It Takes a Village

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© Sgame

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Happy Thursday, blog followers!

Warning: In this week's blog post, I'm being selfish.  I'm making a situation that has nothing to do with me, entirely about me.  But it's OK to do that if you admit it up front, right?

This past week, I received some terrible news. The instructor of my weekly Turbo Kick class, Meg, informed our class that she is moving away.  I’m sure she’s making all the right decisions for her family, but to me, this was crushing, devastating, drop me to my knees in tears while unnecessarily over-reacting, punch me in the gut, painful news. I didn’t see this coming. I’m not prepared.  Do I have enough time to get used to the idea of a new instructor coming in?  It took me SO LONG to psych myself up into attending her class in the first place! And it just can't be the same with another instructor.  Say it ain't so!

So, this week I'm writing about the village of people I've assembled to help me get my health in order as well as the positive impact of attending group exercise classes. This was a great reminder that you might be changing someone else's life without knowing it.  Sometimes I forget this when I'm working with my patients.  I have no clue how I've impacted people other than with their physical therapy, but I hope I've helped others the way Meg has helped me.

I joined the YMCA in August 2018 as part of my elaborate and carefully plotted plan to combat my eating disorder and body image issues, which I first discussed here.  I had been in severe denial about what was going on in my life, blissfully ignorant to reality, and had started seeing my therapist at the same time.  I decided to create a small village of people to help me with my journey: a therapist, a dietitian, someone to revamp my physical fitness - who ultimately became Meg - along with some family and close friends. I was entirely unmotivated to move my body - which I was currently hating - and I was sick of my training routine. I wasn't looking for group classes when I joined, hoping could manage my physical health myself, but considerd I might need another person in my village to oversee that, too.

I was initially opposed to group classes because I experienced a particularly uncomfortable CrossFit situation when the instructor told me that "a girl of my size should be lifting a lot more weight." To some extent he was correct - I could squat and deadlift a lot more than I was using there.  But at that time I hadn't been training much and knew the planned workouts included high repetitions and the volume was too much for me to load up the barbell as they recommended.  They pushed me to lift more, I pushed back saying I wasn't ready, and it was ultimately an embarrassing and painful situation.  It is specifically why I treat my own patients meeting them where they are - not where I want them to be.  So I had that experience, plus, I hate the idea of people seeing my body moving.

2008 CT Sun Yoga Class

Those reasons led to apprehension for group classes with the exception of yoga. In 2008 I went to a group yoga class with the Connecticut Sun and have been able to continue with yoga intermittently since then. I wrote about my recent return to yoga here, but, as I previously wrote, I only do hot yoga where I get high (or delirious) from oxygen deprivation that I basically can't tell anyone else is in the room.  Group exercise class?  For sure the others would notice that I'm fat, that I can't jump, that I will get tired, that I sweat a lot and breathe heavy, and that I'm not very coordinated.  Now, many months later, I'm here to tell you none of this occurred.  It was all in my head!

In October 2018, after walking by Meg's class on several preceding Mondays, I finally talked myself into trying her class.  I told myself that I knew the music was good and that I had to complete the class but that if I absolutely hated it, I would try one different class before swearing off group classes for the rest of eternity.  Dramatic much? Thankfully, Meg ran up to me that first day, super spunky and upbeat, introduced herself saying that her class was super fun and that it didn't matter if I knew any of the steps, just keep moving however I wanted to. I've been hooked ever since.

Here’s why Meg’s departure hit me like a ton of bricks.  I was in a deep dark hole of emotions and confusion when I started this journey and quickly learned that I needed to ask for a lot of help. I built my village including three smart, beautiful, strong women to help me pick myself up off the floor and put my pieces back together.  My therapist and dietitian knew each other, use similar approaches for treatment, and know all about my issues. I don’t think they intend to be sympathetic towards me, but sometimes they are, and sympathy isn't what I want or need.

But Meg is different.  She's not sympathetic towards me because she has no reason to be. She doesn't know why I'm in her class or what I'm dealing with. She barely knows anything about me, really, and that's just how I liked it. She's empowering and motivating because that's in her nature. And yes, it's her job, but there are other instructors in there with totally different vibes. I've walked by their classes a bit, too, wondering if I should add to my routine. Choosing her class was not a mistake. She welcomed me in, kick started most of my Mondays since October with high energy, a positive attitude, motivation, and joy. I purposefully attend her class right before going to see my therapist because turbo kick is basically a class where you can punch and kick your problems in the gut and my G-d I needed that.  It also lets out a lot of energy, which calms me and helps me organize my thoughts before saying them out loud.  When I started pairing turbo kick with therapy, I was really struggling to see my therapist because it was so vulnerable. Dance fighting with a room full of strangers is vulnerable, too, but way more fun than one on on conversations in a room with a couch and too many boxes of tissues.  I can’t actually tell which “treatment” has helped me more over the past six months, but I can tell you what this class did for me.

