The Cost of Doing Business
Weekends, especially in the summer, are not a time for me or anyone else in the performance team to relax. Having spent every weekend for 6 years away with Red Bull, these days I tend to stay at home. However, whatever I do with the family to relax on a weekend, there’s always one thing in the back of my mind – the dreaded ‘phonecall’ or ‘text’. If any of the athletes or support staff call or text me over the weekend, it’s not to ask me how my day is going and what I had for dinner. Getting in from a day out where I haven’t had my phone with me, if there’s two missed calls and a text from a team manager waiting on my phone it means only one thing – it’s going to be a busy week (or weeks).
This 15 minute video is a good illustration of what happens – when I took Danny MacAskill to get to the bottom of what was wrong with his back for his two year project, Imaginate.
Action sports athletes and injuries go together, in fact it’s a process we call ‘the cost of doing business’. If you’re into action sports whether it’s professionally or as a weekend warrior, then the cost of doing business will be an injury, not if, but when – it’s inevitable. Gravity + speed + stopping suddenly (colliding with the ground/tree/other people) = injury. Wearing the proper protective equipment is a given in any sport where speed is involved, you also add the extra dynamic of gravity – and it’s a potent mix for injury. It’s no coincidence that the biggest crash I’ve seen in World Cup DH was in 2012, as the bikes get faster and the athletes on them fitter and stronger.
In any case, regardless of how well protected you are – an injury will happen. It’s a fact of action sports life, and as you can imagine it’s something myself and the performance team spend a huge amount of time dealing with. We don’t just have a sports doctor we work with, we have a specialist per body part. Foot & ankle specialist, knee specialist, spinal specialist, hand & wrist specialist, elbow specialist, shoulder specialist – one for every eventuality. It’s vital that when dealing with elite athletes that the people looking at the injury are a recognised world class specialist in that particular body part – as the athletes career could depend on the intervention and outcome. The more catastrophic and serious the injury, the more important this becomes. MRI’s and X Rays only reveal so much to a surgeon, and more often than not once they open up an athlete something unexpected is found, so when it comes to someone having to play surgical jazz in the operating theatre, you need an expert to pull that off. Equally for the athletes they need to know they’re in the best hands, so walking (or more likely on crutches) into a consultation room a world famous premiership footballer is walking out of helps put their mind at rest. It also allows the athletes to compete with the determination and aggression needed to win, knowing that should something go wrong we’ll be there to catch them. That doesn’t mean the athletes take unnecessary risks or are cavalier about anything – all action sports athletes start from a point of high risk, it just means the support is there to absorb the consequences of ‘The Cost of Doing Business’.
All that is fine for the elites, but what about everyone else? Not everyone has a world class high performance programme behind them like the Red Bull athletes do or other professional sports. The rest of the world also need to get back to work on Monday morning, ‘normal’ people (or civvies as I call them) don’t get to spend the week working with specialist physio’s and trainer recovering. Your boss might not be so understanding about calling them when you’re off work and saying, ‘Its the cost of doing business, the cone said so’. Injuries also don’t happen just from colliding with the ground or a tree at a rapid rate of knots, wear and tear, or muscles and joints in the body not working as they should will cause something to break down. So when the inevitable happens, what should you do?
As with anything prevention is better than cure, so apply some common sense to what you’re doing. Ensure that you are in good working order just as you would your bike, that the muscles and joints are working as they’re supposed to and you’re doing the fitness work to make sure that stays the case. It’s not a bad investment to get a ‘MOT’ from a sports specialist and pre-habilitation programme to keep everything going in the direction it’s supposed to. The more miles you put on your clock the more important this becomes. Make sure you’re prepared for ‘when’ things go wrong not ‘if’ things go wrong. We’re quite happy to spend a lot of money on the equipment and associated kit for the sport, but the kit doesn’t ride itself – so invest in yourself and your performance education. A days training course with Extreme Medics who know the sport and environment you ride in doesn’t cost that much, being the ‘office first aider’ doesn’t prepare you for a massive crash on the hills . When you or a riding partner hit the deck having that basic knowledge of sport related emergencies will pay off massively.
Every injury is unique, just because you’re mate once dislocated their shoulder (which was in fact not a dislocation but a partial sub lux) doesn’t mean that what treatment and outcome they had is going to happen to you. Trails, slopes and parks (like pubs) are awash with experts who will tell you exactly what to expect because it happened to them or a mate of a mate that knew the mechanic of someone that once rode with a mate of someone that races – who had the same injury. The same goes for internet forums and search engines, all you’re going to do is overwhelm yourself in conflicting advice which is entirely inappropriate to your injury. So whatever happens to you, it’s a unique occurrence and your reaction to it and any treatment will also be unique. Also remember it’s not the job of the NHS to get you back to full action sport awesomeness, their duty of care is that you can function as a person – you’re weekend sport is down to you. So don’t get frustrated with them when they fail to appreciate you want to be back riding, that’s not their job. In most hospitals and GP practices there tends to be someone that specialises in sport or has a keen interest in it, so don’t be shy about finding out who that is and asking to see them. A lot of the top specialists spend a few days a week working in the NHS, so ensure you ask if there’s someone around who is ‘sporty’ and you may ‘luck in’ and get one of the countries best specialists looking after you!
You need to ensure you are happy with the treatment path you are on, and once on that path you need to stick to it. Cobbling together your own treatment plan based on several pieces of advice from several different people is not a firm plan with an outcome. Just as with your training, a specific outcome requires a specific plan – so meandering through different things whilst not doing exactly one thing isn’t going to bring you back to full fitness. One of the biggest factors affecting an injury outcome besides the quality of advice is your compliance to it, and one of the largest influences of that compliance is the ‘mental’ side of injuries.
Jonny Walker has the surgical options explained to him, I attend all appointments with the athletes
Being unable to compete or take part in your sport is not a good place to be mentally – for professional athletes this is their lives, and whilst being stuck at home might sound ok to some, for a professional athlete it’s impossible. For a weekend warrior, it will only take a few missed trips or rides and the ‘novelty’ of the injury soon wears off as it begins to affect you in every day life and everything you do. This is made worse by the fact that re-habilitation training has to be the most boring imaginable. I hate to say it out loud, but the fact is re-hab completely sucks and there’s no way around that – but if you know it’s going to suck, and you accept that – in itself that is a step forward in getting better. So much about injury recovery is about positive mental attitude and a determination to get better. So whether you’re a pro or a weekend warrior ensure you have clear, specific plan in place and view your rehab like medicine. It might not be nice, might not be what you want, but it’s going to make you better. From my perspective I have a huge amount of empathy with the athletes, having broken all my limbs, had every soft tissue injury you can think of and with 4 large metal plates and 30 screws dotted around my body – I ‘get it’. Nobody wants to stand waving a theraband around ensuring the muscles around an injury don’t switch off, but if the cost of doing business is injuries, the ‘service charge’ is the rehab training.
It’s also essential you don’t let the injury take over or dominate your life, if an athlete has a broken leg they’re often shocked when I ask what the next gym session is – I point out to them they have perfectly usable arms and another leg. Just remember that whatever injury you have, it usually only affects that one part of your body so it’s not stopping you from using all the other parts! I had Dan Atherton in the gym 6 weeks after breaking his neck doing weights, with his cage on – you’ve got to move to improve. It simply requires planning, effort and determination – and that all important positive mental attitude.
Danny’s rehab and training with me continues in this video