Recovery expectations & dealing with set-backs

: On today's episode, recovery expectations and dealing with setbacks. Welcome to the podcast helping you overcome your proximal hamstring tendinopathy. This podcast is designed to help you understand this condition, learn the most effective evidence-based treatments and of course, bust the widespread misconceptions. My name is Brodie Sharp. I am an online physiotherapist, recreational athlete. creator of the Run Smarter series and a chronic proximal hamstring tendinopathy battler. Whether you are an athlete or not, this podcast will educate and empower you in taking the right steps to overcome this horrible condition. So let's give you the right knowledge along with practical takeaways in today's lesson. Hey, these next three episodes are going to have a very similar theme around recovery. And first of all, thanks for joining us on another episode. I have started getting a bit of an uptick in listeners, which is really nice. I've seen some runners and other people who are listening to this podcast share it out and recommend it. I've been recommending it on Facebook groups, and that's really how this podcast is going to expand. I'm not extremely active on promoting it. I'm just hoping that the listeners, if they come across like Facebook groups or people have any questions or you come across someone who does have PhD and really needs help, if you can just point them in the direction of this podcast, it's exactly what's designed for. It'd be a huge, huge help. And I'm already seeing that, which is, gives me the motivation to continue moving forward and people just reaching out and talking about how. impactful this podcast is and how thankful that it exists. So thanks for all your support. So today we're talking about recovery expectations and there is, um, this lesson around being realistic and, um, expecting the unexpected, those sort of things. This was in my run smarter podcast and it's was a while ago when I did release this, but has huge relevance to PhD. And yeah, we're going to listen to this episode now and I'll chime in at the end to kind of reflect on how this exactly relates to PHT. The next, the following two episodes will be talking about recovery and flare ups and managing your mindset around recovery as well. So there's kind of like this mini theme within these next three episodes. So hope you enjoy. Here is the episode on recovery expectations. If you're injured right now. or if you've been injured in the past, you're probably gonna relate to this a lot and you'll find this information extremely helpful. And also if you, it's also interesting to know and key to know if you have an injury in the future and this sort of information is really, really worth delving into to negotiate any future recovery that you might have. So when it comes to your recovery, it's like, traveling to a destination. You have your car, you have your roadmap and your expectations about how long it will take and with the plan and the map in front of you it seems pretty straightforward and you can, this can resemble like a journey to your pain-free running career and if you're faced with an injury you might have the expectations of this journey back to running being quite swift. and without its challenges, but destinations often have unexpected twists and turns in the journey, and we'll try and discuss as many of these twists and turns as we can in this episode. So here is something else you need to prepare for within the journey, and this is a big one. We need to expect the unexpected. We need to expect that this journey might have twists and turns and setbacks. But if we can expect that and we have contingencies in place for the unexpected, then the discrepancy between expectations and reality start to become a bit closer. So I'll go through four of these roadmap destination considerations to help bridge this gap between what you expect to happen and reality. Our number one goal when we start out for a journey is we want to be nice, smooth sailings and we want to get to that destination without a hitch, but rarely is it the case. And if we do get through our destination without hiccups then it's all happy days. But if we have some mishaps along the way and we've expected the mishaps then you're in a better mindset and you to continue moving forward. So I have four considerations for you. The first one, before hitting the road on your journey, I want you to try and visualize what is your car strong enough for the journey. So if you're setting yourself, if you have say a journey from Melbourne to Sydney, and it's a thousand kilometres, and you have a 30 year old bomb, it still might get there. It might survive the journey, but you'd be pretty lucky if you get there without any mishaps. So, ask yourself, do you have the right car for the right journey? Is it going to make the distance? Do you have the confidence for it to make the distance? Because this resembles your body when it comes to recovery. Is it fit enough for the journey? This could be like addressing weaknesses, addressing your beliefs, addressing any like psychological anxieties that you might have, any imbalances that you might have. And we want your body to become a finely tuned machine before you even hit the road on this journey. And this would be the road to recovery. One of the examples that I can think of, which happens quite a lot, is just assessing someone hopping up and down on one foot. And... I often talk to someone who is injured and they say, yeah, I've been running, but I've been injured and experiencing this pain for quite some time. And I'm trying to get back to the mileage I used to, but it keeps flaring up. And I say, okay, let's have a look how you're hopping on one side, how you're hopping on the other side. And I talk about really fast kind of