Category Archives: Injury Prevention

The Elephant In The Room

If you’re still out there, following my blog, thanks!! And hello after a long break between blogs. I’ve been silent for a while, busy recovering from that “elephant”. The thing we all face when we play derby, but don’t like to think about. I talked a blue streak about it in my blog and while providing strength and conditioning for new derby recruits and my team. INJURY. Sure, we all get bruised, bumped, and sore. We see other girls break legs, arms, collar bones, fingers. But it won’t be me, right? Before my accident (and after), my league had a string of leg breaks – I still never thought it could happen to me. They aren’t inevitable, right? But playing roller derby definitely ups the risk. While it’s true that most breaks are the result of the accidents that happen in our full contact sport, we still need to be as prepared as possible; mentally, physically, and financially.

Here’s my story.

On February 12, 2013, I had double practice. A normal Tuesday night occurrence for Cherry City girls on our travel team. All league scrimmage first and then travel team practice. After months on travel team I was finally feeling a little better about my endurance and skills. During the last 15 minutes of practice we were working on scrimmage-type drills. While working on blocking the jammer, I was knocked out of bounds, and quickly jumped back in to try and get back on the jammer. Instead of landing on the bottom of my foot, I landed squarely on the outside of it. I both felt and heard the bone snap in my lower leg. I went down and didn’t get back up – I knew something was broken. I’m lucky – my home team captain and fellow travel team skater is an emergency room nurse. A couple of other skaters are also nurses and medical personnel. I was splinted and iced very quickly, and only sacrificed a sock and shin guard.

Yep, broken.

Yep, broken.

I’ll be honest – I freaked out. But not for the reasons you think. Yes, it hurt. However, I was lying on the floor, hyperventilating about not having medical insurance, not the pain. I couldn’t work broken, I’m a fitness instructor! No way can I demonstrate exercises with a broken leg! How can I afford not to work?!? My husband was unemployed at the time, and I was really only working part time. Money was tight. How would we pay the rent? Would I have to have surgery like those before me? That had to cost thousands of dollars… round and round by brain went. Thankfully I had a team member who figured it out quickly and reassured me that broke people can apply for charity programs. J I finally got my breath back and put it out of my head for then. Did I want an ambulance? No! My ER nurse was willing to drive me to the hospital. First way to save some money. On a side note, this is the person you really want to go to the ER with. No waiting, you go right back! My husband had been called, he’d meet us there.

Yes, I was wearing this when I broke my leg!

Yes, I was wearing this T shirt when I broke my leg! I didn’t actually bleed though!

I remember that ER visit like it was yesterday. The funniest moment was when I was getting x-rayed. My ER nurse/team captain and my husband got a peek at the screen, and I saw their faces drop. I wasn’t surprised, I already knew it was broken. As I was wheeled back to my room, they conferred in the hallway about if they should tell me before the doctor did. I guess my husband drew the short straw. After he told me, I told him I already knew. Clean break of the fibula. The ER doctor said it probably wouldn’t need surgery, and gave me a referral to an ortho. This is where skaters need to be smart. ER doctors are NOT orthos. They really don’t know the best way to treat your break, especially if they don’t understand your sport. I received a much different plan and prognosis from the orthopedist. See an ortho!

I spent the next six days trying to see said ortho. Turns out the specialty clinic I was trying to get into was busy trying to verify my nonexistent medical insurance. I finally talked to someone in the business office and clarified that I was uninsured. I saw my ortho on Monday and was scheduled for surgery the next morning, a full week after the break. I now have a plate and 5 screws on my right fibula. My ortho felt it was the best way to support the bone, as well as pull the tibia back in place, which was displaced (and missed by the ER doc). He also said I had torn tendons in the front of my ankle. The fall had also created a wicked ankle sprain, which took much longer to heal than the bone. Get insured if you can, it will streamline your care.

I’d never broken a bone before. I’d torn the  meniscus in my knee years ago, and the experience is not even close. I’d never been this immobilized. The nurse on duty that night wouldn’t let my team captain splint me, and her splint was all wrong. I didn’t sleep for the first 24 hours after the break due to the pain, and ended up going back to the hospital for a new splint. It’s easy to let the injury take over your life. I couldn’t work. I hadn’t walked on crutches for 20 years, and it had only been a couple of weeks then. You lose your mobility quickly. I was so excited when I was loaned a scooter, only to have to spend a week working on bending my knee so I could use it! Simple things like going to the bathroom become an event.

I wondered about my ability to return to derby. In my experience, it was everyone’s first question for me. My answer was, “I’m focusing on walking again first”. Of course I wanted to return. When you play roller derby it’s in your blood, right? But I did question it, every step of the way. I’m thankful for my fitness training, as I wasn’t able to see the physical therapist on a regular basis. I just couldn’t afford it. I was on a “cash discount” payment basis with the physical therapist, and had to pay every time I went in. The discount isn’t a big deal if you can’t afford anything. So I asked for a substantial home exercise program, and saw the therapist every few weeks to check in and upgrade my exercises as necessary. I was dedicated to my exercises, which is actually rare, and why most people see their therapist two or three times a week. It turned out that when I got back on skates was my decision. When I asked the ortho and therapist about it, they said you’ll know when you are ready. So helpful!

