So here we are 10 weeks post op with Dan Atherton – and I think it’s fair to say we’ve had a ‘reasonably’ successful rehab phase! It hasn’t been easy, no injury is easy to deal with and the work that Athy has had to put in has been considerable. He had some significant tears which needed repairing – however it is extremely satisfying as a performance team to have such a positive outcome so far.
It’s worth underlining though some key points as to how we got to this point;
- Telling Athy to put his bike down and immediately fly home for assessment as soon as it was apparent there was a problem
- Prompt diagnosis with clear options on how to move forward from Doug Jones and myself
- Once the decision had been made for surgical intervention, this was carried out within 48 hours
- Surgery was carried out by a top sports surgeon – Mike Walton
- Rehab Started within days of the operation with Doug and myself
- Dan was in excellent physical condition pre-op and was training hard in the gym up to the day before his operation
- A civilian may be in a sling for up to 3-4 weeks, we were easing Dan off the sling after the first week
- Rehab sessions were progressive, aggressive – but under the strictest of control
- The whole programme was built around what Dan ‘could’ do, not what he ‘couldn’t’ do
- Everyone being aligned to the same goal – Return to Sport
- We are roughly 6 to 8 weeks ahead of what you’d expect to see in a civilian recovering from the same operation
- Athy was 100% committed to the process and trusted the team in place implicitly to get him back
Athy training with pro skateboarder Korahn Gayle the day before his op
Team fitness coach Alan Milway has worked alongside me every step of the way with Athy. This meant I was able to simply provide over-arching goals while Alan filled in the detailed sessions. I was able to sign Athy off for the types of movements and work he could do, Alan running with that in the detail. Having a great S&C coach like Alan delivering the weekly sessions with Athy was integral to his fast recovery.
Team fitness coach Alan Milway pushes Athy through the next phase rehab – Return To Sport
Dan had done all the hard yards with therabands, low resistance work and pool work – so returning to some strength work and high intensity was a welcome change in the programme. Pushing things as we do, you have to be careful that you’re not creating compensations elsewhere. His left shoulder constantly wants to ‘hitch up’, which if left unchecked turns into neck, back and even more shoulder issues – he’s had enough neck problems in his career! Whenever you work at the margins of your ability, technique and form slip, this is even more important to watch for in this rehabilitation phase. If you allow technique and form slip too much, you’ll be creating problems elsewhere.
Trunk strength is vital for all athletes – you can’t fire canons from a canoe!
It’s easy for the athlete to think they’re a lot further on than they actually are – so unilateral work is vital to ensure both sides are working as they should. With such a significant trauma to the shoulder not only from the dislocations but the operation itself, proprioception work is also vital to the recovery process. Proprioception refers to how well you are aware of where your body is. When you walk upstairs you don’t need to look at your feet to know where they are, you have a ‘sense’ of where your feet are in relation to the stairs. The more highly trained you are, the more developed sense of body awareness you tend to have, however injury can massively affect this – so it’s not just about fitness or strength. Training your body to ‘learn’ where a particular bodypart or parts are without looking at them is integral to not only rehabilitation but any training. In Athy’s case, if his brain isn’t 100% sure where his shoulder is when it’s being moved around by his arm when riding a bike – this causes the muscles to either overwork or not react as they should. Either way, this can lead to further injury and problems.
Proprioception work, on both shoulders
Each injury is unique, and individual to that athlete. Athy could injure his right shoulder in exactly the same way and we could follow a very different treatment path and outcome. As I keep mentioning, this massively accelerated recovery process was under the strictest of supervision with a professional athlete who knows their own capabilities. Right now Athy is at the transition phase of being returned to sport/competition. At this point a footballer or rugby player would be looking at some time in a reserve game before playing a full reserve game. Then onto some time in a first team game before playing a full game. With action sports athletes we don’t have that facility, but we can choose certain races and events for them to test themselves out on, if available. The danger is they want to win, they only know how to go flat out – so managing their expectations and enforcing it as part of the rehab process is always difficult!
It’s obviously great to see Dan back on a bike, it’s required a huge amount of hard work and attention to detail. We’re also not finished yet, this process is not over until Dan crosses the finish line with his left shoulder intact – a race will be the ultimate test.
