Sidelined. This wasn’t part of the plan.

My fall 2015 season was going okay, despite a nagging left glute/hamstring issue that was exacerbated by my “trick-or-treating” injury (unknowingly stepping hard off a slippery leaf-covered curb in the rain and dark). At the same time, my left calf/foot issue from the summer was coming back. It was hard to tell if the glute/hamstring and calf/foot were two problems or all one problem, with possible nerve entrapment. I was starting to get suspicious of my position on my time trial bike; hard bike efforts seemed to cause problems the following day. I was frustrated by all of this, but was going to physio and continuing to train, although in November Coach Mark and I decided to knock the effort down to easy on the bike and run, while increasing my swim to 3x/week, with lots of pull buoy use to rest my legs. Then, in December things got worse, which didn’t make sense, at first.

On Dec 4th my entire right arm from my shoulder/armpit to hand went numb in the middle of a continuous 1000m swim. I was so focused on my ongoing left leg pain that I assumed the two things were connected, trying to visualize some nerve pathway in the body that would connect left leg and right arm. In reality, I had no idea what was going on.

The arm numbness didn’t last long and I finished the workout, but I had some under arm and shoulder pain so I assumed I’d injured my right rotator cuff. I’d recently increased my swimming (given I was doing less on the bike and run) and I was working on a more aggressive hand entry in the water so it seemed to make sense that I’d done something to my shoulder. I admit that I also had thoughts of “over-training” syndrome and just general burn-out and I decided my body was trying to tell me something. So I cut back on swimming too. In fact, I stopped all my training for 1 week over Christmas. You can imagine I was a lot of fun to be around. Ha.

Here is where things got really confusing. During my 1 week of no exercise over Christmas, my shoulder got worse and I wasn’t even swimming! I started getting excruciating burning pain across my shoulders, back, and right arm plus bizarre pin pricks that truly felt like electrical shocks. Since my glute/hamstring seemed to be improving (rest + physio = recovery), I was now certain this new upper body pain was unrelated to the leg issues. At this point I stopped being upset about my limited training and started being scared for my overall health.

There is something I haven’t yet told you. I missed a HUGE factor in all of this. It is so big I’m embarrassed to say, but here it goes. On Nov 30th, I took a hard hit to the head in the pool when another swimmer switched directions without telling me [she started circle swimming when a third swimmer joined us, but I didn’t know this (!!!); I was swimming a hard 50m at the time]. It was a hard impact to my head. It hurt. I cried into my goggles, but, after a brief rest, I finished the workout and then jumped in the hot tub. I had a headache that day, but otherwise I felt okay. To be honest, it is difficult to remember [but not because I hit my head (!) just because life is busy]. When my arm went numb 4 days after the pool collision, I didn’t connect the dots. Let’s blame it on the busy end of the  semester, Christmas preparations, etc. I just didn’t see the connection. Since I thought I was fine, I continued to bike and run (easy efforts) and even swim for the next 2-3 weeks.

Two weeks after the pool collision, I had bad chest and shoulder/arm pain and, combined with my then ongoing calf pain, the after-hours doctor sent me to the ER to get checked for a pulmonary embolism. Scary. The appropriate tests were all fine, no blood clot. However, there was obvious wheezing in my chest (no stethoscope needed!). I didn’t even think to mention the hit to my head (I know, I know), but, in hindsight, the injury was starting to show itself. This is a fairly typical timeline for a whiplash-type injury.

As I mentioned, over the Christmas holidays things got much worse with the arm/shoulder/back/ burning pain that seemed indicative of a nerve problem. I saw my family doctor in early January and have had many tests since then. In fact, I’m sort of a regular at the Guelph General imaging department these days. I’ve had cervical spine x-rays (all normal; no fractures or breaks) and a shoulder ultrasound (also normal; no torn rotator cuff or tendonitis). I’ve had a lumber spine MRI (this goes back to the leg pain, which has now cleared up with lots of rest) and a cervical spine MRI and there is swelling and a hematoma around my cervical spine. There is no obvious nerve compression, no fractures, and no disc degeneration. Unfortunately, there was an unusual finding in my thoracic (mid-back) spine that may be related to the trauma or may be an incidental unrelated finding. Thus, MRI #3 was of my thoracic spine with contrast dye and it confirmed a fluid-filled cyst at T7-T8 but with no identified cause. The implications of this are not clear and I will see a neurosurgeon in May to learn more. In the meantime, I have a repeat cervical spine MRI in a couple of weeks to ensure that there is improvement in the swelling and hematoma caused by the injury.

