The pain game: How athletes deal with injuries

Athletes get hurt all the time. Open any sports page or website and you'll see headlines like "Habs' Markov Out Indefinitely with Knee Injury" or "Patriots QB Brady (shoulder) Questionable." As fans, we take injury news for granted or maybe just worry about how it might impact our fantasy teams. We don't feel the pain.

But they do.Just ask three of Canada's best Olympic athletes speedskating gold medallist Christine Nesbitt, bobsleigh gold medallist Heather Moyse, and alpine skier Kelly VanderBeek.

All have suffered a major injury recently. One has returned to competition (in a big way), one is almost back, and the other still has a ways to go.

These are their stories.

Part I: The Injury: 'It was way too much pain'

Both Moyse and Nesbitt got hurt while doing something other than what they're famous for.

Moyse, who moonlights on the Canadian women's rugby team, ruptured ligaments in her right ankle and foot and bruised her talus bone part of the ankle joint while being tackled during the women's rugby World Cup in England last summer.

As a U.S. player grabbed her jersey and swung her around, Moyse's right cleat anchored in the turf, putting the bulk of her weight on her ankle and foot while the rest of her body twisted.

"You know how sometimes if you roll an ankle, you're in absolute pain, but you know if you give it a minute you can walk it off? This was not that," the Prince Edward Islander said recently from her training base in Toronto, where's she rehabbing in hopes of returning to the bobsleigh circuit soon.

"I knew immediately that I was done."

Nesbitt wasn't competing at all when she got hurt. Riding her bike home from a workout at the Olympic Oval in Calgary on June 25, she wasbroadsided by a car while going through a crosswalk. The gold medallist crashed onto the hood of the car, then fell to the ground on her right side, suffering a small fracture in her right elbow.

"He didn't see me, I guess," the soft-spoken London, Ont., native said last week from a hotel room in Norway, where she was preparing for a World Cup meet.

The motorist called for help, and when firefighters first arrived on the scene, Nesbitt wouldn't let them remove her backpack. So they cut it off.

"My elbow took the brunt of the impact, and right away I pretty much couldn't move it," Nesbitt said. "It just felt so weird and it was incredibly painful.

"They wanted me to straighten my arm for the X-ray, and I couldn't. It took me weeks to be able to straighten my arm again."

The side-effects were debilitating, too.

"Even though there was nothing wrong with my hand, I couldn't even write, because my hand and fingers were so swollen."

VanderBeek's injury was the most spectacular looking. Last Dec. 17 (like Nesbitt, she reels off the exact date without prompting), the Kitchener, Ont., native was racing down a mountain in France, practising for a World Cup downhill event at Val d'Isere.

The training run was going well until VanderBeek caught an edge, knocking her off balance. Watching video of the spill later, she saw that she almost recovered three times before finally going down, her legs twisting awkwardly while her skis, cruelly, refused to unclip from their bindings.

"My knee went in a direction it wasn't meant to go," VanderBeek said from Lake Louise, where she was providing commentary for CBC's broadcast of the downhill season opener while she works toward returning to the tour.

The three-time World Cup podium finisher realized she'd suffered the worst injury of her career even before she skidded to a stop. Tests later confirmed catastrophic damage to her left knee: two torn ligaments (the medial collateral and posterior cruciate), a fracture in the tibial plateau, plus a chunk of bone ripped from the lateral (outside) part of the joint.

"The pain was pretty excruciating, and I just knew instantly. It was way too much pain to be anything I'd suffered before."

Part II: The Rehab: 'I'm going out of my mind'

VanderBeek's was the only injury of the three that required surgery. And what a surgery. In a four-hour operation last Dec. 31 (Happy New Year!), doctors reattached her MCL and replaced her PCL with a cadaver's (hope he was a good skier). The damaged bones were left to heal on their own.

The pain in the first week after the surgery was the worst, and VanderBeek continued to struggle for about a month.

"I just slowly sort of got better every week. It was a very slow process, though."

VanderBeek wasn't allowed to put any weight on her knee because of the bone damage, and using her other leg muscles like the hamstring was out of the question, because that could pull on the still-tender healing ligaments.

Then, in March, another round of surgery to clean out scar tissue that had built up in the knee and essentially made the joint useless.

"After that procedure, I took leaps and bounds forward," VanderBeek said. "I had a functional joint again."

"Then it was a matter of working through the pain and getting more range of motion."

Moyse avoided surgery after the swelling went down, doctors decided her ankle had maintained enough stability but not the tedium of rehab.

As a bobsleigh brakewoman, Moyse's legs are her bread and butter. The explosive power they generate is the key to the inertia-defying act of getting a 400-pound sled moving off the start.

Staying off her injured side so long caused Moyse's right leg to atrophy to the point that her right calf and quad shrunk to a noticeably smaller size than her left. One of her therapists raised another concern: the hip on her injured side was likely weakening and losing flexibility, putting it in danger of being injured when Moyse returned to normal workouts.

"My concern was, by the time I'm allowed to start running again [three months after the injury], I'm going to get all these other injuries from the rest of my body not being where it's supposed to be."

To combat this, Moyse loaded up on exercises designed to build her hip muscles. The regimen of leg raises and single-leg balance drills proved excruciating, both physically and mentally.

"We're talking lying on my side doing endless leg races until I was completely fatigued," Moyse said.

But it worked. Moyse soon returned to the weight room and resumed squatting at first with no plates on the bar, her trainer watching closely to ensure she wasn't tilting too much of her weight to her good side, which could cause another injury.