First- a group class has other people working towards their own goals- but the goals can be kept private as you work towards them together. I don’t know if people in the class are trying to lose weight, get stronger, let off some anger issues, or hear some current music. I don't know if they secretly wish to be a performer on a stage - but instead work as an accountant because they need to pay their bills. I don't know if they want to learn ways to protect themself if they were attacked, because truthfully, I would definitely use the moves I've learned there if someone came at me. I don’t actually care why they’re there. It doesn’t matter. We’re all going to do the same moves and at the end be disgustingly sweaty and high five each other with a sense of accomplishment towards our own goals.  I can go deadlift and have an awesome lift on my own, but there won't be anyone to high five me when I'm done. And because people start recognizing each other, it really does start to feel like community. Like if you missed a week, someone might ask if you were OK, or if you went on a nice vacation. Sometimes you just need that!

Second- all my concerns about other people watching me were entirely unfounded.  Nobody else is looking at what I'm doing in this class. They don't care. Once we get started, I barely even notice there are other people in the room, except to watch out for kicking my neighbor and to follow Meg instructing the moves.  Everyone is trying to get the steps right for themselves.  The rule is to keep moving even if you don't know the steps... but sometimes I know the steps and choose to do something different. For example, I CAN do burpees... but I hate them... so when there’s a burpee in the routine, I do jumping jacks or squats or whatever I want. Because for me, the whole point is to move. Not get better at burpees. Once I stopped exercising to lose weight and started doing it because it made me feel good, things in my life started to get a whole lot better. It’s still a struggle to make myself move regularly, so I attend a weekly dance party with some uppercuts and roundhouses thrown in and I actually feel like I’m prepared to conquer the week - whatever it may throw at me.

Third- and probably most important for my personal journey- the room is lined with a wall of mirrors. For the first several weeks, it disgusted me to see myself in the mirror. I was sure others could see how gross my body was. When I was diagnosed with my eating disorder, my testing suggested that I didn't have any body image issues. This was apparently very wrong. I've learned it was/is a huge problem. Prior to facing my issues, I didn't realize I was avoiding mirrors.  We have them at work, too, and I didn't even notice how much I put my back to them.  If I lifted at the gym, I didn’t want to see myself doing it. I don’t have a full length mirror at home and have never had one since I moved to Seattle.  I didn't actually realize how much I had been avoiding looking at myself until one class I caught myself in the mirror while doing a punching move and realized holy crap! That's me!  That's my body! It's doing all these things.  It's working hard and feeling pretty good. I’m actually able to tolerate looking in the mirror and smile at myself a little now.  That may not sound big... but for someone who went from not knowing what their body looked like at all and hating her own skin to tolerating her body and appreciating the things it’s capable of, I think it's huge. I’m sure somewhere down the road, there will be a time when I might like my body- and maybe even love it. That's not where I'm at right now, but I’m sure that the road started with the mirror in turbo kick.

And so, while I am sad to know my village is evolving, I’m eternally grateful for the role Meg played in it at the beginning.  Can't wait for the next Turbo Kick class.

"Long Term Cost of Quick Fixes"

Earlier this week, I attended the Seattle Pediatric Sports Medicine quarterly symposium entitled "Long Term Costs of Quick Fixes." I've previously written about that group with regard to their ACL Injury Prevention program here and here. This symposium was a panel of 4 elite athletes discussing their careers and injuries and some of their interactions with healthcare providers.  It made me think of all the sports movies, like Varsity Blues, with scenes of an injured athlete with a needle about to enter their body to get them back on the field right away. For me, the highlight was seeing Seattle Storm co-owner and Rowing Olympian Ginny Gilder! It's always fun attending networking and educational events and learning of the connections between people you know and the people you meet.

Ginny Gilder, Kerry Carter, Seth Orza, and Peter Shmock

Here's a little bit about each of the elite athletes who were included along with some insight to injuries they sustained and some quotes they said which stood out to me.

1) Ginny Gilder -  An Olympic Silver Medalist in Rowing in the 1984 Summer Olympics and also qualified for the 1980 games that were boycotted.  She attended Yale University, has launched multiple companies, all civic-minding and many empowering young women.  She is currently one of the owners of the Seattle Storm - so I was super excited to run into her, and she wrote a book called Course Correction: A Story of Rowing and Resilience in the Wake of Title IX reviewed as "Wild meets Boys in the Boat, a memoir about the quest for Olympic gold and the triumph of love over fear."  Guess what's now on the top of my reading list for 2019!?!

