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How I Work With Acute Injury (using my background as an orthopedic PT)


For those of you in Practical Strength at this time, you know I am currently in the midst of healing an easy ankle break.

(I use the word “easy” as it describes how clean the break was, and how little ligament damage- no surgery required, which is quite lucky.)


I have dealt with a multitude of orthopedic ailments, none requiring surgical intervention, and also an autoimmune disease (which requires long term medical management).


I have had questions from some of you with respect to how I look at and work with not feeling well and injury in general- and so I wanted to jot a couple of ideas down, in hopes they might be helpful. Please know, this is in no way meant to be in place of a session with a trained behavioral medicine specialist- it is just my own biases and opinions jotted down.


In my responses I will draw on both the frequent and short lasting orthopedic issues, as well as the longer lasting immune challenge for perspective.


1) Acknowledge that something has happened


It sounds silly, but I still struggle with this point. When I fell recently and heard a loud crack, I just sat on the grass for a minute, allowing myself to take in that something had indeed happened.

When I last fractured my ankle, I was 2 miles out on a trail. Many people I passed offered (well intentioned but) unhelpful comments: “take your shoe off to allow the swelling” etc.

I knew better. If I took that shoe off, no way I was ever getting it back on, and I had to get myself out. Something had happened.

Acknowledgement of our current status, is really key- it lends a guide to all other facets of self-care that follow your injury.


2) Seek medical intervention


Andy was getting ready for a day of mountain biking and was wearing his clip in shoes, walking his downhill bike down the stairs to the gondola when he stepped down, landed in an inverted position where he could see the bottom of his shoe.

He acknowledged something had happened, so thankfully he rested that day, but he drove his manual transmission car down the mountain, got back to the city, and got on with his life.

His ankle turned purple, as did his foot, and still he continued to go about his business until someone convinced him to go see his doc. Who confirmed he has a fracture and needed stabilization.

If you sustain a fall- please go see a doctor. Preferably an orthopedist if you have the option- if not an urgent care or ER will do initially.


3) Know, in advance, you are going to feel as though you fell off of a cliff- and that this feeling is temporary


Not so much physically, but certainly with respect to limitations.

Orthopedic injuries are unique in the experience of symptoms in that they HIGHLY restrict movement – especially for the first 6 weeks.


A bone break results in a cast. A ligament tear requires bracing and or surgery.

You are going to be severely modified in your activity- and it will be (fairly) short lived. It feels like you went from 100% on Monday, to being bed ridden on Tuesday.


Contrast this experience to someone living with a degenerative condition such as type II diabetes, or Parkinson’s disease. In these systemic conditions, you feel flares of your disease that affect your felt sense. But your overall day to day function feels fairly similar to yesterday’s.


4) Know that unlike chronic conditions, orthopedic issues are fairly short lived.


This does not mean that when you get your cast off, you will feel 100%. Or that you will ever feel exactly the same as you did prior to surgery. But most acute injuries heal really well when you treat yourself well during the first 6 weeks.


5) Have multiple goals