Unnoticed damage

The best thing that can come out of injury is knowledge, I’ve concluded.

I’m more knowledgeable about the construction of the spine, I’m more knowledgeable about the tendon structure in the foot, and I’ve become far more knowledgeable about pain.

My gauge of pain tops out at the pain I felt in 2009 after I pulled the muscles in the left intercostal space – the section between the lungs and the ribcage. I had difficulty sleeping that night, so the next night I slept sitting upright and I woke in the middle of the night. I don’t know why, whether it was my bladder, or just the fact that I was sleeping sitting up, but after I woke up, I went to move, and I felt the most godawful pain in my side.

I gasped from the pain, and the sharp intake of breath into my lungs pulled at precisely where it had hurt. It was a vicious circle. I stumbled into the bathroom, grabbing the plastic rubbish bin, certain I was going to be sick. I was in tears by now, and at some point I passed out from the pain. When I came to, the pain had subsided some and I got an icepack from the kitchen to try and numb my side.

So that is my ten, on the pain gauge.

Somewhere below ten is my pain threshold. For this exercise we’ll say it is at 3.4. Anything below 3.4 doesn’t really register as pain. If it’s small it doesn’t register, a little bit more and it’s discomfort, a bit more than that and it’s just a bit sore, but it still isn’t pain.

This means I can do something small, something minor, and it isn’t an issue. It’s a niggle. And I can dismiss it.

What I’ve learnt this time round about pain, is that you can do actual damage to something without realising. You bash on with your life, and something that you did a few days ago gently builds. Then it subsides, and the discomfort dissipates, and the whole time you carry on regardless, but underneath, you are carrying an injury.

One day my physio drew up a graph. A pair of X and Y axes, with days at the bottom and 0 through 10 along the left hand side. The black line indicates the pain threshold.


Looking at the graph above, we’ll pretend this is the pattern of an injury I’ve sustained over 31 days. On day 1 and 2, nothing. On day 3 I jagged something which registered as a one. On day 4, it’s built to a two – either from inflammation or because I didn’t stop wandering about on it. Days 5 through 7 it sat at three, being quite sore, but nothing particularly violent. Day 8 is where I screwed it up entirely, and it’s shot up to an eight.

You can see it step down all the way through to day 25, where I decided I was completely OK, healed, good to go and then 2 days later it spikes again, bumps up a bit further and then starts to drop back down past my pain threshold. Why did I think I was OK on a day where the problem body part just nagged as a one? Because after a while of being injured, you forget how it feels to not be injured.

With back injury number two, I rested, ran, rested, ran, rested and ran. My graph would read like a saw tooth. Fine, sore, fine, sore, fine, pain, sore, fine. I never let it rest long enough to heal, and it wasn’t until I was three months into my injury before I just stopped that constant continuous irritation and inflammation of the injury.

Now my injury appears to be coming good, I have that constant worry that it isn’t OK, that it’s going to be inflamed by my returning to running and eventually running long again. So I’m starting off slow, just picking and choosing my runs, the surface I’m running on and my distance to limit the chance of me inflaming something and setting off on another bout of physiotherapy. That’s also why I’m doing the pilates classes, and the rehabilitation work with Lauren.

I’m not putting any timeframe on fixing myself, because I worked out today that since February 2012 I’ve had at least 112 physiotherapy appointments, and feel like I’ve already spent far too often being broken.

One thought on “Unnoticed damage

  1. Pingback: Ice. No, not that one. | Not Travelling at Speed

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