Injuries: Ginny told about her experience breaking a rib and having a cortisone injection to the intercostals to calm things down and being told by the physician to take some time off from rowing, only to be on the Charles River in Boston on a beautiful sunny day and knowing she just had to be on the water, getting into her boat for a casual row, and ultimately feeling a pop in her ribs that she knew was because of not listening to the advice she had been given.   She also commented on back pain that has been chronic and requires continued care today.  The common theme throughout the presentation was that at the elite level, athletes do whatever it takes to compete, sometimes ignoring advice for the long term.

Quotes:
- "Young athletes depend on competent adults to make decisions for them.  As a parent, you may not know how to deal with your kids injuries.  Parents just don't have the knowledge/experience to make all these decisions."
- "Ask parents why they encourage their kids to do sports?  What role sport is playing in setting up their child for success."

The controversial Goldman's Dilemma was also referred to, though not by name.  This was a study done in the 1970's where athletes were asked if they had the option to take a drug that would promise them the highest level of success, would they take it even if they knew it would kill them in five years.  It was a component of the anti-doping legislation that would later come out because at that time, the surveyed athletes would frequently respond that they would take the drug for the success.  Later editions of the study found different results, but some of the commentary focuses on the differences of how an elite level athlete thinks and operates compared to the general population.

2) Kerry Carter - played fullback for the Seattle Seahawks in 2003-2004 and the Washington Redskins in 2006 as well as in the Canadian football league. (I didn't actually know that Canada had a professional football league!)  He currently works as the Vice President for Football Operations for a company called Atavus Rugby and Football - whose CEO is Karen Bryant, former President/CEO for the Seattle Storm.  Kerry's responsibilities at Atavus include teaching football coaches how to teach football players proper tackling and they use scientific metrics to try to prevent injuries.  When asked about the other sports he played, he said volleyball - which is a rare combination for a football player.

Injuries: Kerry described an ACL tear, a shoulder labrum tear, a shoulder AC joint injury, and others that were not as severe, but that he went through multiple surgeries and worked hard each time to get back to the field.  He also discussed some of his lingering aches from those past injuries, and could describe some of the tactics his teammates used including one who had a pharmacy in his locker and would pop tons of pills daily to be able to tolerate the rigors of football.

Quote: "The thing I wish I knew when I was hurt was if there were other options available.  But to be honest, I may not have chosen any alternative that would have taken me longer to get back on the field."

3) Seth Orza - a principal ballerina for Pacific Northwest Ballet and a 20-year professional dancer.  Seth discussed that he also runs and conditions and lifts weights in addition to a 90 minute daily warm-up routine with the dance company and about six hours of rehearsals per day.

Injury: Multiple episodes of back pain.  He said "my back exploded at age 14" and he actually didn't receive healthcare for it, though he's not entirely sure why.  He spent some time in bed and then was able to return.  Since that time he has had additional back injuries and multiple PRP treatments to his knees, and he gave considerable credit to his PT, (my former coworker) Boyd Bender.

Quote:When discussing elite level sport or performing arts: "You're going to get injured, but it's a matter of how you deal with it, who you trust and surround yourself with, and whose advice you take to get through it."

What struck me with Seth's input was the words he used to describe his back injury - because this has come up in presentations that focus on the biopsychosocial model and how much impact words have.  Seth is in his mid 30's and the imagery of his back exploding at age 14 has been reinforced into him for 20 years... but maybe it doesn't impact him!

4) Peter Shmock - An Olympian Shot-Putter who competed in the 1976 games and also qualified for the boycotted 1980 games and now works in Seattle as a high performance coach.  In the late 1990's, he was the weight training coach for the Seattle Mariners and Pacific Northwest Ballet and has trained a long list of elite-level athletes.

Injuries:  Peter was the only one of the group who reported that he hadn't had any major injuries because of the innovation of legendary track and field coach at the University of Oregon and for the USA team, Bill Bowerman, who believed in recovery and a more holistic approach.  If his body didn't feel right, his training or competing was modified and he felt this was essential to his performance.

Quotes:
- In consideration for those he trains - "What is enough for you today?"
- In consideration for athletes who tell him they think they need to just keep doing more, rather than modify their training - "Do you want to do mindless work? Or do you want to improve?"
- "Train or rehab with intent and at a sustainable rate."
- "Be an advocate for the kid you're working with.  The problem with parents/coaches is that they often don't know how to advocate.  They only know go hard or go home."

As a healthcare provider for children and young athletes as well as for elite athletes, I took many important pieces from this presentation and had a great time.  Looking forward to seeing what the group puts together in 2019!