hops. So you want to recoil really quickly and see how you can absorb that load and release that load because that just mimics what you're doing when you're running. And they can hardly do it on one side. If you can't hop, then you probably shouldn't be running. I always say that to people and sometimes it's a big realization for some and they never realize that they struggled to hop. So maybe with this analogy, maybe go get your car serviced or go to a mechanic just to assess things just to see if it's equipped for the journey because there might be... some mechanics in there, I'm not much of a car person, sorry, there might be something wrong with the engine, that might be under the hood that you might not even realize and it's still not equipped for the journey. So that's tip number one or consideration number one, making sure that your car is fit enough for that journey that you've set it. The second thing that you might encounter is heavy traffic along your journey. So This might not be expected. We might plan out our journey from Melbourne to Sydney, and Google Maps is saying it takes 10 hours, but before you even get onto the freeway, you encounter some heavy traffic and you struggle to get out of the blocks. Anyone can relate to this, and this might require spending some time or time longer than expected at a particular stage in your road to recovery. An example I can think of would be spending more time in your rehab phase prior to starting to run again. So we back you off for running, we could do some strengthening exercise and say we need the body to get strong enough, let's just say we need to get you hopping equal to the unaffected side in order for you to run again. And we might set a couple of weeks, but in reality, the body's not recovering as quickly as it should and you spend a little bit more time practicing on your hopping and building up the strength for your hopping and spending a little bit more time and not getting to that run phase as quickly as you'd hope. So spending a lot more time doing some, doing that phase can be very frustrating but we have expected this, we've encountered heavy traffic before and we know that sometimes we might need to spend more time, be more patient. on a particular phase before moving forward. Another phase that might take a little bit more time is spending more time doing a slow walk jog interval before getting into some continuous running. And I have a nice return to run program they like to give people and they roll their eyes at me because it is very slow and patient and it's walking for one minute, jogging for one minute for the first phases but quickly jumps up and you're quickly doing some continuous work but others, other people might need to be patient and avoid the urge to skip to skimican. lead to a bit more trouble. So just remember if you try and fly in and out of heavy traffic, you're probably going to cause an accident, but we have prepared for the unexpected, and we've expected the unexpected, so be patient when you encounter heavy traffic. Number three, we are encountering possibly a detour along your journey. You are not necessarily backtracking, but getting to the destination requires a few unconventional twists and turns. So you're still heading in the right direction. Let's just say if you're on the freeway on the journey to Sydney and you're out of the traffic but then once you're on the freeway you see some roadworks that forces you to take an exit and this is only temporarily before you jump back onto the freeway and you're heading back to Sydney. So these are like adjustments. to your existing rehab plan and we're not backtracking at all but we're modifying possibly your running schedule or modifying some of your rehab exercises in order to adapt to the current situation because something might occur as like symptoms might be not responding as well as we might have hoped or the current situation like adapting to certain running distances. and we just might have some fine-tuned some tweaks here and there. It just means that we can't keep to the same roadmap the entire way through. We plan out the map, but sometimes it might take some adjustments on the fly depending on how you're responding to certain exercises. So don't be discouraged if we do need to tweak some things or we need to adjust some of the running program parameters, but it's all in all heading in the right direction. This one is a little bit easier to digest because you are still heading, you're getting closer to that goal and that destination. But that leads me to number four. And this one you are backtracking. So number four is when you hit a dead end in your roadmap. So let's just say we're getting closer to Sydney and We're starting to hit the outer suburbs of Sydney and it looks like all's going really well. And that early heavy traffic that we encountered now seems like really minuscule and we can't believe we're getting frustrated at that heavy traffic. But now we hit a dead end. Maybe we lost track of the map and maybe we made a wrong turn. Maybe Google Maps didn't update like those really old school. What were they? NavMan, something like that, one of those. Always used to lead us down dead ends because it just didn't update. Whatever the case, you're now having to go back and find your way onto the right path again. Now this is the most frustrating expectation because you're finally starting to, let's say you're getting back to running, you're finally running and feeling really good, but then you encounter like a flare up symptoms or perhaps another injury forces you to take a couple of steps back or even start from square one, start all over again. You can understand how frustrating that could be. And a lot of people might just try and push beyond it and keep going to that destination through that dead end. But