Below is a some amazing GoPro footage of him doing a ‘warm up’ run on his DH bike on the infamous quarry line…
Athy drops in for a ‘warm up run’ 10 weeks post op
In the final part of this story – Dan returns to racing…..
Jonathan Rea post femoral pin insertion
I’ve covered injuries before, a decent piece on ‘what to do if’. Full of lots of sensible and meaningful advice, as you’d expect coming from me. I wanted this to be more personal though, more from the heart – which I do have (a heart that is) although the athletes may think differently.
Taylor Vernon hitting the deck hard, he rode away from this eventually
If you compete in extreme sports professionally you will become injured as sure as the sun will rise in the morning. These can be a series of mishaps which disrupt the smooth flow of the season, competing and training ‘hurt’ soon becomes a fact of life for any professional. However you may be unlucky and have a ‘big one’, the season ender and maybe career threatener. It can happen and it does happen. There’s nothing worse as a coach than to hear one of your athletes is seriously injured. It’s a mixed bag of normal emotions that immediately starts to conflict with the ‘coach’ side of your brain as you start running through an immediate ‘to do’ list to get the athlete back.
Has to be easier ways to get a ride on a private jet that doesn’t involved smashing your leg
You feel bad for the athlete, personally and professionally – maybe they’re in a foreign country trying to decipher what’s being told to them in another language or a hospital that looks more like a butchers shop than a place for delicate career saving surgery. They’re scared, and you know they are, but you have to keep your coach head on and start being the problem solver – the island of dependability in a sea of uncertainty. Where are they, what have they done, what’s been done about it, how do we get them back to UK? The list charges through your mind like the proverbial bull in a china shop. It’s great for the athlete to receive all the ‘get well’ messages and flood of ‘healing vibes’ via social media – it does help. However when everyone else moves onto the next race the real battle begins, as its no longer about internet based ‘healing vibes’ but facing the reality of recovery, physiotherapy and the long road to get back racing.
Watch this video for one of Gee Atherton’s bigger crashes…
The three over-arching goals going through my mind are:
- Return to function
- Return to fitness
- Return to racing
As soon as is physically possible this over-arching plan and what it might look like is immediately discussed with the athlete – no matter how serious the injury. It may seem to the athlete that they are a million miles away from racing when they’re prone on a hospital bed. However talking about how we’re going to get back racing and the steps involved isn’t just blowing smoke up the injured athlete’s arse, it’s a genuine part of breaking down a lengthy process into manageable chunks. It’s not a marathon, its 26 x 1 mile efforts. You can have the best surgeon in the world work on an athlete, but if the plan to get them back is anything but clear, concise, specific and well executed – the surgery may as well have been DIY.
I’ve been through some tough injuries with athletes, and it never gets easier emotionally – you ride the rollercoaster with them albeit yours is internal as you project nothing but ‘matter-of-fact-optimism’. Watching them return to a start line from injury is like winning the world champs for me – that’s a selfish statement as it’s not meant to be about me, coaching is about the athlete. You don’t work in this job for the plaudits as there are none and it’s largely thankless – however the struggle against adversity and the will to come back and win is where the real work is done with an athlete and future champions made.
I’m often asked what training an athlete should and shouldn’t do. Which exercises are best for certain sports or to help improve performance. The thing is, I’m not sure what ‘performance’ means anymore, ironic as I’m supposed to be a high performance manager. A fitness or S&C coach (not sure what the difference is there either) will try and ‘improve’ performance by manipulating adaptations to muscles and energy systems. We make the athlete fitter and stronger through constructing pretty undulating periodised training plans with micro and macro cycles, all coloured coded and everything. By getting the athlete to follow these plans, they follow the undulating wave upwards – riding the supercompensations. As coaches we sit back and marvel at our work as the athlete gets fitter and stronger which is making them a ‘better’ athlete, it’s improving their ‘performance’ isn’t it? Maybe not.
Metaphorically we train athletes today based on information we found out last week, when we really need to be preparing them for tomorrow. Preparing athletes for competition, to ‘perform’ in front of a crowd – with everything and anything ‘riding’ on the performance isn’t something that is achieved through simply increasing 3 rep max on deadlift. An SRM crank isn’t going to help with the split second instinctual reaction an athlete can make at a given moment which may decide whether they’re world champion or not. I’m not talking about sports psychology, or NLP – but a rounded approach which acknowledges the ‘performance’ in the performance, in a theatrical sense.
