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Beyond Yoga Skiing Skiing, Triathlon and Sports

Rehab Badge of Honour

Today is two weeks post-ACL reconstruction surgery. I’ve awarded myself a badge. Just like Instagram pics of babies with a three-months sticker, knee surgery people get to use weekly milestones to gauge progress.

three month baby
The tyranny of progress

Two weeks!

I can…
Bend my knee to 90 degrees
Crutch to the mailbox
Walk upstairs

 I like…
Watching Youtube
Pedalling 1/4 revolutions
Visiting my physiotherapist

milestones
Badge of Honour

And just like new mothers who hear endless advice about how to raise their children; the internet, surgeons and physios and everyone at the gym have opinions about a recovery timeline after surgery.

Where you at? Ten degrees of extension and 90 degrees of flexion? Hmm. That’s not good enough for two weeks post-op. You should have zero degrees of extension by now.

Do you have a cryocuff? You’ve gotta use the cryocuff to get that swelling down. Fifteen minutes on, 45 minutes off.

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Don’t get in the pool until 28 days post-surgery. You’ll get an infection.

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A Facebook Friend triumphantly returns to the pool post-surgery

But it turns out that mothers throw away the baby books because there isn’t a specific formula for raising a child. And I’m skeptical that surgical recovery adheres to precise numbers. Rehabilitation is the aggregate of rest, patience and hard work, but it’s different for everyone.

In his twelve rules for life, Jordan Peterson is clear that instincts dictate the difference between good habits and bad. Just like constantly scrolling Instagram and eating chips for dinner are bad habits, instincts for knee rehabilitation are accurate as well. Don’t just lie around on the couch, but don’t push the trail running too early either. Pay attention to your instincts and don’t be overly prescriptive in your recovery schedule.

We all want some kind of validation that we’re doing enough. Mothers want to be told that the kid is walking and talking at the appropriate age; post-op patients want to know they’re progressing at the correct pace to get back to sport.

Fozski
the singular goal is to get back to sport

But I wonder if measuring specific targets is overly-prescriptive. I wonder if recovery  should be predicated on intuition instead? The medical system is busy. Physiotherapists and physicians hear the same story every day. Oh you were skiing and you blew your knee? Not very original. But here’s a nine-month program to get you from surgery to skis.

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It makes sense that there is a rough guideline and one should refrain from “dangerous” activities like skiing, surfing or soccer earlier than nine months (apparently that’s how long it takes the graft to adhere), but milestones along the way are loosely paved.

Abiding by a tyrannical schedule will create anxiety.  If you can’t achieve 120 degrees of flexion three weeks after surgery, you’re not doomed to arthritis. Trust your instincts! You know if you’ve done enough squats for the day. You know if you wasted a whole day lounging on the couch. Find the right balance of rest and rehab.

Surgeons and physios do everything they can to help, but they can’t know what you’re feeling and they can’t do the work. If the physiotherapist says to do 30 knee bends once an hour, do it. If the doctor says to elevate and ice, then do that. They offer a prescriptive strategy for recuperating, but it’s individual intuition that asks the right questions and guides the appropriate amount of work.

Ice
Doctor’s orders

Mothers know when something “just doesn’t feel right” in their kid’s development. Injured skiers know how much to push and when to back off on the road to recovery. It’s all based on experience and observation.

Judging progress by a weekly schedule is incongruent with skiing. With exception to athletes who are training, skiers don’t mark their progress with checkmarks. Imagine your buddy is just starting out on skis. You aren’t going to give him a schedule that says by day 100 he should be skiing all black runs, by day 200 he should have acquired a backcountry setup and by day 800, he better have ticked off some big ones like Corbets, Cosmiques and Saudan Couloir. This is an arbitrary metric to gauge skiing and fails to account for individual variables. My point is that rehabilitation follows a unique path and is based on athletic ability, personal goals, fitness level, flexibility, strength and appropriate rest.

Hike
If you don’t have a backcountry setup by Day 200, are you even a skier?

So with this, I’m going to stop reading the internet in search of validation. I doubt that having my knee pin-straight two weeks after surgery is critical to long term recovery. I’ll weigh advice from gym people against my intuition. In spite of the guy on the bike saying I must have exactly 120 degrees of flexion by now (but no more, lest I cause laxity!), I’m just going to go with my instincts.

