the past 7 weeks have been a test of my patience, my sanity, and my ability to believe in a light at the end of this injury tunnel.  It has been nearly 2 months since my back went out on me.  In that time, I have gone through some seriously dark sh*t, and now that I finally have begun to turn the corner with measurable improvements in my condition, I have been able to start gathering together everything I've learned in this process, and want to start sharing it all. This experience, I know, will be well worth it's weight in gold in the end.

The first four to five weeks of my journey were some of the darkest times I've ever experienced in my life, ever.  If you want insight on that time, read my last blog post:  The Injured Athlete: Why it Took Me So Long to Write This.  

Kent had THREE herniated discs at one point. He made
 a full recovery without the need for surgery.

After 3 weeks of acute chiropractic therapy, my back finally began to stabilize and I was introduced to my physical therapist, Kent.  Kent has been working on addressing the great number of things wrong with my body for the past 4 weeks, and he's been nothing short of amazing.  A former competitor himself, the injuries Kent sustained from overtraining, overly aggressive weight routines, and general lack of observation of developing injuries, eventually cut his bodybuilding career short.  But through his own rehabilitation process, he developed a desire to devote the rest of his career to training and treating injured athletes in an effort not only to treat their ailments, but also to change their mentality through education so that the athlete could train sustainably in the future.

I intend to share everything I have learned (and  continue to learn) from my sessions with Kent in this blog.  But for now, I want to focus on one conversation I had with him last weekend.  I'm going to call this the "Sun Tzu / Art of War" talk. Here's the backstory.

I was on the table getting ready for some ART therapy in my lower lumbar, and Kent and I were talking about sustainable athleticism.  We spoke a lot about the wide variety of injuries common amongst athletes, and how most of them almost always effect the spine to some degree.  We talked about baseball injuries, soccer injuries, triathletes, marathon runners, you name it.  Kent said to me, "You see those super competitive triathletes out there?  The ones who don't have an ounce of body fat, and all look like the endurance-version of Superman?  Don't be fooled, they're ALL injured.  They are ALL on my table."  So I asked Kent, despairingly, "Is there any way to be a competitive athlete, but still be able to preserve your body so that injuries like this don't occur??"  Kent's response:  "The second anyone decides they want to compete or strive for real greatness, fitness from a health and wellness standpoint immediately takes back seat."

This was a shock to me; I never have thought about how my health and fitness goals might actually be affecting my overall health and fitness in a negative way.  I know that moderation is key, but I still never thought that my ambitious athletic pursuits could all actually be doing more harm than good, from an accumulative stand point.  But then common sense kicked in; we preach so much about pushing ourselves; "No excuses", "no days off", and all those other mantras.  We praise people who push harder, who don't quit… and rightly we should! But when people have too much zeal, their pain tolerance goes up.  They, like me, are more prone to skipping rest days.  They get used to the toils of training and can't distinguish between good and bad pain.  They choose to push through injuries instead of stopping ("Only quitters quit!").  And they tend to continue to push harder as their thirst for "better, better, better!" gets stronger, stronger, stronger.

You can see how large my quads here; you can't see
how much bigger they are than my hamstrings.

My back injury is a result of various factors. First, my spine has been strained and sheered by an unnatural degree of pull on it from my pelvis.  My pelvis is rotated forward because it is being pulled straight down by my quads.  My quads are FULL of scar tissue from old injuries, my IT bands are as hard as concrete, and my quads in general are overdeveloped in relation to my glutes and hamstrings.  This has effectively rendered the back of my legs useless in trying to pull my pelvis back into place, which then has put a lot of pull and strain on my spinal erectors as they fight to keep my spine straight and in place against the force of my quads. My glutes and hamstrings are weak because (a) I haven't trained them properly and proportionately, and (b) because, between school and then an office job, I have basically been sitting for 8+ hours a day for the past 25 years of my life.  2 hours of working out a day cannot offset sitting for 8 hours.  Sitting down for that long ruins your hip flexors, allows your quads to tighten up, and stretches out your hams and glutes, which just adds to their inability to pull the pelvis back and in place when tight strong quads are pulling it forward.  Add on top of this two instances when I was told I had piriformis syndrome which I treated with oral steroids (and NO physical therapy…wtf was I thinking!??), when in actuality I had sprained my lower back, as evidenced by all of the scar tissue currently surrounding my injured vertebrae.  I pushed through the pain, I rushed the healing process of injuries (or didn't treat them at all!) and I continued to build my program harder and stronger.  I was a ticking time bomb.