It’s not just about ‘positive self talk’ from a psychological view, or how effectively the muscles can produce and maintain strength, power and endurance, how efficiently the cardio vascular system can transport oxygen to the muscles. It’s putting on a show, rising to the occasion, literally ‘performing’ in front of a crowd with very real consequences to both failure and success, which are also public. When does an athlete stop being a collection of data points, key performance indicators and energy systems to be manipulated and become a person? If coaching is as much an art as it is a science can’t the same be said for athletes? We see artists as creative people, creating something from nothing. Isn’t this what athletes do? Aren’t they creative? Isn’t that creativity and emotional expression key to their performance?
I was at the NIke Performance Summit recently, and humbled to be invited to it again. A question was posed. In percentage terms, how much is that ‘moment’ that deciding moment when a game turns, a decision by an athlete which turns events – is down to the mental x factor, creativity whatever you want to call it?’. 150 of the world’s top practitioners generally agreed it was 60%+. Now that’s an arbitrary number, but the point is we all agreed it was a significant portion of the deciding factor in a competitive environment, in front of a crowd – but does that play a significant part of our preparation? No.
There’s a lot more to high performance than physiological and psychological measures. What can be learned from other people that have to perform at a high level, such as special forces? They don’t know what they’re going to do, or where, with life threatening consequences but still manage. In sport we know when the races are, how long they are and who else is going to be there – in fact there isn’t anything we don’t know about the challenge the athlete will face (apart from possibly weather), so what’s the problem?
Are we making it too complicated for ourselves? Possibly, but the next frontier in athlete performance is not exponentially more complicated ways to gather data to manipulate muscles. The next frontier is in creativity, artistry – exploring and understanding the art of performance. So the key message, is get yourself signed up to your local amateur dramatics society and watch your race times fall!
Building the elite mindset, Tay putting in the hard yards in rehab.
It’s been a busy few weeks for me and the performance team, not just with Tay – we’ve had a few bad injuries to deal with recently, not least of which Jonathan Rea badly breaking his femur. With Tay we’ve all been working hard to get him back as soon as possible, especially Taylor himself. It’s not a cavalier programme of pushing things too far, but we are always on the very edge of what’s possible. Tay has been splitting his time between home in Wales and with me up in Manchester and the specialist team. Team fitness coach Alan Milway has also been down to see Tay in Wales and go through the rehab sessions with him, so the poor lad has been getting it from all sides. It’s not easy for Tay, he was just 4 weeks post fracture when we started taking him in the gym so we were being conservative – for us. I’ve written many many times before how hard this is for professional athletes to take things so steady. One minute you’re operating at the maximum of your ability and the next minute you feel like you’re working at the minimum of what you’re capable of. Athletes only know how to go full gas, not cruise in neutral.
Re-assessment with Doug – it’s a great working relationship and Tay knows we’re all geared to getting him back racing
It might not be something a normal process would tell Taylor at this early stage, but riding his XC bike on a bike path keeps him sane. Yes he could fall off the bike, but he could also fall down the stairs at home. I’d rather he was riding along a flat path at home than on a road bike – of course he’s got things to think about such as position of his pelvis and back. But you can only imagine the ‘feel good’ factor of him being able to spin out on that XC bike for an hour.
Where he wants to be, 8 weeks post fracture and back on a bike
The focus for Tay was this;
- The deep core muscles can suffer after a spinal injury, they act as propriocepters telling the larger trunk muscles what to do – we’ve been working them to prevent problems further down the line when things get more dynamic with larger loads
- With such a large fixation in his thoracic spine, movement can bet transferred to his lumbar (lower back). Putting it under a lot more stress and load, so we’ve been working to ensure he has control of his pelvis and this area of his back
- Increase loads to get Tay into great physical condition to allow the metalwork to be taken out
- Start to look at his upper back muscles which will have been damaged during the surgery (they have to cut through them and/or pull them apart)
Working on the above is tedious and boring, there is no way around that. It’s medicine the athlete needs to take to make them better. Tay isn’t going to explode in a super-compensation wave of strength and lean tissue gains doing the above work. But it’s doing this type of work now that pays off later when we do start to load him up. We’ve been able to step things up slightly – introduce more movements and even use some weights!
