søndag 31. mai 2015

Report from rehab - I

They tried to make me go to rehab but I said, 'No, no, no.' (Amy Winehouse)

Last week I wrote about the five phases of rehab I have been experiencing since April 22: relief, acceptance, resignation, change, and determination. I think it is even more important to name the phase before the rehabilitation finally starts: denial. For a long while one experiences pain and discomfort which actually gets worse and worse, but still one chooses to ignore the signs and believe that there are ways to run which will make the whole thing go away. You can easily see this in some of my earlier posts, when I truly (and with a lot of hope) believed that there was nothing wrong with me, I just needed to run uphills and terrain for a while. Well, in the end everything became so painful that it was simply not fun to run anymore in any way. Still I kept doing it until as late as April 18, looking perfectly happy:
It turns out that the denial phase is extremely common, perhaps most among new beginners, but also among surprisingly many experienced and even professional runners. Just look at the story of Tom Goom, who is an experienced runner and racer, as well as a physiotherapist! He ended up with exactly the same injury as myself, going through exactly the same stage of denial before he had to accept the situation and start rehab. We run as long as we can even as the pain increases, until we simply cannot anymore. If we could stop a little earlier, perhaps the recovery would be quicker as well. What is for sure it that giving advice to others is so much easier than following that advice ourselves. Tom Goom had seen hundreds of patients doing the same mistake, and had given them advice and guidance which he did not manage to follow himself. What I know from my own experience is that we are not willing to take advice that comes lightly or appears to be not thoroughly enough thought through.  Of course I received the advice of taking a few weeks off running and resting more many many times, but I did not trust it because I did not have the impression that people who gave the advice had complete understanding of my situation. There were two people whose very clear advice finally made me see the realities, agree to stop running and to go into a complete rehab program. My running friend Eva, and my current physiotherapist Ane.  Their advice was the same: you must stop running. In every possible way. For as long as it takes to fully recover.

So why did I take their advice and not others'? First of all the two advices coincided in time and I was in more pain than ever. Secondly and more importantly they both showed a great deal of real empathy and true compassion. Just after my first consultation with Ane, I got a long message from Eva, where she explained how she had been observing me over time, how she could see how much pain I was in, how she has experienced similar things, how she actually feels very uncomfortable to give this advice because I might take it the wrong way, but how she must say it because she really cares. I cannot describe how much I appreciated this advice. I had got the similar advice (well, rather instructions) from Ane the day before, and it was great relief to get a confirmation from Eva, as well as having somebody who understands and cares, at the time when I was feeling the most depressed about the whole situation. When it comes to Ane, she was much more strict and clear in her instructions than any other therapist had ever been to, but more importantly she understrood exactly how I felt. She forbade me to run, but she also explained to me that she knows that I will feel very sad about this, that it can even be compared to a depression, because running has become a part of my identity, an ingredient of what defines me. No therapist ever had understood me to this extent. She also did several things that she did not have to, like posting a letter to my doctor herself (rather than leaving it to her secretary) to speed up the start of the process, and to send me motivation and encouragement through text messages. This kind of understanding and care (especially outside of scheduled visits and office hours) from a therapist is really rare I think. It builds trust, which gives courage and motivation to continue the rehab and not fall into the temptation of starting to run as soon as the pain feels a bit better.

What also really helped me through the difficult time was the care and compassion that I received from friends. For example, when we were in Oslo for the Holmenkollstafetten, the day after the race, my friend Tone went running very early in the morning before breakfast (although it had been a very late night), so that she could keep me company when all the others went for the scheduled running practice after breakfast, which she knew I would not be able to join. I cannot describe how much this meant to me. Tone has been supportive in many ways during this period; she has a similar story with a hamstring injury, and I have learned a lot from her experiences. Her caring but direct way of telling me what she thinks is extremely helpful, and I appreciated a lot when she (and in fact her whole family) kept me company when I had to cut short of a long hike with friends last week. 
As you know, I am now in the determination phase, and things are in fact going much better. After the four weeks of complete rest for the legs, I started the heavy slow resistance (HSR) training and got back to uphill fast walking. I have, already after two weeks of HSR, noticed a significant improvement of the situation and I am in much less pain than in a long long while. I am also surprisingly fast up Stoltzekleiven and Ulriken after such a long break, so my spirit for the time is really high and I am feeling better and more optimistic than in several months.

Yes, I've been black but when I come back you'll know, know, know. (Amy Winehouse)

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