Note how muscles both directly and indirectly affixed to the spine and pelvis, go all the way down to the knee!  Knee pain is often a symptom of -- or precursor to -- back injuries.

So, back to the Art of War...  

Kent told me that there is a way to be a healthy, competitive athlete, and a way to stay a healthy, competitive athlete, but it requires common sense which, at first glance, may look counter-intuitive.  He said that for whatever sport you do or compete in, you must, MUST ensure that you train opposing muscle groups in the gym.  He said that many athletes think that since their sport requires them to do or be strong in certain movements, then that's what they should be training in the gym.  While it is important to develop those muscles and agility and motor skills in what is required of you, it is perhaps even more so important to train and develop the muscles and movements in your body that are NOT worked out as much in your sport.  Why? You must stay balanced! Your body should maintain a uniform level of muscular development.  Too much of one muscle group will overpower the other, and wham! Injury.  Too strong of one muscle group in relation to another will cause you to subconsciously move differently, which in turn puts strain on joints, ligaments, and other tissues that aren't being moved properly.  Kent said you have to attack the weak spots, not the strong ones.

"The Art of War" is an ancient military treatise authored by Sun Tzu, a legendary Chinese military general, sometime in the 6th century B.C.  There are a great number of proverbs that come from the book, and one of them goes as such: "兵之形, 避實而擊虛."  Or, in English, "Avoid what is strong, and strike at what is weak."  Of course, Sun Tzu was talking about how to efficiently overthrow a foe.  But when Kent told me that the training program I follow for the rest of my life must be engineered to attack the weak spots, not the strong ones, I immediately thought of Sun Tzu.

Goals are kind of like war:  Your mind is set on them, you develop a strategy, and you don't stop until you either succeed or you surrender.  My body is a battlefield that has seen it's fair share of bloodshed :/  But I know now that, while being a competitor (of any sorts) will require a certain degree of risk and sacrifice, if approached properly, one can develop one's body in nearly perfect balance by focusing not on making the strong parts stronger, but bringing the weak spots up to speed.

As such, when I am finally healed and Kent helps me engineer a training program, you can bet your boots it will be chock full of hamstring and glute exercises and deadlifts, and there will be a striking absence of the incline leg press… possibly forever?  And I will most certainly share this program when I have it!

That's all, for now :)

The Injured Athlete: Why it took me so long to write this

Today is Tuesday, February 26th.  29 days ago, on Monday January 28th, I had a Back Attack.

I was baking a quiche in my kitchen after a super basic evening of 60 minutes of steady-state elliptical cardio at the gym.  It was a completely non-descript day; I did biceps, triceps and shoulders in the AM, worked all day, then cardio before I went home to do my customary monday evening meal prep.  I even remember having "I Shouldn't Be Alive" playing on Netflix on my computer as cooked, watching someone's harrowing ordeal and being thankful I was healthy and well.

That's when I noticed the pinchy tightness hitting my left glute.  I couldn't stretch it out, and it nagged at me.  I figured I was having a cramp.  I took 2 advil and tried to ignore it.

Two hours later, as I was just lying in bed to sleep, that growing achey pinchy cramp finally seized into a brain numbing pain shooting through my left glute, around my hip flexor and down my leg.  I immediately thought what I thought was the worst - that I was having a flare up of Piriformis Syndrome, which I had been shoddily diagnosed with twice before in my past.  Both times took MONTHS to recover from, and I laid in bed in a blinding panic, especially since I had done nothing to provoke this.