Tay working on controlling his pelvis and spine while being pulled off balance using a theraband
The devil’s tricycle doesn’t mind if you have a broken back! I was able to hit some of Tay’s high intensity energy systems using the AirDyne. For no other purpose than to light them up after not being used for 2 months, the result was a whitey and some time alone!
Moving the exercises on, whilst still doing the foundation work
The other key milestone was to attend an appointment with a spinal surgeon who also specialises in young people/athletes. Dr Dashti is based at Spire Manchester, he also completely understands that Tay is a professional athlete and we need to get him back racing. Tay has already had an initial appointment with Dr Stuart James down in Cardiff, this was a private appointment and unfortunately the NHS system doesn’t have Tay down for an appointment until mid October – when Tay is 90 days post injury! The NHS has an incredibly difficult job to do – even so, the NHS first intervention with Tay being 3 months after his accident really is quite staggering. All because the operation was carried out in France, despite being an emergency operation, the NHS system in Wales can’t seem to recognise the urgency of this and it’s being treated like any other specialist referral from a GP. So with Tay due a review at the 8-10 week point and the NHS unable to do this – we of course got him to the right specialist. The initial feedback was the metalwork would need to stay in for 18 months, which was a huge problem as there is no way Tay can race with that level of fixation in his back. Should Tay have a big impact with the metalwork still in, it would cause catastrophic injury his back.
Dr Dashti reviews the mechano set in Tay’s back
Just as Dr James commented on in his meeting with Tay, Dr Dashti was not impressed with the level of fixation in Tay’s back and offered his opinion on what he would have done. As mentioned previously, the insurance would not fly Tay without the operation and the docs in France said they would fixate just one vertebrae above and below the fracture. However when we got the x-rays, they’d done most of the thoracic spine. It’s a little bit like taking your car to the garage with a puncture, and they decide to replace all the wheels and tyres. I’m sure they had their reasons – and what’s done is done, so it’s what we’re doing now thats important and how to move forward.
The main thing we wanted was of course the opinion where Tay is at now, how we move training forward and of course the million dollar question – when can the rods be removed? I was looking to accelerate the timetable from 18 months to 6 months. Dr Dashti’s opinion on what happens next was this – CT scan Tay at the 5 month point and if everything was still ok, whip everything out at 6 month point! YES! To say Tay was happy is an understatement.
This comes with caveats though;
- Tay needs to be in excellent physical shape
- The fracture needs to have healed properly
- He must keep on all the boring control exercises
In terms of training;
- Tay is going to Hafjell and Leogang with the team, just to get him out of the house and keep him sane! But he can ride his XC bike with him and ride the fire roads with other considerations which have been explained to him
- He will do his rehab with the whole team in the mornings, it’s team mobility every day!
- We can up the intensity of the training including weights, as long as we’re avoiding major flexion and extension of the spine
There’s still a tonne of work that needs to be done, but to be able to have Tay 12 months ahead of schedule is a huge step. As long as we keep paying the attention to detail as we have been, doing the foundation work and directed training – it’s a real goal to have Tay back racing for the 2014 season. As long as Tay doesn’t do anything silly when he’s on his XC bike. I know other racers and riders have had similar injuries and internal fixations – and some have got back on the bike quickly. But there is a huge difference between coming back to riding or coming back to racing AND being competitive. Tay is ‘riding’ his bike now, but that’s not racing at world cup level – an obvious point maybe, but still one worth making. There’s no point in any athlete being on an accelerated return to racing schedule, to get nowhere in the results when they do race. It’s a common mistake I see over and over again, an athlete coming back early from injury into competition to then under perform with all the negative knock on effects that go with that lack of performance.
5 days with me – little Butty was tired out…
I took Tay to see the rest of the team and we all got a gym session in, Rach was struggling with the control exercises!
We finished the week off with a trip to see the whole team, Tay hasn’t seen most of them since the crash – it was a great visit with a ad-hoc team BBQ. Rach might be world champion, but she was on cooking duty.
We’ve now got some firm timescales to work to, which gives us a specific destination rather than some vague outcome in the far distance. I won’t see Tay now until he stops off with me between Norway and Leogang. The plan was to keep this accelerated programme under wraps in terms of timescales, but I didn’t quite explain that to Tay and of course he blasted it all over twitter about how we’re now a year ahead – you can’t blame the lad he was so stoked with the good news. We’re in a good place, and hopefully we’ll stay in this good place and have the little Butty back shredding on the world cups for 2014….