Just like ultramarathoners who abandon heart monitors in favour of RPE and refer to it as “training by feel,” I think rehabilitation by instinct is a crucial part of the process. New mothers eventually reject the baby books, developing skiers abide by their own agenda, and post-op patients should go by intuition as well.

Xterra
not an ultramarathoner, but training by feel nonetheless

This doesn’t mean I’ll stop awarding myself progress badges or start ignoring physio advice. It’s a big deal to pedal a full revolution or finally do a one-legged squat. Those are important milestones and prescribed by professional empirical observation. Intuitive rehabilitation is just relief from the tyranny of the schedule.  It’s worth noting weekly milestones, but the rigid prescribed schedule isn’t the only way back up from the operating table.

MVIMG_20190215_113637
from OR….
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….back to skis

 

puppy nine months
apparently puppies aren’t exempt from the tyranny of achievement either
Categories
Skiing Yoga

Meditation and Rehabilitation

Meditation is the art of freeing yourself from life’s annoying circumstances. Life’s ups and downs happen all around. Highs and lows. Pain and ecstasy. Love and loss. Meditation is the tool to free yourself from suffering and feel at ease in your circumstances.

A couple of weeks ago, I tore my ACL. Behind me is the foolishness of my pre-injured youthful self. Now I’m a grim-faced gimp. In a moment of inattention, I metamorphosed from an egotistical and childish skier who didn’t know the debilitation of injury into a sedate and crippled adult humbled by the limits of my own body.

Slalok
Since I can’t ski right now, I’ve illustrated this article with gratuitous shots of my friends skiing.

Where formerly I would roll my eyes at friend’s descriptions of injuries to meniscus and patella, now I understand the anatomy of the knee with the same clinical accuracy that Jordan Peterson defends gendered pronouns. I hadn’t heard the sickening pop of a torn ligament and I was blissfully uninformed of the difference between MCL, ACL and PCL. They were just acronyms and I was just skiing. “No more conversation about knees…” I’d plead and loudly sigh as yet another friend detailed ACL injury and subsequent rehabilitation.

waiiiiiting
This is actually a conference on knees and skis. More than one person is bored listening to his friend talk about knee surgery.

But those days are over. Skiing and normal activities stripped away in a moment of complacency; the road to recovery lies ahead. The banality of a knee injury is not lost on me. For skiers, it’s as common as a cold. The tedium of thinking about my knee is oppressive. I’m obsessed with it’s healing, I’m terrified of slipping on the sidewalk and I can’t fathom the elasticity it’s going to take to get back in my ski boots, let alone on to my skis.

posing in the sun
Here’s a bored snowboarder unable to withstand the tedium of her skiing counterparts talking about their knees.

So what to do? So far, I’ve made it up and down a few flights of stairs and done some step-ups onto a 4-inch box. Those feats are a significant departure from bootpacking a 500-metre couloir or even doing consecutive box jumps.

Keyhole - Chamonix
First – walking up the stairs. Then – back to bootpacking

But it doesn’t matter what I could do before. All that matters is what I can do right now. Circumstances can’t be changed, regret is a waste of time and the only thing to do is whatever it takes to heal and get back to the mountain. And that includes yoga.

road to recovery
The road to recovery – one step at a time

I’ve told countless injured friends over the years that they should get on the yoga mat. Regardless of injury, regardless of perceived inability to “do” yoga. “I can’t go to yoga because my back/neck/knee hurts.” Well, you should go to yoga because your back/neck/knee hurts. I’ve said this to injured friends, with tyrannical authority, but I didn’t have any first-hand experience on the logistics of getting an injured body onto the mat and into the practice. Until now. Bitterly tasting my own medicine.

Waves
It’s a deep season that I chose to miss. Cayoosh – January 2019

On the day after the injury, I went to yoga. I wanted to stay home and watch Netflix. I was unhappy about being hurt. It was all so predictable. Skier injures knee. How typical, how prosaic. I was despondent and defeated by my circumstances. Yoga, meditation and the accompanying introspection was the last thing I wanted to do. I didn’t want to accept my circumstances; I didn’t want to be free from suffering. I was furious. This was the strongest I’d felt in years. This season was going to be mine. But that strength and confidence was gone. And I wanted to wallow in self-pity, not meditate on the gift of the present moment.