The next day, the pain was gone.  I felt pretty ok.  I took Tuesday as a rest day, and when Wednesday came around, I decided to have at it and see if the pain came back.  I ran 7 miles, did lower body weights, and ended it with a course of yoga.

Brilliant, aren't I?

Thursday was the true beginning of a horror story I am still not even near being out of.  The pain which seemed to grow stronger and stronger each hour, each day, the aches, the nerve pain, the impossibility of getting into a position to alleviate the pain…. it was maddening.

I survived to Monday, February 4th, when I saw a Chiropractor for the first time.  He immediately said I had sprained my L4/L5 disc, that I was a pretty textbook case, and that I shouldn't worry; the pain would subside, and they'd help me learn how to prevent this in the future.  But… disc injury?  He might as well have told me I had cancer, to be honest.  I knew what back injury meant.  I had seen my brother suffer chronic pain from it, saw it sideline many people I knew in my life.  It was the first disability I had ever been diagnosed with, and the pain was blinding.  I couldn't sit, I couldn't lay down, I couldn't drive, I couldn't work.  The instability of my spine was always constant, the nerve pain was unresponsive to any quantity of drugs I took.  One night I was so desperate I took three 200mg Advils, one Advil PM, and 5mg of Flexeril.  Not a single change in the pain.

What ensued was a heart-defeating dance of having a couple "ok" hours, and then spasm.  A day or two of tolerability, and then suddenly days of cramps and nerve pain of varying, inconsistent degrees.  Some mornings I would wake up fine, others I would begin my day with awful cramps through my left quad and down the side of my calf.  Usually between 11a and 2p I would have such intense nerve pain focused around my sacrum and radiating to each of my hips, that I would break down sobbing in the lobby of my work.  People would stare, some had the decency to ask me if I needed an ambulance.  All I could do was just say I was in a great deal of pain that nothing but time could alleviate.  I would call my mom who unfailing absorbed all of my inconsolable tears, who with patience and a love only a mother could emit, showered understanding, reason, sympathy, and options we had to help me find healing.  Even if it meant steroids and percocet, she would remind me we hadn't exhausted all the options, that there was a way to escape the pain if I really needed it that badly.  Part of me admittedly didn't ask for steroids or hefty pain killers from my doctor for fear that they wouldn't work either, and I don't think I could face that defeat.  It was comforting enough just to know there were other options that might still work.

Amidst the physical pain, was the pain of being told I obviously couldn't work out.  Weekends were the worst.  Seeing my minifeed full of people getting in their 20 mile trail runs before 7am, people hiking, cycling, hitting the gym….All my friends were out playing volleyball and I couldn't even be near it, the depression and jealousy and anxiety would consume me. It still does.  It brought back nightmares -- literal nightmares -- of the time I tore some tendons in my knee and had to retire from soccer.  But at least then, I was still allowed to lift, still allowed to swim and cycle until my knee healed.  I couldn't sit or lay down for the pain due to this back injury, but I wasn't allowed to work out or do anything that I loved that would take my mind off of the misery, and all of my friends were out doing athletic things that I couldn't participate in.  The first 3 weeks were a blur of unending tears, anxiety, and massive amounts of depression.  The weekend of President's Day I spent indoors with the blinds drawn, my phone shut off, and went between bouts of pain-induced tears, depression-induced tears, and complete mental breakdowns before exhaustion would consume me and I'd fall asleep for 3 - 4 hours.  I would wake up, realize I was trapped in a nightmare, and continue the cycle.