it just leads to a pothole or a pit or I don't know, a cliff or something like that. So have reassurance to know that this mishap rarely happens if you follow the correct guidance, if you have the right professional by your side and they're giving you the right advice and you're asking for that advice along that whole journey so you don't make any misturns. But a lot of times when people start to see the finish line... a lot of runners throw the map in the back seat and they smash down the accelerator to get there and this often brings on danger and leads to possibly making the wrong turn because that map is now in the back seat and if you like smash down the accelerator to get to that finish line it could potentially blow out your engine and it requires your once a strong card to get repaired for a couple of weeks. So this is a huge one but... have the patience and if it does happen, it's very extremely frustrating. You might need to go back a couple of steps, but there's usually a mistake in your plan that's led to you going down to this dead end. And so if you learn from this, have to take those steps back and then take that knowledge of the mistake that you've made moving forward, then it's going to set you up really well for the next time round. This podcast episode is sponsored by the Ransmata Physiotherapy Clinic, which is my own physio clinic where I help treat a wide range of PHT sufferers, both locally in person and all over the world with online physiotherapy packages. In the years I've been self-employed as a physio, close to 70% of my entire caseload has been helping people with proximal hamstring tendinopathy, which is why I decided to launch this podcast. So if you're building upon your own rehab knowledge through the podcast, but still require tailored assistance, I'd love to be on your rehab team. Whether you are a runner or not, head to runsmarter.online to see your available options for working together. If you're still unsure if physiotherapy is right for you, or if you need a rehab second opinion, you can always schedule a free 20 minute injury chat with me. Find the free injury chat button on my website or in the podcast show notes to be taken to my online calendar to book in a time. So it made me think of my conversation with Dane a few months ago on the podcast. And he mentioned having the discussion with your athletes and discussing the risk versus reward. when returning back from injury. And this conversation you have with your therapist or a coach, and it's all about establishing how much risk you're willing to take for the benefit of returning quickly. And this might be due to a race that you have coming up. Let's say you've been training for a marathon for six months and the marathon's in three or four weeks and you've started to get symptoms. It's probably worth the risk of continuing to run and push. through symptoms a little bit in order to get to that marathon. But if you have nothing planned, we might not take on that much risk and actually be more patient and get you back as quickly as we can, but not taking on those risks. So when we escalate that risk and take our chances, the expectations of these setbacks needs to be matched. So we need to have that realistic expectation. If we take on risks... it increases the likelihood of encountering these setbacks. So it's really, really important. I really liked the quote from a book that I've quoted a couple of times on this podcast. It's called Rebound. And it constantly says in the book that rehab is now your sport. And runners identify themselves as runners. They only care about running. They see themselves. They talk about running and say, they're proud to tell people that, yes, I am a runner, but. when they're injured and when they're rehabbing and not running, this creates like a cognitive dissonance. It's, um, this discrepancy between what you tell yourself you are and what you're currently doing. And this dissonance leads to, uh, jumping back to running way too quickly because they just want to get that identity back and it's a big trap. So, If you keep telling yourself recovery is now your sport, it can help calm your mind and say okay, let's temporarily take that focus away from running and let's get that right mindset before getting back to running because that's a big, big important step. So if you can tell yourself that, it's a big key. So a bit of a recap before we finish up here. Number one, make sure that your car is ready for this journey. Number two. make sure you're expecting to encounter some heavy traffic and maybe spending a bit longer at one stage. Number three, encountering a detour, which might mean modifying and not backtracking but taking a couple of unconventional twists and turns. And then four, being hitting that dead end and expecting that this might happen and you might need to take a couple of steps back or start from square one. Okay, without me, I'm chiming in. Hopefully you've had your own revelations or realizations with your recovery in the past. But, um, I think the main lesson here is to have realistic expectations. And I've got a couple of examples of our, um, our three or four conditions around like this roadmap back to recovery. The first one being like, is your cast strong enough? And when it comes to PHT, we need to know, okay, are your tendons strong enough to go through whatever bout of recovery or rehab you're taking on? So for example, if you decide to do shockwave, or if you decide to go through surgery, we know through previous episodes, the tendon needs to be strong. The tendon needs to be strong for you to tolerate shockwave and actually have a good outcome with shockwave. It can't just be a weak tendon that we shock and expect to get better. Same with surgery. Surgery doesn't do anything to change the strength of the tendon. It