As always, big thanks to all involved and Karl Steadman at RCF3D for letting us use his great facility.
In part 3 – Tay starts to hit higher intensity training and more weights….
“Two years in the making, street trials rider Danny MacAskill releases his brand new riding film. Whilst previous projects have focused on locations and journeys, MacAskill’s Imaginate sees Danny take a completely different approach to riding. Enter Danny’s mind and enjoy.”
And with that, the film was released to critical acclaim – the industry saying bike riding films had been changed forever. Simple, and everyone is happy. Except it was the polar opposite of simple, it was one of the toughest athlete projects I’ve worked on (besides Dan Atherton’s broken neck). At almost every step and on a seemingly weekly basis this project was under threat, the time effort and resources that had to be employed to get Danny on a bike and keep him there were staggering. The actual filming was 6 weeks, the previous 98 weeks was all spent getting him to that point.
I first saw Danny on YouTube the same way everyone else did, I’d been given the heads up that Red Bull were speaking to a potential athlete and to check his video out. Just like everyone else I was amazed at what I saw – this was a true artist at work. He was signed up and of course he was already injured with a broken collar bone. That in itself wasn’t a big deal, he’d done it riding the pump track at Oakley HQ in California, the problem was he’d rebroken it getting thrown out of a bar meaning it had to be plated. This meant he hadn’t been riding so it was the usual conversation of ‘can you do something with him?’.
Just in case you’ve been living on the moon, the original YouTube video with Danny
It was January 2010 and I was about to leave for California with the Atherton’s for winter training and I suggested that maybe Danny meet us out there. It got him out of simply hanging around, put him with bike athletes that train professionally and generally a good environment to get back on his bike. Immediately Danny was reluctant to come out and took some serious persuading (a sign of things to come…). He’d been off his bike for weeks longer than he should have been already, it made sense for him to head out – I had to work hard to make that ‘sense’ to him.
The house we were staying in was full, so Danny shipped into a hotel just around the corner. It was going to be great to have him around and switch up the usual training dynamic with the group. It was immdetiatley obvious that Danny did no physical preperation whatsoever, and was riddled with ‘compensations’ which are muscles over working and joints not moving properly. Exactly what you’d expect from someone who rides his bike all day, but doesn’t do anything about his body being able to tolerate that riding. So the slow process of trying to educate Danny on the importance of looking after himself began, and I hoped that seeing how hard the Atherton’s trained might inspire him to look after himself a bit better. The problem with athletes like Danny is they don’t subscribe to structure or plans, which is also why they’re so amazing at what they do! So it’s a constant upstream swim to get them to engage with a process. Also Danny didn’t and doesn’t ride competitively, unlike racers who ‘have’ to ride – Danny essentially rode for ‘riding’, the thrill of seeing a line and riding it – and if he wasn’t feeling good then he didn’t ride. That’s cool if you’re working in a bike shop, but as soon as you turn ‘professional’ things change. Danny was still coming to grips with being a ‘professional’ athlete and I was trying to help him make the transition.
It’s not about using constant ‘stick’ with someone like Danny, they’re educated (*cough*) free thinking adults – I was simply trying to open doors for him and explain the different paths he could take. However the key over riding message from me was that he needed to look after himself in some way, as his body needs to ‘tolerate’ what he’s asking it to do. We got some decent training in over the first week, there was a gap in the schedule where the Athy’s were racing DH at Fontana down near San Diego. I gave Danny the option of staying and training with me for the day, or head off with the Athertons and hang out at the DH race. Of course Danny chose to head to the race, and off they went. I thought it would be a nice day for the whole crew and Danny would be fine, by the end of the day things would be the complete opposite of ‘fine’.