Sorry for the lamp. This is how you take pics when you're high on pain meds.

Sorry for the lamp. This is how you take pics when you’re high on pain meds.

I waited six months. The bone was long healed by then; I’d been working on healing the ankle sprain and strengthening my ankle. I was slowed down by my jobs. Fitness training and working retail kept me on my feet on surfaces that were not conducive to healing. I went back to recreational skating first. I skated around my neighborhood, and went to our league’s rec skates. We don’t have a local rink. This is where recovering skaters can make a big mistake. Six months off, with little to no exercise besides rehab, does not prepare you to go straight back to practice, especially team level practice. I started with level 1 practices. In our league, this is actually pre-fresh meat. We take gals that can’t even skate. I was nervous about falling, and didn’t have a plow stop anymore. Let’s not even talk about my footwork skills. But I had a plan – I was bouting with my team in January.

I spent the next five months refreshing my skills, getting back to home team practices. Frustrating is too light a word for it. I’d spent so long carrying all my weight on the right leg as the left was healing, that the plantar fasciitis I already had in my right foot was exacerbated. My right hip started bothering me too. An old back injury resurfaced. My skating was all over the place, hit and miss, depending more on how my foot felt than my ankle, while also dealing with back and hip pain. What was I doing? Was derby realistic for me? Breaking a bone in your 40’s is not the same as doing it in your 20’s. During this time I also started coaching our level 1 girls, on top of the newbie boot camps I ran every three months (I’ll have to write a separate blog on running a boot camp two weeks after breaking my leg… that was an experience!). I was also training more, teaching more classes and working with more clients. I kept pushing, even though the doubt was always there.

My first bout back was last weekend in Washington against the Hellbound Homewreckers of the Dockyard Derby Dames. I can tell you I was super nervous! I’d had a pretty good scrimmage the previous Thursday with my league, but I had pushed hard and was very sore, and had some pretty severe foot pain. I wondered if I would even be able to skate. Friday after work was recovery day – ice, foot soaks, stretching, special exercises for my feet, lots of rolling out of my feet and calves with a lacrosse ball. I had to figure out how to protect my forearms, too. I received my first sport court burns that same night in a fall. However, I woke up Saturday feeling pretty good, ready to go.

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We had a great bout, the score was close and went back and forth. We ended up losing, but only by 26 points. As you know, that’s close in derby! We actually won the second half, which is what our coach asked of us at half time. We play them again at home next month and we’ll be ready. I had foot pain after the bout, but was not as sore on Sunday as I thought I would be. Maybe I can do this. I’ll admit, the doubt is still there.

I don’t know if I’ll ever go back to travel team. My goal right now is to continue working on gaining back what I lost. Endurance (always a weakness before), footwork (not the best before, but it was better than it is now!), hard hits (yes, I had those!), and oh yeah, confidence. I need to be a strong skater for my home team first. There are hours outside of practice needed for icing, stretching, soaking, rolling, etc. This is the reality of derby after an injury, especially after 40.

What I have learned from this:

  1. Don’t ignore the possibility of major injury. Plan ahead!
  2. Get insured if you aren’t. XSI.com offers extreme sports insurance that is recognized by WFTDA as medical insurance. It’s cheap. I pay around $20/month. It will significantly lower your WFTDA insurance deductible. Check out what’s available now through the Affordable Health Care Act. Look into Aflac, etc.
  3. Cross train, eat right, quit smoking. None will protect you from an accident, but being strong and healthy will help you heal quicker. Smoking and poor diet will slow bone growth and healing. I healed fast and gained back range of motion pretty quickly thanks to the first two. I’m lucky, I’ve never smoked because I’m allergic to it.
  4. Put some money away if you have no paid leave from your job. Having the financial struggle on top of the physical one creates more mental anguish. Believe me, I’m speaking from experience here!
  5. And here’s an odd tip – get comfortable and “okay” with falling. You’ve been taught to do it right and you’re wearing protective gear. I used to pride myself on never falling, always getting my feet back underneath me. I can’t prove it, but I believe that if I had just let myself go down that night, I’d maybe just have some bruises and an ankle sprain instead of a permanent plate and scar. Literally, learn to roll with it! You’ll practice getting up more often and that will make  you stronger and faster.
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My Off Skates Warm Up Crusade, and, oh, Newbies!!

One of the reasons I love being a Cherry City Derby Girl (CCDG) is that our league takes anyone interested in derby, no matter their skating ability.  Our Level 1 coaches will actually teach you how to skate!  How cool is that? Our newest group includes 24 girls, many who haven’t skated since childhood.  Since our current Level 1 girls are getting ready to start their two day testing cycle that will catapult them to Level 2, it’s Boot Camp time for the newbies!!  Boot Camp includes a functional movement assessment.  You really get a clear view of your own balance while trying to do an inline lunge with a dowel in your hands behind your back! While being functionally assessed can be a little daunting, it really helps new skaters be aware of imbalances that could create injury for them later on.

