CAT FITZGERALD, PT & DPT
Setting and adjusting expectations come with the territory of working with injured athletes. It’s something I have to do with my clients on a daily basis, typically throughout the entire day. So when it came to adjusting my own expectations for my own injury, you’d think I’d be a pro. (Hah).
About 10 months ago in December 2019, I had pretty serious knee surgery. It was planned–I have had chronic issues with my left knee since my early teenage years. Through a combination of unlucky genetics and participating in sports for my entire life, my patellofemoral joint had become severely arthritic. The tipping point was the 2018 NYC marathon. The weeks leading up to the race and the race itself is a story for another time.
It took me a long time after the marathon to fully accept that it was time for surgery. I had succeeded for so many years with conservative treatment! If my knee acted up, I adjusted my PT routine accordingly and the problem was solved. Maybe not quickly, but it always returned to “baseline”.
Once I finally came to terms with reality and scheduled the surgery, I started to plan for the long rehab process that would follow. I would be out of work for 7 weeks and knew how debilitated and dependent on other people I would be early on. I got all of the “stuff”: a lap desk, a shower chair, a thermos to keep my meals warm, extra pillows to elevate my leg. It was incredibly helpful to have my husband, also a physical therapist, and my mom, a nurse, around to help me.
So even though those first two months were really challenging (I think I slept entirely through the night two or three times), I knew what to expect and saw it play out that way. The mental hurdles came later for me, and I know I have some more ahead.
Despite repeatedly telling myself to expect setbacks and that progress isn’t linear, I still couldn’t help anticipating how long it would be until I could start a return to run program. I even started to think beyond that to running goals. This anticipation and internal build-up of expectations were setting me up for disappointment.
After some disappointment in my “expected timeline” and running into a few setbacks (stubborn joint swelling that would just not go away), I was pretty dejected about my ability to run in the future. Would I be anywhere near these expectations I had been thinking about? Couple that with the state of the world and I can confidently say I wasn’t feeling optimistic.
The good news is that I was able to get a bike. I cannot express how freeing it felt to move quickly outside under my own power. I was never a huge fan of biking because it was uncomfortable on my knee, but now I had a better joint to work with! I was surprised at how much I enjoyed it.
I’ve always done my best thinking during the long run; it’s simultaneously meditative and productive. One morning during a longer bike ride I was listening to a podcast with Hilary Allen. She is an amazing ultra/sky runner who literally fell off a mountain and sustained huge injuries. (It’s worth noting that I am in no way comparing my planned surgery to Hilary’s near-death experience!) I was listening to her describe the ups and downs of her recovery process and how she realized she had to accept that she didn’t know how things were going to turn out. And she was excited by that!
A lightbulb went off in my head when I heard this. For some reason, I thought of a bright beam of light traveling straight through the darkness. That beam of light can represent your progress with an injury, or on an even bigger scale, your life. Right until this moment, I had always considered (not consciously) injuries or hard times in life as deviations off of that path… maybe the light detours or goes backwards for a bit or does loop de loops. But during that bike ride, I realized that those moments are actually on that same, continuous path forward. I pictured them as bursts of light, like fireworks, along the way.
In this frame of mind, there are no setbacks, you just don’t know what’s going to happen next. What will “full recovery” from my knee surgery look like? I can’t be 100% sure. But I have accepted that and I am excited to see what does happen. I have already been surprised to enjoy biking and am excited to see what else I discover.
I have truly let go of any expectation of what “fully recovered” looks like. I don’t plan out any timelines or think about potential future races. I wake up each day welcoming the unknown, a lesson emphasized by the backdrop of the pandemic. It took a very long time for me to get here, but now that I’ve arrived, I understand fully letting go of expectations. It’s freeing and exciting, and I want everyone to experience it.