Japow
Shredding the present moment

But on crutches, in pain and feeling sorry for myself, I wobbled into the yoga studio. And at risk of sounding imperious, I’m here to emphasize that yoga is, indeed, the thing. Logistically, I couldn’t do many of the poses. In fact, doing any poses was out of the question. But I could lie there and quietly breathe, do a few knee bends and focus on cultivating a positive attitude. And as cliche and over-stated a positive attitude is, it really is all we’ve got. A positive attitude, unshakeable by circumstances, is the means to survive all of life’s disagreeable circumstances. Yoga and the accompanying meditation teaches comfort with discomfort.

DOA + Whistler
Keeping your skis going fall-line is the best strategy against knee injury

Yoga is so much more than the poses. The poses are only 12.5 percent of the practice. I’ve said this before, but I don’t think I truly got it until I was lying there unable to do any of the asana, but still participating in the class just by being present. The other 87.5 percent of the practice exists in the mind. Concentration, discipline, meditation, freedom from suffering.

up and away
Freedom from suffering in perfect pow

It’s the freedom from suffering that is central to yoga and the tool to manage life’s circumstances. A knee injury is not the worst tragedy to befall anyone. It’s not really even a crisis, but it’s a temporarily debilitating detail in my story. We all have debilitating details in our stories. Whether it’s the unanticipated loss of a job, illness of a parent, being a victim of burglary, paralysis following a car accident. These are all tragic circumstances. The hard truth though is everything could always be worse. But it could also be better. The point is that good and bad things happen with equal regularity.  Meditation teaches that surviving the ups and downs is possible. By meditating on the present moment, you teach yourself that the collection of experiences that populate your life’s story are not the totality of your existence. Furthermore, the collection of experiences that cause pain and difficulty do not need to equate to suffering.

Spruceman on skintrack
The wise (spruce)man on top of a mountain.

The myth of the wise man sitting on top of the mountain is an archetype of someone escaping the confines of life experience in order to seek enlightenment and avoid suffering. It’s a story to illustrate meditation as a transcendent and literal state of being. But glorifying meditation in this unlikely scenario is a hyperbolic way of viewing the practice. Literally escaping the trappings of society and its accompanying pain and sorrows isn’t necessary because meditation provides an avenue to metaphorically escape the confines of difficult circumstances. The trick is to use meditation to pay attention to the present moment, cultivate a positive outlook and refuse to suffer from unfortunate circumstances.

On the skintrack
Forward locomotion – still doable with a torn ACL (apparently)

Experiences and circumstances are sometimes beyond control. Events that cause pain are unavoidable. But choosing to suffer (or not) is definitely within your control.  Practice meditation as a strategy for accepting and coping with difficult circumstances. Learn to be comfortable with discomfort and maintain a sense of ease through all life’s injuries.

Cosmiques
Comfort with discomfort in the mountains

Lying on my yoga mat with a swollen knee, I didn’t feel prepared to accept my circumstances. But recovery will follow a specific trajectory and there isn’t any way to expedite the healing. I can’t change what happened and my ski season is over. So many details in my life are different now: the inability to walk the dog, waking up to searing pain because my knee twisted in the sheets, boredom with the only cardiovascular exercise I can currently do (swimming). But my ability to tolerate these frustrating changes and to thrive as a contributing member of society is predicated on making the conscious choice not to suffer.

Sprucedude
Suffering is optional

 

Suffering from these circumstances is easy. Using meditation to alleviate suffering and to understand my intrinsic worth is hard. Living a worldly existence populated by experiences and injuries is easy. When something as consuming as injury happens, it can be hard not to obsess with the story and the healing. But circumstance does not represent the totality of existence. Meditation is freedom from preoccupation with circumstances. Pain and difficulty is mandatory. Suffering is not.

Black dusk + skiers
Three pairs of knees functioning at full range-of-motion