THE ANATOMY OF TROUBLE
STRATEGIES FOR DEALING WITH YOUR WEAKEST LINK
My left ankle is my Achilles’ heel: I’ve broken it six times. The first time was when I was 16. I was out surfing in Kauai and got run over by a guy on a huge longboard. He had the early morning sun in his face, and he couldn’t see. Ran straight into me. The impact broke my ankle, but then things got worse. I had to walk across this reef to get to shore, which caused the bone to break through my skin.
Since then I’ve snapped my ankle so many times that I’ve had some fairly dark moments wondering if I’d be able to surf again. There’s nothing like a potentially career-ending injury to make you think. I recall times when I did things like cut casts off because they felt uncomfortable or played tennis on a broken leg. I haven’t always been 100 percent smart about healing, but over the years I’ve come to learn what works and what doesn’t. I’ve had a fair number of injuries where I’ve had to sit and watch giant swells go by—when you’re hurt and you can’t use your body, you quickly stop taking it for granted. These days, my left ankle works just fine, and I think that’s due to a combination of luck and these strategies.
EARLY MOBILITY AND CONSTANT MOVEMENT The first thing I do for any kind of foot or ankle injury is head directly for the sand. Walking in loose sand is the ideal way to slowly strengthen the muscles and help recover a sense of proprioception, or feel for movement. The important thing is to do it barefoot, with the sand as your only support. That way your body works to stabilize your movements. If sand isn’t available, most gyms have balance boards (or slabs of foam) you can stand on that will deliver the same sensation as sand. Anything that allows you to rock in any direction works for rebuilding ankle strength. In general, when rehabbing injuries, my theory is to be aware of your weakness, but don’t coddle it
ICING Ice is a miracle cure, although it took me a while to learn that. Swelling is inflammation, which means the body’s in a defensive mode rather than a healing one. Gabby and I both use a cold therapy system called Game Ready, which uses NASA spacesuit technology to deliver pressurized icing to the wound. It’s high-tech and supereffective, but when it comes to icing, you can go as low-tech as a bag of frozen peas and still do your body some good.
NATURAL TREATMENTS I use comfrey and arnica, both of which you can find at any good health food store. Comfrey is an herb that promotes healing of cuts, burns, bruises, and broken bones; its name comes from the Latin word conferta, meaning “grow together.” Comfrey contains a naturally analgesic compound called an alkaloid (codeine is also an alkaloid). Use comfrey as a compress or a salve—don’t ingest it. Arnica is a plant that’s been used for medicinal purposes—to reduce muscle aches, bruising, and inflammation—since the 1500s. It’s applied as an ointment or taken internally as a homeopathic remedy.
Another amazing natural product is Wobenzym. It’s a proprietary mix of enzymes, created by a pair of German scientists in the ’60s. It’s also the most popular pain medication in Europe, used extensively for arthritis, joint pain, and injuries. Enzymes are critical for every chemical reaction in our bodies, and though internally we produce our own supply, the body’s efficiency at doing this diminishes with age. Wobenzym’s ingredients work synergistically to help the body heal itself, breaking down harmful proteins that cause inflammation.
ACUPUNCTURE Acupuncture is a traditional Chinese medicine technique of inserting tiny needles into the body’s energy meridians. Western medicine is also beginning to incorporate its theories, which have their roots in neuroscience—the acupuncture points are places where you can stimulate nerves, muscles, and connective tissue to boost your body’s natural healing activity. If you don’t think acupuncture works, you probably haven’t tried it. In my experience, it’s powerful stuff. The key is to get a great practitioner—ask around for a recommendation.
HYPERBARIC OXYGEN CHAMBER This therapy is becoming standard practice for athletic injuries—many sports medicine clinics have them on site and use them to speed the recovery process. Basically, you’re lying in a pressurized cubicle, which delivers a much higher concentration of oxygen into your body and therefore into your bloodstream. When the red blood cells are saturated with oxygen, injuries heal at a much faster rate. After my ACL reconstruction, I went twice a week to a clinic in Santa Monica, which rents these chambers by the hour. If you look around your area, you’ll likely be able to find one.
OCEAN THERAPY I’m a big believer in the healing properties of the ocean and made a point of immersing my ankles every day when they were healing. If the ocean isn’t nearby, pour some sea salt or Epsom salts into a bucket or bathtub and soak in it. The trace minerals and elements in the salt will be absorbed through your skin.
DROPPING IN
NEAL S. ELATTRACHE, MD
In the past, if you busted yourself up, you were told to rest, lay off of it, apply a little ice. Not anymore. The goal of the best doctors now is to get you up and moving the injured body part as quickly as possible. In 2006, I had my first operation, a reconstruction of the anterior cruciate ligament (ACL) in my knee. My surgeon was Dr. Neal ElAttrache, head of the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. His client list includes athletes from the NBA, NFL, NHL, and Major League Baseball; Olympians; dancers—all kinds of people who put high-performance demands on their bodies. Here, in his words, is his advice on how to heal.
Make It a Priority Everyone has demands on their time and obligations they have to attend to, but it’s critical to dedicate yourself to recovery, at least for a brief period of time. If you’re distracted, if you’re not goal oriented, if your mental outlook is to fight the process or be intimidated by the pain—it sounds simple, but you won’t do well. If you do the right things with regard to diet and exercise, you will do well. And a positive attitude helps immensely.
Get Moving Good physiotherapy is critical. For every moment you spend immobile or inactive, it takes twice as long to get back to where you were. And a lot of bad things happen in the process. For me, getting the patient up and moving is paramount. Now, whenever you have structures that are difficult to heal—like tendons, ligaments, or bones—you have to balance out the need for mobilization with giving the tissue a chance to become strong enough to mend. One of the ways we’re addressing this is by improving our surgical procedures so they’ll better withstand the rigors of movement.
Lifestyle and Diet Play a Role For healing, bone mineral supply is very important. The proper minerals are calcium, phosphorus, and magnesium. Vitamin C is critical to bone health as well. In general, keep your diet high in protein, vitamins, and minerals.
And whatever you do, don’t smoke. Smoking is a big problem. It affects vascular health, and it’s devastating to tissue healing in the body. When you’re mending bones and joints, you’re counting on tiny blood vessels—microvascular circulation—to be able to transport every bit of oxygen they can to the injured area. It’s not like you’ve got big pipes of blood bringing that oxygen in. When you smoke, that microvascular circulation is the first thing to go. That’s why in smokers you see a higher incidence of disk-related back problems and more difficulty healing bones and tissues. If you don’t smoke and you’ve kept yourself in good physical condition, your blood vessels will thank you.
Consider the Future of Healing The new frontier is to enhance the biologic process of healing. We’re doing things like isolating the growth factors from blood, concentrating them, and delivering that to where it needs to be. You’re going to see stem cell–related biological manipulation happening over the next several years. It will really speed up the healing of injured tissue. It’s a very exciting time. Kids born today are going to see amazing things done with tissue healing, cancer … things that could significantly lengthen people’s lives. Now how we deal with one another as human beings when it’s possible to really lengthen someone’s time on earth, that’s going to be a whole different problem.
