Anatomy of Injury

Twelve weeks past my shoulder dislocation and I am numbing to the routine.

There are infinite variables to an injury, but most of us share the same anatomy; and I don’t just mean physically.  I’ve been an athlete my entire life, but I can’t remember a time when I injured myself like this. Past injuries have always been more of a chronic, nebulous matter. This is the first time facing the shock of  being in the game one day and out the next. This injury reaches beyond my physical body and permeates my mind and spirit. Suddenly my anatomy takes on a whole new meaning.

In the beginning there is trauma

Because my injury happened while I was upside down, in my kayak, in the middle of a rapid, I was not aware of pain. I was actually not even aware that it had happened. In those few seconds the only thing my brain wanted to do was right itself to breathe and safely reach the eddy at the bottom. Not unlike watching a toddler skin their knee and cry only when the blood rises to the opened skin, I too couldn’t feel that something was wrong until I reached the eddy.

Next comes pain

It was a struggle to steady my kayak in the turbulent tight eddy. My left arm felt weak and pain was shooting through my shoulder as I moved my paddle. I lifted my blade up and the pressure of the water caught it. A definitive THUNK! sound came from my left shoulder and I felt the head of the humerus make a dramatic move back into the joint. It was instantly hot with pain but felt right again. I knew the joint had reduced itself from a dislocation, but then I felt completely unable to use my left arm.

The euphoria of adrenaline

I was helped out of the water and upon inspection of my drysuit found that my shoulder had dislocated from a direct impact with a rock which had left an abrasion hole in my suit. I thought it was funny. Funny? Why would that be funny? Because my wonderful body was sending me mass doses of chemical coping mechanisms. Adrenaline. I thought the entire 45 minute drive home was funny- haha- this was just a blip that I would recover from next week. My brain was in outer space and nothing anyone said really mattered. Doctors in the ER said there was nothing on the x-ray, gave me some painkillers and my high continued.

The morning after

The day after my injury, reality set in. More pain set in. I realized how hard it was to even get dressed. I realized that the kayaking trip I’d been planning for the past three years was going to have to be cancelled because there was no way I could paddle big water two months out from this injury. I realized that it wasn’t just kayaking I couldn’t do, it was also climbing, swimming, surfing, carrying a backpack and bicycling. I packed up my car to leave Coloma and on the drive back to Santa Cruz I felt myself begin to sink. I thought I would never stop sinking. How could I keep sinking so low without dragging my ass on the highway.

Dreaded doctors

For some people, it’s a relief to go to the doctor. I’m so glad that they feel that way. A lot of it has to do with insurance, and while I have it, it is slow and restrictive. After being healthy for a few years in a row and never needing to see my doctor I discovered that I had been dropped from her care and was now considered a new patient. (I guess you’re supposed to pretend to be sick and go at least once a year.) There is not one single doctor in Santa Cruz in the major medical organizations who is taking new patients. Thank you Planned Parenthood! Our clinic does not have a doctor, but the good PA’s there got the ball rolling on referrals. Still not fun, not as informative, not exhaustive, but at least I received some sort of professional opinion.

Contrary to western thought, medical care starts from within. Had I not spoken out and advocated for myself, I would just be sitting in a sling for the next six months. It was up to me to push for a thorough examination and interpret what the tests really meant for me and translate the importance of my full recovery to my health care providers.

As my friend Lisa recently learned- an MRI is not a tell-all image. What doctors thought they saw in her shoulders wasn’t at all what they found when they went in for surgery. In her case the surgery was still a good and necessary step forward. But this case is impetus for getting as many opinions as possible.

Depression

You don’t have to be a professional athlete to experience a major life change with your injury. The loss of ability to use the physical outlet you’ve grown reliant on can be devastating. What started as unhappiness turned to anger, then to withdrawal, and morphed into apathy and got all wrapped around depression. My whole life I have identified as an athlete and centered all of my activities around it, so to have about 80% of that taken away is devastating. While I still have full use of the rest of my body (thank goodness!) I threw myself at all the stationary exercise machines in the climbing gym. Some days this is good some it is not. I watch in frustration as my arm muscles waste away. Therapists help some, but I have yet to find a good one for myself. The thing that keep me going is truly listening to all of my friends when they say, “you’ve got this.” Many of them have made it through the same thing and worse.

Getting help vs accepting help

Everyone wants to offer their opinion on how to heal yourself and they all start by sharing their own experience. It’s a kind gesture that I do too, but it also overwhelmed me. Doctors started telling me conflicting things. My own recovery didn’t seem to be keeping up with the progress of someone else. At some point you have to take a hard listen at what your body is telling you. People throw around this term ‘body intelligence’ which is true, our bodies have an innate way of knowing how to fix some things. The problem is, it gets lost in translation.

Healing is so individual and most of us are not intimate enough with our own body to really understand the subtle cues it sends us. If I did, I know that I wouldn’t have injured myself. I would have listened to myself that morning and how disoriented, nervous and rushed I felt.

I won’t get to see a physical therapist until 3 months after my accident (again due to insurance), but I have found plenty of starter tips on healing from friends and the internet. You would think I would be jumping on the recovery wagon, but lingering depression keeps me battling thoughts of just walking away from my former life and changing directions entirely. This part of the injury still poses mysteries to me and it probably does for everyone.

The long and winding road to recovery

I have goals to get back to where I was athletically, but I gave up having expectations of when that will happen. While I’m far from recovered I did experience a minor watershed moment when I realized my shoulder wasn’t constantly aching. That’s when I started pushing more movement and actually visualizing getting back to my normal activities. It’s not that all the rest of the pain, disappointment, depression and anxiety just fell away. They still creep in around all the edges. I don’t know if I’ll ever get back the incredible range of motion that my hyper-mobile joints have afforded me thus far and the amazing things I used to do with my arms. But I can finally see a path. Or at least I tell myself its underfoot with every blind step that I take.

A new normal

Whatever state my shoulder returns to is what I’ve got to deal with. Injuries can take years to fully recover and recognizing that I’m in it for the long haul is an accomplishment in itself. I don’t acknowledge it all the time. I wish I could say there’s a happy ending here, but I’m not there yet. For some friends, they have paddled their most challenging whitewater or climbed to new levels post-injury. Erin B. In the recovery of her splintered wrist, David M. After the dislocating his shoulder, Chris L. After having his hand smashed to pulp – all of them carried on to get right back and beyond where they had been after recovering. So there is inspiration out there. I’m sure years from now this will just be a fuzzy blip for me. But for now, I’m still dissecting the structure of this, trying to make sure all parts are accounted for.