Rowed to recovery

By Beth

Historically injury and recovery are things I have never managed constructively. Physical pain associated with an injury is generally only a small part of the overall ‘hurt’. The bigger issue is often the mental and emotional pain associated with the loss of the sport.

I suspect what I say next may ring true for a number of people: when the physical hurt pales in comparison to the mental hurt, the urge to just ‘power through’ is often hard to suppress. My utterly deluded and warped logic has been to exercise the injury away. For example, I have run 18 miles in driving rain and sleet with a chest infection to ‘keep to programme’, and pared back triathlon training to ‘just the cycle and swim’ to accommodate a ruptured calf. Neither scenarios worked out well.

So doing the Three Peaks back in 2019 with a ‘niggly hip’ barely warranted mention. It was just a niggle…or at least it was ascending Ben Nevis. Scafell Pike? That niggle needed breathing through. Snowdon? Chewed on a handful of ibuprofen before we even started and promised to ‘deal with it’ when I got home.

Thing is I didn’t deal with it. I ignored it, and all the while the pain gradually got worse. But a bit like putting a frog in a pan of cold water and bringing it to the boil, as the pain increased so did my tolerance of it. Ditto my creative ability to deceive myself into believing I didn’t have a problem and it would pass!

The prognosis

It was only because of concerns about the amount of ibuprofen I was taking that a GP appointment ended in a referral for an x-ray in early 2022. With a diagnosis of severe osteoarthritis in my right hip, the initial prescribed course of action was to ‘activate [my] glutes’. Not wanting to question the advice of a medical professional, I spent an inordinate amount of time consciously squeezing my ass cheeks in and beyond the confines of a gym while muttering darkly under my breath that I failed to see how my glutes could be any more active.

Ironically the release of dopamine and endorphins associated with exercise was possibly the most effective pain relief I could get my hands on. So, I doggedly focused on that – my exercise-junkie logic being that if I was still training, could it really be that bad?

But it was. This was never going to improve or stabilise – it was only getting worse. It affected everything: my mood and my ability to concentrate, sleep or walk. It was there all the time, a nagging incessant pain that nothing could touch, and which became all consuming.

Confessing this to an osteopath through a fug of snot and tears resulted in my being instructed to get an appointment with an orthopaedic surgeon at Nuffield Health, Oxford, who specialises in young hips.

Two weeks later, the prognosis was stark, and the options limited. Steroid injections might help, but all they would do was stave off the inevitable: a total hip replacement. I had stage 4, bone-on-bone osteoarthritis and if I wanted to row the Atlantic, this was my only option.

Beth and Kit out in Cardiff Bay the day before Beth’s hip operation

So, on 7 November 2022 I sat on a hospital bed waiting to go into surgery. In retrospect my present self can laugh at my historic self who sat there genuinely debating doing a runner/hobble. Maybe I just had a really low pain threshold and this whole scenario had escalated rather unnecessarily? In the 48 hours prior I’d done a gnarly boot camp, an hour of skipping drills and had an outing on the boat we’d be crossing the Atlantic in. Was a full hip replacement really necessary?   

Left to my own devices I may well have run, but the timely appearance of an anaesthetist put paid to my seeing the plan through.

Coming out the other side

Around 90 minutes later I came too and found myself having to contend with a new and brutal pain in my right leg and a very different challenge to face.

Post-op there’s no opportunity to malinger. They get you up and out of bed quick. At 9.30am the next morning, accompanied by two physios, I gingerly hobbled down a hospital corridor ineptly using two crutches. It was then reality came crashing down: there was no quick comeback from this. I was effectively learning to walk again.

Irrespective, having once ascended and descended a flight of stairs 48 hours later, I was handed a piece of paper with some mobility exercises, an appointment with a physio for two weeks hence, a selection of ‘implements’ the purpose of which even now I’m still unsure (giant shoehorn, anyone?) and summarily sent home.  

As to what followed, it came as no surprise to anyone (except perhaps me) that I proceeded to spiral to a dark place. The preceding summary of select incidents comprehensively illustrates the abject denial I was in about the severity of my problem. Be in no doubt, I had buried this DEEP. But it wasn’t staying buried…

Road to recovery

‘They’ say emotions are an important part of the healing process and only in acknowledging them can you even start on the road to recovery.

It wasn’t so much that I acknowledged them but that they bubbled to the surface completely unfettered.

The sight of gym kit on the washing line; Concept rower in the dining room (or rather a rower-shaped mound in the dining room after a quick-thinking family member covered it with a blanket in an attempt to disguise it); and messages from friends along the lines of ‘you could take up knitting to pass the time…it’s very mindful?’ reduced me to a panicked and despairing mess.