A main focus of Boot Camp is to teach our skaters proper warm up, workout and cool down exercises.  This not only gets them active before they get on skates, it also teaches them proper form that will help their bodies adjust to skating 3-4 days a week. I really stress the warm up to all of our girls.  Even if you are late to practice, still spend at least five minutes ( 10 minutes is better!) warming up, OFF skates.  Then put your skates on and jump into practice. I know there is a lot of pressure to get on skates and into practice, but think first about how much practice, and maybe bouts, you will miss if you tear a muscle. Plus, warming up can prevent muscle cramps, which really makes a practice painful and frustrating.

So here’s a little science behind my warm up crusade:

  1. Warming up increases the body’s core temperature.  Higher temperatures create the Bohr effect, which improves oxygen delivery. Higher temperatures facilitate oxygen release from hemoglobin and myoglobin, making it more available for use in our muscles.  Think about going swimming in a cold river.  Many of us stick a toe in, say “Brrrr!”, and don’t get in right away.  It works the same for oxygen.  It’s happy to stay bound to hemoglobin and myoglobin when the environment around it is “cold”.  More available oxygen means that your muscles can work longer. Oxygen is absolutely required for aerobic work.  In fact, if you are working aerobically, it means that  you are producing the necessary ATP (your muscle’s fuel) through the use of oxygen. Therefore, more oxygen, more ATP!
  2. Warming up increases muscle temperature.  Warmer muscles are have reduced viscous resistance, which means they move and stretch more easily. This reduces the possibility of muscle tears.
  3. Warming up increases blood flow to active muscles, which in turn increases nutrient delivery to muscles.  Those pathways that create ATP require the necessary building blocks to move forward. More nutrients = more ATP = more work possible!
  4. Warming up enhances metabolic reactions. The metabolic pathways that produce ATP move faster at higher temperatures.  Faster reactions = more ATP = more work!
  5. Warming up creates faster muscle contraction and relaxation.  This means you will can change direction faster, move your feet quicker. The rate of force development increases and reaction time decreases.
  6. Warming up loosens up joints.  Joint or synovial fluid can be more solid when cold, like the fat that solidifies in the frying pan when it cools off.  We’ve all experienced this before when going for a long car ride.  You’re stiff when you finally get out of the car. You need to move a little, your joints warm up, loosen up, and then you feel fine.  When that fluid is liquefied, joint range of motion is improved as well.  You’ll get lower, twist farther and move faster.
  7. Warming up “dusts” off the nerves.  Sport specific movement “wakes up” the neural pathways to our muscles, increasing force production, strength and power.  If you’ve already done some side shuffles, quick foot movements, and a few jukes on  your feet, you are going to respond faster and do them more quickly once you have your skates on.
  8. Warming up also “preloads” the muscles, putting them in the best position for work which = faster contraction. Our muscles work based on the sliding filament theory of contraction.  Two components, actin and myosin filaments, work together to create muscle contraction.  In a preloaded muscle, these filaments lie slightly one over the other, aligned optimally to create cross bridges. A muscle contraction is the result of the flexion of these cross bridges, which pull the actin filaments inward.

Response to Injury – The Derby Girl Way

Warning – I’m about to get on my soap box!! I love my derby peeps, but they are the MOST stubborn when it comes to injury response.  How many derby girls do you know that skate through their injuries?  How many take a day off, and then think they are fine?  Sadly, this is most.  Some of it is just plain stubbornness.  These girls love to skate and nothing will stop them from it.

Let’s take a step back for a moment and analyze an injury response.  Let’s say you sprain your ankle.  You should take a few weeks off skates, depending on the severity of your injury.  But you don’t.  A few days later, there you are, back at practice on your skates.  Your ankle is weak, so you wrap it up tight.  Feels good, right?  Nice and stable.  Oops.  If you’ve read most of my website or listened to me talk about joint mobility versus joint stability, you’ve just broken one of my rules just so you could skate.  So your ankle isn’t healed, and now you are putting stress on your knee by wrapping  your ankle tight.  Your knee starts to ache.  Now you compensate for that through a funny hip movement.  Now your lower back hurts a little…

See the progression?  By not allowing your ankle to heal, you’ve just put the rest of your body at risk!!

Let’s look at it another way.  By getting back on your skates too soon, you don’t allow your ankle to heal.  Now you have a chronically weak ankle.  Say you have a job where you are on your feet all day.  Your ankle is sore EVERY day.  You wrap it all the time.  You and your significant other love to go hiking.  You can’t go anymore because of your ankle.  Wait – you’re still skating though….  But your knee hurts, your back hurts, and you’re even starting to get some neck pain.  You now have chronic pain on a regular basis.

This might sound like an exaggeration, but it is all possible!! We all have lives outside of derby.  How active do you want to be?  You need to consider the future consequences of not healing NOW.  Taking a week or more off now means years of derby and active life later.  Not taking that time to heal could mean years of therapy and inactivity AND a shortened derby career.

I know this is tough!! Depending on where you skate and your derby peers, you may get extreme peer pressure to continue to skate.  Be strong and take care of yourself.  Do what is right for your body.  It will thank you later!