does things to clean up maybe scar tissue or fraying bits of the tendon, or maybe remove degenerative portions of the tendon. But it- The actual tendon itself is still the tendon. If the tendon is very weak, your after surgery, you are left with a weak tendon. And so when you go back to your rehab exercises, it still needs to be that same gradual process. If you decide to start doing deadlifts or any sort of strength and conditioning approach, is your tendon strong enough for what you're about to do? If you're returning to running, so you've done your strength and conditioning for... a couple of weeks or a couple of months and you want to start giving running a try. Okay, well does my tendon have the eccentric control required for running? Does it have the speed component of strength that is required for running? So knowing is your car ready for the journey? Is your tendon ready for the rehab that you've put in front of it? If it isn't, then maybe we need to take more gradual steps or maybe we need to put steps in so that it becomes strong enough for that journey that you have planned. The next one was heavy traffic was the next kind of condition when it came to your rehab. And when it comes to heavy traffic, maybe when we talk about like a strength and conditioning phase before you return to your run, a lot of people want to get back into their cycling or want to get back into their pilates or running or whatever they really love doing. But maybe heavy traffic is spending just a little bit more time in that strength and conditioning phase in that strength training rehab phase before returning to that exercise that you love doing. Maybe that's the case. And maybe we have to just be a little bit patient, wait a little bit longer and not just fly straight through heavy traffic into that exercise that we love because that might lead to major setbacks. Detours were some of the examples like the examples that I can think of for PhD for a detour is Not agreeing with a certain exercise So if you start doing deadlifts and all of a sudden deadlifts just isn't agreeing with that tendon maybe we need to modify things and do another type of exercise or maybe we need to change around the Variables so the sets reps how fast you're doing it what recovery is like in between sets All those sort of different variables, maybe we need to continue deadlifts, but do maybe some sort of nerve-based flossing exercise before and after. Maybe we need to warm the tendon up beforehand before doing deadlifts. So we're still moving forward, but we just need to modify things with these detours in order to continue moving forward. And lastly, we had those dead ends. And so this is just like life throws us curve balls. We know that sometimes we go on a holiday where, um, or like a road trip where we have to do a lot of sitting. And then when we get out of the car, we do hiking or we go for a run or, um, yeah, we're just really active. And then we're sitting on the way back and all of a sudden now tendon flares up and it requires a week or a couple of days or a couple of weeks of, um, setbacks. And so this is where dead ends may come into it. Another scenario that I can think of is maybe increasing. like work hours, work requirements, so you've got increased stress. Maybe you're sitting for longer if it's an office-based job. You're having less recovery because we know that's good nutrition, good sleep. Less stress helps the body recover. And maybe there's less like rehab time, maybe because you have all these work commitments, there's less time to actually do your strength and conditioning or do your rehab exercises. So that could be a bit of a dead end because life's given us curve balls, but... We need to accept these that they might happen down the track and have a plan in place, which is kind of like this episode, this topic is around if these things happen, if your tendon does have a flare up, it's having a plan in place. If you have a flare up plan, which I do with a lot of my online clients that I see with PHT, it's a huge game changer because we know what to do. And if there's, there is a flare up instead of just being frustrated instead of, um, just thinking what you're doing is not working instead of just taking complete like powerless unhelpful strategies of just dwelling in like your the negative emotions and the negative side of things to say, hey, we expected this flare up. We have this flare up plan in place. Let's just start the flare up plan. And mentally it's a lot better, physically it's a lot better. And yeah, I do mention In this episode, I know I mentioned that rebound episode that, um, where I interviewed Carrie Cheadle that will be in one of our next episodes, not next episode, it's the one after that where I'll be interviewing her. So look forward to bring you that. Um, so hopefully you've had some realizations about things that you've done in the past, maybe, and things that we can do in the future when it comes to your recovery and dealing with managing setbacks. Um, so I hope you found this really insightful and Next episode, we're going to talk about pain versus sensitivity and the difference between the two when it comes to your recovery and when it comes to a flare up. So it's going to tie in really nicely. And so I look forward to bring you that episode next time. Thanks once again for listening and taking control of your rehab. If you are a runner and love learning through the podcast format, then go ahead and check out the Run Smarter podcast hosted by me. I'll include the link along with all the other links mentioned today in the show notes. So open up your device, click on the show description, and all the links will be there waiting for you. Congratulations on paving your way forward towards an empowering, pain-free future, and remember, knowledge is power.