Pushing Through..and Finding that "Extra Gear"

As you all know, I broke my clavicle just over 4 weeks ago (to be exact: 4 weeks and 3 days), and I was doing my best to continue training through all of it. At points it did hurt a fair amount - and when it did I listened to my Doc's instructions of "Do not do anything that causes pain". So whatever actually hurt, I had to hold off on. Luckily, this was really only walking fast, running, and things that required range of motion (ie: reaching bike handlebars was way out of the question). Basically my biggest issue was sleeping and keeping comfortable throughout the day; putting on clothes and showering were more like a challenging game than a problem...and keeping a lot of tasks as independent as possible probably was my own form of early recovery PT. I quickly learned how far I could reach and what rate it was progressing at and also what I could carry in that arm and what I would be able to hold without pain in a week's time.

The one thing I did not let up on, was keeping myself active...even if it meant I could only withstand 25-30 minutes of high discomfort while on the trainer. Sometimes it isn't what you do, it's why you're doing it. I kept going because that's just a part of me and I've never let anything get in the way of what I enjoy on the most fundamental of levels. That is not to say nothing is more important (clearly, that is a different story), but usually a half hour is viable regardless of situation.

So I kept it up. And I progressed pretty damn quickly compared to what I expected - and what I had heard from a lot of other people. I was on the exercise bike the day after I crashed (and couldn't walk faster than 25:00min/mi without pain), I awkwardly jogged 0.5 miles for the first time 15 days after the crash, did my first bike workout on day 16, and ran just 23 days after the break. Today I did a brick and it was my third run of the week...my arm swing is even coming back!

What surprised even me (I usually have pretty lofty goals of recovering from injury and returning to good form) was a workout yesterday. A few of us at Maine Running had a Time Trial race on the CompuTrainers, it was a 19.7mi moderately hilly course with a noticeable net elevation gain overall. I knew I was going up against Ryan and Adam, but figured out once I got there that Doug Welling would be participating...so instantly I thought I was going to be absolutely destroyed in this race. It was all out of good fun, so I welcomed the challenge and I will be the last one to ever not want someone to push me to a new level. I had a pretty solid cold and little use of holding onto the handlebars, so it was going to be difficult no matter how I cut it (unless I dogged it, but that option is deemed erroneous before even being contemplated). I figured I should at least go out with hitting my date FTP, and then go from there. (For those of you who don't use power...FTP is functional threshold power: a wattage that was estimated from a workout a couple months back, and is the expected power output I can sustain for an all out 45-60 minute effort). I had never done a 1 hour TT and was both excited for it as a whole and a bit nervous for how the last 15 minutes would feel.

We took off riding pretty solidly, and about 15 minutes in my Avg Power was in the low-mid 290's...elevating a bit on climbs, dropping a bit on descents. I had developed a good lead, but Doug had been holding in the mid-280W range (despite having done a murderous bike workout the day before) and I knew he wasn't going anywhere. I hit the last good descent to the lowest elevation and was averaging 23.6MPH, but knew that a lot of climbing was ahead. I tried to hold above 23.0MPH. That quickly was out the window. Then, like I should have been doing all along,  I turned my complete focus to my power - even effort yields the best result. Sadly, as I suspected, it started to burn pretty bad with 15 minutes remaining. With about 3.5 miles (mostly climbing) to go, Doug tells me to go for 300W...this means I would have to average somewhere over 320W, something that was unmanageable for much time no-handed. So I sucked it up and held the bars, with surprisingly no pain and some moderate (but bearable) discomfort. I kept pushing with all I could, and the 295W jumped to 296W...and was miserably slowly working it's way up. With just over a mile left it was at 299W, so I started giving it my last surge. It hit 300W with about .3 miles to go, and with .2 left I started pushing all out and sprinted with .1 left. Only issue...in my effort I think I became slightly delirious and though the finish was at 19.3 miles. I literally had just blown all of my reserve and had just went far beyond my red line...and I had .4 miles to go. I forgot about everything else and just gave every last bit I had to keep that power over 300W. It dipped into the 280's and 260's a couple times, and I got to the point where I actually was putting out less power when I tried to stand up. I was about to pop. Finally I crossed the line (and thank goodness we were on trainers or I may legitimately have fallen over before I stopped) and stopped pedaling. My legs were shaking more than I could ever recall.

I ended up averaging 301W for almost 55 minutes, well above my expected value of 291W. I was very surprised to see this after a lackluster few weeks of training. One thing stands, I would have been nowhere near this level had I just taken time off...looks like I saved myself a month or two by training through for a few weeks.

That TT was pure joy. I had never before given my all for a final effort, then somehow dug deeper and continued pushing. For the first time in all my athletic experiences, I have proof that there is always just a little more to give...I guess the thing is you have to bypass logic (or trick yourself) to find that it's there.

The picture below is the results for the race: I'm rider #2 AKA Dexter.

Collarbone: On the Mend (And On the Run!)