A lot of thoughts crossed my mind during this time.  It's difficult for non-athletes to understand what it's like to suffer an injury that not only sidelines you, but drowns you in pain that nothing can alleviate.   I think of it as a brilliant mathematician being diagnosed with Alzheimers, or a guitarist getting into an accident and losing his hand.  Or Julie Andrews losing her ability to sing due to that vocal chord issue she had. When it wasn't physical pain, it was psychological warfare.  No matter who was around to make me feel better, to uplift me, to encourage me -- and believe me, I have had many angels through the darkest times of this! -- nothing was enough to give me any hope to cling to.  I thought of those survivors on I Shouldn't Be Alive and realized that if I was ever in a life-or-death predicament, I likely would not have the strength or the willpower to see myself through it.  

One time, when I was on a walk (which is all I am allowed to do), I was able to put my finger on why I was having so much anxiety and depression; after all, I had only been injured 3 weeks! I realized it was because I had put all my eggs into one basket.  Not only did I love being an athlete, and not only was I addicted to the high, the endorphins, the lifestyle, the sense of community, and all that came along with it, but it was my sole identity. I don't want kids, and I don't want marriage.  My career is mediocre at best, and I certainly am not climbing any corporate ladder any time soon.  My athletic activities defined me, they were everything my life was about.  If I had a bulging disc that prevented me from being the same ever again, then who was I?

In 2008, I suffered an awful heart break that I have never recovered from.  After enduring that pain, I came to my own personal conclusion that anything love had to offer, was not worth the risk or the pain.  All I needed was myself, my freedom, and I was perfectly content with that.  When I lost that relationship, the same thoughts flooded my mind; what is life worth, if the only person I ever loved was no longer in it?  What is there left to live for?  

Now, certainly these are dark thoughts we all experience during our darkest hour.  And we see it through, we learn, we grow, and we become better people for it.  But on my walk, when I was thinking the same thing for this injury as I was during heart break, I began to wonder if there was not anything in this life we can ever truly count on.  What is it all worth?  What is the one thing in life worth fighting for if you don't even have your own good health?  That is an open-ended question that I am on a quest to answer for my own self, in due time.  Surely there is so much to cherish and enjoy in this world besides athletic endeavors.  The problem really lies in how we view ourselves and where we fit in society.  If we lose our identity - whether it be to injury, loss, career obliteration, bankruptcy - if we lose the thing to which we've anchored our existence, then there is nothing left to keep us from floating away and being lost forever.

On President's Day (Monday), I had a chiropractor appointment.  I had been in spasm since the prior Thursday.  When my doctor saw me in such pain, after several weeks of treatment, I think he began to realize that he was dealing with a larger beast than he had once thought.  At first he suspected I'd be better in two weeks.  But then he felt scar tissue around my compromised vertebrae and told me that this was not my first rodeo -- that those times I had piriformis, where actually flare-ups of this same disc injury.  Which means I technically blew my back out first in 2008 when I was only 24, and again in 2010 when I was 26.  Here at 29, my third back injury.  A now chronic injury.

A later xray of my back would reveal a properly aligned spine with a slight narrowing of the L5/S1 vertebrae; this supported my therapists' diagnosis of soft tissue trauma and spinal sheering caused by pelvic strain placed on my spine as a result of imbalanced muscular development and misdiagnosis/poor rehabilitation of prior sports injuries.

The doctor worked to create space in my spine and then did deep tissue ART massage on my back erectors, which were as hard as concrete.  I spent the rest of the day in continued pain, which culminated in a full-scale, not even joking panic attack in the middle of Whole Foods with my mom and sister.  I stood absolutely frozen; I don't remember much, but I do remember going completely numb next to the Food Bar.  I heard a ringing in my ears and I started sweating and that's when I realized the panic was no longer in my head, it was taking over my body regardless of how I felt.  A searing dread came into me.  I was aware I was in a public place, and knew I needed to snap out of it and get agrip on myself, but there was this stillness in the eye of the storm that I was drawn to. It's like, my whole body was responding to this fear and dread and panic overcoming me, but the core of my mind was in this quiet, numb place that held me captive truly like a dear in the the headlights.