Late afternoon I get a text from Gee saying, ‘Danny took a big hit and has re-broken his collarbone’ – of course I dismissed this as a standard wind up text from Gee and didn’t think anything else of it. However 90 mins later when the team rolled through the door, Danny walked in with his arm in a sling and appeared to have been attacked by a wild bear. His clothes were shredded, he was covered in blood, he had huge deep cuts to his arms, legs and his face was also cut up. I stood there and said, ‘what the f**k happened!?!’. It must have been a huge crash to have sustained all those cuts and for his clothes to be all ripped. Danny pointed out very matter-of-factly that the damage I could see wasn’t from the crash which had (probably) re-broken his collarbone but the several crashes he’d had throughout the day including a couple of huge ones! I stood there struggling to take this information in, he’d left for the DH race with nothing but shorts and a cheque shirt so what the hell was he doing on track at a US national race? He’d simply borrowed a hard tail bike from the Athy’s, an open face ‘skate’ type helmet and set off down the run, sleeves rolled up on his cheque shirt, as you do. There’s actually a picture of him somewhere at Fontana charging down the run, dressed as I describe. Of course, I went into orbit.
We went to hospital for them to confirm what I was trying to convince myself hadn’t actually happened, he’d re-broken his collarbone at the end of the plate. I knew there was nothing we could do about it, the plate he had was already the largest available. So unless we wanted that large plate removed and two smaller one’s placed, we simply had to leave it. Along with a nice lump. Danny was gutted and I was fuming. We’d flown him out there to get back into shape, I was angry he’d been so irresponsible. This new break meant no more bike for yet another 4 weeks on top of the 12 weeks he’d already missed. Then again, as I’ve mentioned – the kind of attitude that tells you it’s ok to ride a DH race on a hard tail with your cheque shirt on and open face helmet is the same process that tells you can ride across a 1/2 inch wide spiked fence. It’s in their nature.
That little story pretty much sums up the next 3 years. Danny dropped from my radar when we returned to UK and for over a year I didn’t see or hear from him. I had a load of other athletes that needed and wanted my help, with Danny choosing to dissapear into the jungle and look after himself was on him. Every now and again I’d get a call from him asking for a physio for his ‘bad knee’ – but he was busy taking opinions and advice from anyone and everyone whilst not actually getting anything sorted. Then in mid 2011 things had deteriorated to the point he couldn’t even ride his bike. I have to say from a personal point of veiw, at the time I was fairly unsympathetic. I tried to tell Danny a year earlier that he had some miles on the clock, a bunch of compensation issues that needed sorting or they would all mount to a series of overuse injuries leaving him unable to ride – and here he was, in the worst shape he’d ever been in unable to ride his bike. There was so much going on with him physically, it was like a wave of white noise. Trying to decipher what was a symptom and what was a cause was almost impossible.
The immediate and most obvious thing was his knee – he now had a massive leg strength difference, was walking differently and couldn’t ride. I took him to knee specialist Prof Phil Turner who gave him a thorough examination but couldn’t find anything definative wrong – but clearly there was. As a precaution we got the knee scanned and it revealed a large tear on his meniscus, who knows how long it had been there. Danny thinks he can pinpoint the day and what happened, and whilst this may be true – the simple fact is this was always going to happen which I’d tried to warn him about. Sure it may well have been when he had to put his foot down on a move and twist his knee, but almost every part of his body wasn’t where it was supposed to be or as strong as it needed to be to tolerate things like this. He was also complaining of some back pain, but his hamstrings were so outragously over-engaged he could hardly bend over past 90 degrees (the worst I’ve ever seen anyone) due to his ridiculous quad dominance. Also his insitance on permenantly riding left foot forward meant his pelvis was completely bent out of shape – so no wonder he had back pain. But like I said there was so much going on it was difficult to cut thought the noise.
Danny post knee op at The Alexandria Hospital in Cheadle
As always, I got Danny to the right specialist, as mentioned he was scanned which revealed a large tear in his meniscus and booked in immediately for the operation with Prof Phil Turner. We were under some time pressure, Danny was committed to shooting a commercial in San Francisco and the departure date was right on the return to sport date from a meniscus resection. However, Danny worked really hard – the hardest I’d ever seen him work to get fit. I hoped we’d turned a corner in his physical preparation, and from now on he’d pay more attention to himself and what he’s asking his body to do. We got him ready and he flew to San Fran to shoot the commercial. Things were looking up for Danny and it was around this time he started telling me about this crazy idea he had, ‘It’s so big’ he’d say, ‘I’m not sure it’s possible to even do’ – my response was, ‘It definateley won’t be if you can’t ride your bike you tit!’.
Danny’s commercial shoot in San Fran
In part 2 things go from ok, to good to bad to absolutely awful….