My Journey Back to Work Following 12 Spinal Fractures (Part 1)
Late August 2020 I sustained multiple spinal injuries and a knee injury falling from my horse in a training exercise. It was just one of those unfortunate accidents and no one was at fault. If you participate in a high risk sport it is accepted that at some point you are going to come a cropper! I did think 12 fractures of the spine was a bit excessive though!
As much as I thought I was unlucky, I was actually very lucky. My spinal cord was not affected and 10 of the 12 fractures were in "not so important" parts of the spine. As a physiotherapist, this has given me a new prospective on back pain and the rehabilitation of fractures. I have over 15 years of physio experience and knowledge behind me but to fully experience the range of effects that come with being seriously injured takes my understanding to a whole new level. I am not a patient person, especially when it comes to myself, so learning to give myself time to recover has been the hardest challenge. I have had to heed my own advice and think "what would would I say to a client?". From the outside I have made a very quick recovery, to me it feels like an age! I was back at work at 6 1/2 weeks..... so how did I do it?
Firstly, each case is different. It is tempting to compare one injury in one person to another injury in another person. There are so many variables, too many to list! but here are some key differences; age, pre-injury fitness, the site of the injury, the structure injured and other health conditions. Then there are things that we can try and employ from others like healthy food choices, good sleep patterns, good pain management and a positive/determined mindset.
Due to my profession and sporting history I have a good awareness of my body and more importantly my core. I was 'asking' my core to work almost 36 hours after the accident. I was patient with it and was careful not to contract too hard and kept it within a pain free effort - so led on my back. To find out more about the core see earlier blog posts here. When you have had an accident and are in pain the body will inhibit some muscles from working correctly, so it is important to establish a good pain management regime so that you can gently begin to re utilize the important stabilizing muscles. Also, good pain management allows you to just generally move which is vital for our general health (circulation, joint stiffness, respiratory system, digestive system and mental health) and self care.
At 4 weeks post injury I used a highly experienced rehabilitation specialist and good friend, Peter Faulkner (Founder of FK PRO and FITS Nailsea) to aid me in re-installing good movement patterns. When we are in pain or injured our bodies compensate (use other muscles over the usual ones, load weight to one side to avoid using the injured side) in order to get you from A to B by any means. This can lead to not recovering from the injury, new injuries/pain or both! The FK PRO system enabled me to perform functional movements whilst being supported, hence achieving a better range - this was good for the joint mobility and allowing the soft tissue to stretch without overloading the injury sites. Peter was very good at making sure I did not push myself at this point, it had to be pain free.
As the weeks went on I began to reduce the painkillers for a couple of reasons; 1) I did not become dependent on them, 2) So I knew when I was overdoing it. Although I started off by saying that pain killers are important, there is a fine balance. Using my knowledge of fracture healing times I was able to calculate when it was appropriate to load the bones more and reduce the painkillers. Don't get me wrong, I had to reinstate some painkillers due to me not being ready to reduce them and finding myself led up in bed in a lot of pain!
I started back to work only seeing a couple of clients a day at about 2 1/2 months post injury. I had to. I'm self employed. This was HARD! There were days when I had to immedeately lie down due to the pain in my upper back (Thoracic). I would come home and lie on my electric heat pad every day. I was just on paracetamol at this point and only taking it as I needed. This is where a local swimming pool would have been so valuable. Hydrotherapy is one of my favourite physiotherapy treatments and if I had the money (lottery win!), I would have a clinic with a hydro pool. I continued to see clients on 'light duties' and things gradually got easier, especially with my strength progressions with Peter at FITS Nailsea.
As I started to get more active and get back to caring for the horses, I noticed that my left knee was unstable. It kept giving way backwards and I had reduced range (how much I could straighten and bend). I had noticed that the knee felt wobbily when I first started walking in the hospital, but it was thought to be the effect of the back injury. There were no qualified individuals to test the knee for me before I was promtly discharged and at the time I did not have anyone to call upon to come and test the knee for me..... not even the spinal consultant on my follow up appointment would test it! So I had to book to see a knee specialist privately and sort myself an MRI. This was all about December time 2020 so the NHS was still very under strain, hence having to go private. On receiving my MRI scan images I could see that my ACL (Anterior Cruciate Ligament) was torn, but I was not sure by how much. After seeing Mr Robinson (The Knee Specialists) it was decided that the ACL was partially torn and that I would allow it time to heal and rehabilitate. Should I not come right then I will have to consider surgery........
The story continues with Part 2