I had a full physiotherapy assessment in early January, which confirmed that my brachial plexus is unhappy; there are a lot of irritated nerves in there, which is understandable given the trauma and inflammation in the area! I am on both anti-inflammatory and nerve pain medication and this is helping; I am sleeping better on most nights, which is vital to the recovery process. I’ve been going to physio 3x per week plus doing my home stretching and strengthening exercises and making good progress. You know how sometimes it is hard to fit this in? Not any more! I had muscle/nerve function testing done at the Toronto Rehab Institute and thankfully there is no permanent muscle or nerve damage related the cervical spine injury or related to my brachial plexus. So, with physiotherapy and time to recover, this injury should heal. The unknown is still the thoracic spine cyst, but I’m trying my best not to dwell on this until I know more in a few months.

So, there you have it. I am currently focusing on recovery and pain management. In early January, I couldn’t even walk for 10 min without unbearable pain and now I’m well over an hour of walking as fast as I possibly can without breaking into a run (running remains a big unknown right now) plus I’m up to an hour of easy/moderate effort cycling (using my mountain bike on the trainer provides the best posture at the moment). I’ve been back in the pool a bit (swimming entirely with a snorkel right now), but usually my hot tub time is longer than my actual swimming time, and last week I went back to pilates for some one-on-one sessions with my amazing instructor at Pilates in Guelph. If you add in my physio stretches and strength work, I’m getting back to some decent hours per week, but these sessions are far from training workouts; there is no intensity in anything right now. I haven’t seen my Garmin in weeks, I can’t remember my Trainer Road password, and the other day I laughed out loud when I felt an odd sensation on my skin and realized it was….sweat! Ha. Without a doubt, even with the pain, I have significantly better days when I’m active and it even helps me feel more like my old triathlete self to fit in a swim, bike or walk in a busy day (just not at 5 am; don’t be crazy, there has to be some perk to this rehab!). I am just very grateful to be moving. Baby steps.

Thanks to my friend Wendy for sending this my way!

None of this recovery process would be possible without daily support from my husband, Glenn, and our children who are putting up with my less than stellar mood on some days! Let’s be honest, an injured triathlete doesn’t make great company. Ha. I am also incredibly grateful for an amazing assortment of talented health care professionals: my physiotherapist at the University of Guelph Health and Performance Centre, my family doctor, the Toronto Rehab Institute, and my RMT.  I am also very thankful for family support from my brother (a neurologist) and my sister-in-law (a physiatrist) who have taken time to discuss all of this with me and who provide ongoing encouragement. Other colleagues with expertise in an assortment of areas have also been invaluable. My parents, family and friends deserve extra special mention  – thank you for being there for me in-person, by email, text, phone, for a walk or for brightening my day with flowers or coffee. I won’t name names as I’d hate to miss anyone, but I have some incredibly supportive and caring friends; you know who you are and I love you for all that you do.

A January weekend in Toronto with my best friend, Sara, was awesome medicine and a ton of fun! Thanks Glenn for this wonderful birthday gift!

I’ll be honest, I am VERY up and down with my feelings about this drastic lifestyle change that I didn’t ask for; replacing training with medical appointments and pain medications is hard to deal with, but I am trying my best to stay positive. I have good days and bad days, related to physical pain (apparently recovery isn’t a linear process, who knew?) or  emotional issues. I certainly didn’t ask for 2016 to be my Year of Recovery but that is the current outlook and I’m trying to come to terms with this change of plans. As I joked (trying hard) to Coach Mark on the day I had to quit my triathlon club, teamLPC, and his excellent coaching, “at least I’m 44 in the 40-44y age group; it isn’t a bad year to miss I suppose”. It isn’t easy though.

Thanks for reading and best wishes for health and happiness in 2016.

Swim safe!
Lindsay