All has been going well, aside from a couple rough nights of sleep. After meeting with my Orthopedic Surgeon a couple weeks back we finally decided on what approach, healing or surgery, would be best. This conclusion came about for a variety of reasons, which I will summarize as best as I can:

*Very Important Note: This is my individual experience and is simply to give a little insight to my injury. Every single case is different, so this is my experience and really only applies to individuals who have a 50/50 shot at no surgery vs. surgery. Many cases are either definite surgery (shatter) or definite natural heal (fracture but little or no displacement). Mine was a fracture with enough displacement to make surgery a possibility, but not enough to require it. If you ever think something different from your surgeon TALK IT OUT, they are professionals for a reason. If it still doesn't seem right/smart to you then get a second opinion, being too sure cannot hurt especially when it is your body.

On to my experience:

I really wanted surgery. Four and 5 nights after the break I was miserable. I don't like medication or painkillers (tylenol/advil I'm okay with but I will take as little as absolutely possible). I couldn't sleep, was uncomfortable to a pretty maximal level (I have a pretty good tolerance with discomfort), and generally not loving this whole process. The 6th night I took Tylenol PM and I have never taken a sleep aid in my entire life, so I passed out for 12 hours and when I woke up I felt amazing, but my shoulder was another story - the Tylenol PM made me sleep through shifts and I didn't wake up when it hurt...so it hurt for three hours after I woke up. From there on out things got a lot better.

Natural Heal:
Pros:

• No surgery, anesthesia, or hardware (this is pretty huge, noting the inherent risks of going under and having hardware interfacing)
• Ability to resume activity is based almost solely on if it feels comfortable (aside from arm impact things like skiing and pumping the iron)
• Being able to say my body doesn't need metal to be complete

Cons:

• There is a small (10% or less) chance of non-union, which would require surgery at 6-8 weeks through healing...and then 6-8 weeks additional recovery from that
• You don't know when you'll be able to resume activities
• Some additional discomfort in very early healing stages (note: breaking bones is not supposed to be comfortable...you destroyed a naturally functioning part of your body, so don't expect it to feel 'only a little bit bad')
• Not being able to call yourself a "bionic man" (or woman)

Surgery:

Pros:

• Knowing an exact timeline and specifics of when activities are permitted
• Guaranteed recovery by a (very well) estimated date
• More comfort in early recovery

Cons:

• Surgery (cutting stuff open - infection; anesthesia - inherent risks; and foreign, albeit bio-compatible, objects in your body)
• Metal + bone usually leads to some magnitude of a thing called stress shielding, and removing the hardware can lead to problems - a portion of what I have come across has been leaving the metal in typically works out fine and taking it out can be problematic
• Even if it feels 'good' or 'comfortable' your surgeon dictates what you do, and you have no say to push things sooner

So, both have a very good side and another side that isn't that bad. What did I decide to go with? I was initially pretty convinced I wanted surgery, but I talked it out pretty seriously with my surgeon - I spoke with him a couple days after my first appointment on that Friday, and then again at the next appointment on Tuesday, which was to check in to see how the first (miserable) weekend was. At the appointment 1 week out from the break we decided to continue this approach, switch to the figure of 8 brace to place my shoulders in a better healing position and then take x-rays a week from that day (2 weeks out from the fracture). At the 2 week appointment, the bone appeared to be in the same or, if not, better position. And it seems as though the bone has started to regrow. I had been able to sleep better and got better acclimated to the figure of 8 brace.

How are things at week 3? They are going well and, as expected, I have bouts of moderate discomfort, but that is usually from being out and standing up/moving around for hours or getting a real good workout in (read: self-induced discomfort!). Aside from that, I'm doing more than I probably should...but if I hit a decent level of discomfort or any real pain, I back it off immediately. If this continues I call it off and rest my shoulder. I have been steadily cycling on the trainer (no hands thus far) and had been strictly walking until a little under a week ago. I ran Wednesday (1mile WU, 3x0.5mile, with 0.5mile walk for rest). I have run nearly every other day since then. Luckily I have a pretty smooth stride, otherwise the bouncing would be pretty painful. At jogging paces (10:00/mi) it was too bouncy to be worth running, at 8:00-9:00/mi it was better, but not optimally smooth. I was reminded extremely quickly that running faster = smoother, and played around with pace enough that 6:45/mi feels pretty much optimal as much faster and (with my complete lack of running training) it would require a legitimate arm swing.

I'm definitely looking forward to being close to cycling outside, which is probably 1 week. The real big thing is that I am running 23 miles on my 23rd birthday (January 26th). Without having done an actual run yet, I am 7 weeks out from the run and haven't run more than 10 miles in a week since the first week or August. I haven't run more than 5 miles in back to back weeks since my front wheel broke and I wasn't able to bike.......in June. I have written my training plan to get to the 23 miles, which sets my first actual run for Saturday: 4 miles. The next Saturday is 10 miles, and it just builds from there.

Thus far I'm glad I am going with the natural heal, and will continue to be quite happy as long as everything is clear in 3-5 weeks (which will be a total of 6-8 weeks from the break, the normal expected "full heal" time frame). As always, if you get any injury (especially traumatic injuries) go see a specialist and listen to him or her...you will not regret it.