Oct. 29--We Americans love our extreme fitness and sports. We fill adventure race rosters and CrossFit boxes as fast as they open, spurring an explosion of greater -- and more extreme -- offerings. Death Race, anyone (www.youmaydie.com)?
And while enjoying the benefits of physical activity, we've also racked up injuries. Words like rhabdo (which few people had heard of before recently) are popping up as exuberant athletes are discovering the delights -- and dangers -- of shattering their limits.
On a hot summer day in Louisville, Ky., 44-year-old motocrosser and P90Xer Chad Scharlow set out on a mountain bike race. The first lap felt good, he said, although his heart hammered violently. Then, "I passed out on a downhill. ... I woke up the next day with a breathing tube and a catheter, in ICU." His limbs grotesquely swollen, Scharlow had rhabdomyolysis, a potentially lethal condition that can result from overexertion and dehydration. He was hospitalized for two weeks, endured six more of dialysis, lost 25 pounds and had to start over just walking. Rhabdo is an extreme example, but injuries are all but inevitable for many athletes and fitness buffs who push too hard.
So when injury comes knocking, what next? How can the most breakneck among us transition from the all-out school of fitness to one more sustainable? How can recovering extreme athletes work around injuries suffered during their phase with the cult of fitness?
First, it might help to consider what's behind the excesses. "We caused this with the no pain, no gain BS," said Erika Mundinger, a physical therapist at TRIA Orthopaedic Center near Minneapolis. She sees the results of overzealous athleticism daily.
"We have this mentality of 'push through it,'" Mundinger said. When it comes to people playing through pain and injury, "They say, 'Isn't he an amazing athlete?'" she said. "That is the stupidest thing we could do. We cheer them on and say they pushed through it. But at what cost? We're sacrificing short-term achievement and recognition for long-term investment in our health and well-being."
Often compounding this mentality are professionals urging their charges on. "There's a lot of well-intentioned trainers who just don't know any better and then a small percentage who are willfully ignorant," said coach David Dellanave. At his gym, The Movement Minneapolis, "people who have experienced the cost of extreme fitness are something we get a lot of."
So when an injury puts the brakes on your fitness pursuit, is it time to say goodbye? "With people who do extreme exercise, it's their addiction," Mundinger said. "When you tell ultra-marathoners they have to stop, they will break down. They need that runner's high. And it carries over (to other sports). The solution is not telling them to stop but to modify."
"I think you can almost always go back to what you were doing if that's what you loved," Dellanave said. "It comes down to ... doing it the way you should have in the first place, which is working in your limits." When athletes go to extremes, he said, they aren't listening to their bodies' signals. When approaching their sports after physical setbacks, they must "'pregress' rather than progress," pregress being a term he coined.
The simple language change helps with client psychology, he said. It means preparing the body properly before moving on and taking note of what works for a person and what doesn't.
Most people need help learning to pregress. And finding the right professional is critical. "It can be tricky," Mundinger said. "An amateur personal trainer may not have the proper education as to what you need to modify, so you might get more hurt."
The trouble is, "people don't ask enough questions. They don't advocate for themselves," she added. So what should you ask your trainer or physical therapist?
"Not, 'Can I run again?'" Mundinger said. Instead, "What can I do, in the meantime, to help me get back to it? What kind of game plan can you set out for me?" Then "use your gut instinct. If you go to someone two to three sessions and you see zero gains, you're with the wrong person. Get out."
Your commitment can influence your outcome. "Treat recovery with the same amount of passion and time and effort," said Erin Beresini, author of "Off Course: Inside the Mad, Muddy World of Obstacle Course Racing." "Make that your sport, and that's how you will come back."
This time, start where you are, as Dellanave cautioned. Listen to your body, but figure out what that means. "Everyone pays lip service to (that idea), but no one knows what it really means," he said.
"Intuition is great." Dellanave said, "but if you don't have informed intuition, you can't rely on it." He relies on biofeedback. Using tests such as range of motion and grip strength, Dellanave helps clients assess what they shouldn't be doing. "To me it's a no-brainer. It takes two seconds; it gives you actionable feedback." He teaches clients these skills, so they can become self-sufficient.
And if that can happen, maybe fewer people will end up facing the crushing loss of a sport. It will take teamwork, though.
"We need to educate trainers on how to know if clients have a legitimate pain issue ... to not push to that level," Mundinger said. She also hopes to see coaches and athletes start a new anti-no-pain-no-gain trend.
"I think we're starting to tap into it," Mundinger said. "People are finding ways to use biofeedback to guide their training. They're learning that fatigue and pain are real indicators on when to hold off."
And, she added, "eventually people are going to just get really tired of getting hurt."
Or, perhaps, find other reasons to dial it back. Before rhabdo, "I didn't know where to stop," Scharlow said. "We've always been taught push, push, push, and you'll get better every time." Back in racing form, he promised his wife he won't push his limits again. "I have two young kids. I want to make sure I'm around."
Dana McMahan is a freelance reporter.