But then the truck struck me.  I began feeling my hear racing, feeling the dizziness and nausea and that horrifying desire to run away from imminent danger and then becoming aware of huge muscle cramps and nerve pinches. I began to uncontrollably sob. I basically just gave up, and gave into it.  I gave into the pain, I gave into the fear that kept trying to squeeze the breath out of my lungs.  I surrendered all hope I had mustered in my "silver lining" attitude that in the end, this would all be worth it, that I would be a stronger athlete and a stronger person for all of this.  I was exhausted; I couldn't sleep for the pain, I hadn't eaten in at least 48 hours, and I had spent any remaining energy I had trying to push down the dread and the pain that kept coming closer and closer to engulfing my whole body, like a thick gray fog that veiled the whole world from me.  My mom rushed me out of the store as I began hyperventilating, and somehow managed to keep me on my feet when my sobbing turned to dry heaving and I thought for sure I was going to pass out.

Over-reacting?  I hope to god one day I can look back and say I was overreacting.  I hope to god one day I can look back in shame and say, "God, what a pussy I was about that one time when I had a back spasm!"  I hope to god one day I can look back with embarrassment for proving just how weak and vulnerable and impatient and soft I am.  I hope to god this was just an instance of weakness.  Because right now? 8 days after that episode?  I look back with horror thinking that that was one of the realest, most genuinely terrifying experiences I have ever gone through.  I remember that moment as being the closest to death I have ever come, to be honest.  I had never experienced a panic attack before, I have never had a near-death experience, I have never suffered from depression or anything like that.  With all of those intense sensations, all that pain (both in and out)… it was like, I had never been more aware of my existence than in that moment, and I had never been more aware of how fleeting it was, either.  

Since that day, I have made some improvements in my physical condition.  I still have the spasms (last Friday night I woke up to one so bad that I threw up).  But I am sitting better, lying better, am not in constant pain all the time, and have been allowed to lift light upper body weights which has saved me.  I struggle with anxiety and impatience and hopelessness still, and fear that I will never escape this pain (despite my doctors telling me I will surely recover).  After that last panic attack, I vowed to put as much of my energy as possible toward healing, and changing - both as a person, and as an athlete.  I have practiced meditation; taken long mineral salt baths with incense, music and candles; I've begun to read more, cook more, and strive to keep my mind and heart at peace.  Strangely, I think of Lance Armstrong a lot.   I think to myself what he must have gone through when he found out he had cancer.  Chemo, radiation, and the thought of not only losing his passion, but his career at the same time.  And he survived, and he came back.  Steroids be damned! I couldn't care less about that decision of his anymore.  I think about female athletes who get pregnant and have children and have to deal with - and rebound from - all the physical changes that procreation requires.  It's only been 29 days for me.  I am still in pain, still fragile, and still fearful…. but I can walk.  And I can maintain upper body.  And I can dream of the day I get better, and can finally hire my trainer and my nutritionist and start tackling my physique goals.  I may have to give up volleyball, but I've had to redefine myself as an athlete before; who knows, maybe triathlons are in my future?

But alas, I get ahead of myself.  The reason it took me so long to write this, is that it has taken me so long to stop hurting.  I haven't stopped hurting yet, but I realize that my experience may be consolation to people who come after me, and sharing all the dark and painful details that no one wants to talk about for fear that others will judge us as being hypersensitive or crazy might encourage others who find themselves in this dark place right now.  I've come across quotes and songs and such that I'd like to share as a part of expressing the experience of an injured athlete who is struggling with pain and identity crises, but I am tired so I will share those later.  For now, though, two quotes that I enjoy, which both convey trying to create opportunity in times of disadvantage:

"Every wall is my door." -- Ralph Waldo Emerson

"When the winds of change blow, some build walls while others build windmills."  -- Chinese Proverb

I am considering having the Emerson quote tattooed on my back once I heal from this injury :)