The final straw came when I had to ask my 12-year-old daughter to help me put my knickers on (we both agreed, “let us never speak of this again”).

The turning point came when a straight-talking friend called to check in. Having listened patiently while I wallowed in self-pity, he sighed, asked me if I’d quite finished and asked me this: “So what do you need Beth? Empathy or strategy?”

I paused.

Strategy?

So, this is what I got:

“Mate. I think you are the ONLY person who didn’t see this coming. You’ve been carved open, had the top of your leg sawn off, a new hip inserted, before being sewn back up and sent on your way. It’s not just your leg in trauma. Your whole body, heart and brain is in trauma.

“You are in recovery. You had a general anaesthetic; your head is all over the place. Be depressed for a few days. Be sad. It’s ok, it’s allowed. But you need to deal with it. Be realistic. Treat rehab like training. Set goals…achievable goals. Lap of the park by Tuesday, four by Friday. 8,000 steps a day by the end of next week. And keep looking forward. So what if you were doing boxover burpees last weekend? You’re sure as hell not going to be doing them again anytime soon. So tomorrow morning get your ass over to the park and back and take the win.”

Those words did the job. They were the strategy I needed. You know who you are…thank you.

And with that, 10 days later I was on 10,000 steps a day and had abandoned the crutches. I was lapping the park and doing my mobility exercises in 4 sets of 20 twice a day. It felt good and the improvement was stark. I had done away with any painkillers and, more pertinently, I had the startling revelation that for the first time in over four years I was pain free. That nagging, constant pain that had kept me awake at night and on bad days made me completely intolerable? It had gone.  

Photo credit: Dunleavy-Harris Photography

Treat rehab like training

With the nod from the physio, I started back in the gym at the start of week three, limited to using the erg bike in moderation, along with new and beefed-up mobility exercises and measured upper body and core work. Never have I been so aware of every muscle and sinew, or how much I bloody love endorphins!

I obsessed. Treat rehab like training. I embraced being boring, unable to shake the feeling that if I deviated from my daily routine of running through the mobility exercises and nailing 10,000 steps my world would implode.

And it paid off. At my six-week post-op check-up the surgeon declared I was ‘back in business’, completely disproving his original ‘optimistic’ suggestion that it would be mid-January 2023 before I could get back on a rowing erg. Now it was mid-December, and I was being given the green light. The only caveat was that I had to build back slowly and avoid anything high impact which might damage the bone that was still growing back round the hardware. Listen to your body.

For once, knowing the risk of self-sabotage ran high, I did what I was told.

There’s still some way to go. Five months to the day since being sat on that hospital bed and rehab has segued seamlessly back into training. I’ve been building time through interval sessions on the rowing erg, and I’ve restarted conditioning and functional fitness classes. At the beginning of March as a team we completed our first 24-hour row with a hilly night walk tagged on for good measure (because we all know that if anything is going to go wrong on that boat it will happen in the dark!).

A ’not too shabby’ outing as a mixed pair at the end of March in an in-house gym competition also felt like something of a milestone.

Stubborn pig-headedness has had a large part to play in getting this far, that and just being goddamn boring. There are no short cuts. Putting in the hard yards day in, day out, grinding it out and slowly building was what made the difference. ‘Treat rehab like training’: the most valuable advice I was given and which I was wise to follow and continue to follow. I might be back doing nearly everything I did before – but rehab remains central to staying the course.

Rehab is prehab

Beth following The Stronghold gym competition (note from Lizz: ‘not too shabby’ means she came FIRST!). Laura (left) kept her company on the podium. Photo credit: Dunleavy-Harris Photography

In some respects rehab from my operation is prehab for the crossing. It might be boring, but there is a reassuring comfort in boredom. And I’m not by myself.

Getting to the point of being able to put in a shift hasn’t been done in isolation. I’m not rowing the Atlantic by myself – I’m part of a team. A team that, ironically, I only became part of at the point of my surgery date being confirmed. Have my teammates at any time quietly doubted my ability to claw my way back to fitness after surgery? Quite possibly. Did they express those concerns to me? Never.

In those first few weeks after surgery, they didn’t just leave me to get my shit together by myself; they rallied and cajoled me out of every slump with humour, honesty, encouragement and patience. So much so that you could almost argue that having a hip replacement has been less of a setback and more an important milestone in our evolving as a team. Though for clarity, if major surgery needs to feature again as a team-building exercise please can I be exempt? I’d rather do group hugs and role play.