Now she's squatting almost as much weight as before the injury, and though she's still dealing with flexibility issues in the ankle, she isn't experiencing swelling after her lifting sessions.

Still, a couple things curb Moyse's enthusiasm these days: she still hasn't been cleared to resume running, and her bobsleigh teammate Kaillie Humphries began the season without her last week at the Olympic track in Whistler, site of their greatest athletic triumph.

Meanwhile, Moyse remains stuck in the weight room.

"It's been extremely frustrating, especially knowing that my team is sliding," she said. "I want to be out there, especially now that the races are starting.

"I'm itching. I'm going out of my mind."

Nesbitt's recovery would seem the least problematic as a speedskater, how much does she really use that arm anyway? Well, plenty, it turns out.

Think about the start of a race. When the gun goes off, skaters swing their arms furiously from side to side, match their churning legs in an effort to get from a stationary position to top speed as quickly as possible.

"You don't think your arms are the most important thing, but they set a pace and you need them to be explosive off the start," Nesbitt said, offering a challenge: "Try doing a running start without your arms."

Nesbitt discovered another problem when she got back on the ice: speedskaters, like NASCAR drivers, always turn left. That means on every bend, it's the right arm that's swinging.

"After weekends of racing [my right elbow] will be quite sore from swinging my arm," she said.

Nesbitt was luckier than Moyse and VanderBeek in that her injured joint wasn't immobilized for an extended period. Doctors at the hospital in Calgary, after learning what Nesbitt does for a living, opted to forego a hard cast over her fractured elbow in order for her to keep as much range of motion as possible.

But even now, five months after the injury, the elbow still doesn't feel right.

"You know that feeling when your elbow or your knee or your ankle or your fingers want to crack, and then you crack them and it feels better? I get to that point, and it becomes so painful that I can't do anything about it.

"Sometimes I can bend my arm, and then two seconds later I can't do it. It's just so unpredictable."

Nesbitt gets so dialled in during races that she doesn't notice the elbow, but the injury continues to hamper almost everything she does before and after competition.

Even sleeping something most people take for granted became uncomfortable. Nesbitt never realized she liked to doze with a crooked arm until her elbow couldn't bend and she had to sleep with her injured right wing extended straight out.

Off the ice, Nesbitt still can't do many upper-body weight workouts. That's a problem for a speedskater, because while it's not good to be top-heavy, a lean and strong upper body is vital for supporting those massive legs and maintaining proper technique through gruelling races.

"My range of motion is OK when I don't have weight in my hand, but as soon as I try and pick something up with a straight arm, I can't do it," she said. "I just drop the weight."

Nesbitt, who'd never suffered a major injury before, admitted to struggling with her rehab program, which seems to be taking forever.

"Everything they did to my arm really hurt it, and the exercises they gave me really hurt," she said. "My arm was so weak that everything felt like a chore.

"I didn't want to do [the work], but I didn't want to prolong the injury."

Part III: The Help: 'He was amazing to have in my corner'

Nesbitt credits the Canadian speedskating team's "really good" medical and training staff with putting her on the road to recovery very quickly.

"The day after [the injury] happened, I was in physio. They got me in right away, even though I couldn't do anything, just to start trying to reduce the inflammation."

Moyse tips her hat to her "phenomenal" and creative Toronto-based trainer, Matt Nichol, who also helped her rehab from a broken shoulder suffered in a 2008 rugby match.

"He's the best, in my books, at modifying workouts and training not only for the individual person, but also for individual injuries."

VanderBeek's "No. 1 person" was her husband, David Ford, a former world champion kayaker who competed in five Olympics.

"He was helping me get up the stairs, helping me get stuff, helping me with my physio . He was really amazing to have in my corner to help get through it emotionally and physically."

VanderBeek was also floored by the support from her Canadian teammates, her family, and the group of kids who showed up on her parents' doorstep in Kitchener, where she was recovering from her surgery, to sing O Canada to her after her Olympic dream was dashed. The Canadian Athletes Now Fund charity even sent over a package of DVDs to keep her occupied on the couch.

The injury and its aftermath also earned VanderBeek a measure of celebrity she never enjoyed from her athletic feats. She landed a television analyst's gig with CTV during the Olympics and started getting recognized in public for the first time.

"All these things happened that really helped me get through it," she said.

Part IV: The Comeback: 'I have to take baby steps'

VanderBeek achieved a major milestone last weekend at Lake Louise, hitting the slopes for the first time since her injury.

As much as a test of her reconstructed knee, the casual run down a blue-square (the second-easiest level) hill was a reward for all those long, painful hours of rehab.

As a way of saying thanks, she took along her surgeon, Dr. Bob Litchfield, and the Canadian alpine team's head physiotherapist, Kent Kobelka.

VanderBeek gives herself a 30 per cent chance of returning to the World Cup circuit before the season ends in mid-March. But she vowed not to push the knee too hard and jeopardize her ultimate goal: to ski at the 2014 Winter Olympics in Sochi, Russia.

"I have to take baby steps," she said.

Moyse, on the other hand, is certain she'll return this season.

"Definitely," she said. "That's my plan."

If she's cleared to resume running this week, Moyse wants to starting pushing a sled again at next week's World Cup stop in Park City, Utah, which would put her on track for a potential return to competition the following week in Lake Placid.

If that doesn't happen, she'll have to wait at least until after the Christmas break when the tour moves to Europe in mid-January.

"We're just going to play it by ear," Moyse said.

Remember all those concerns Nesbitt had about how her injury derailed her summer training schedule and forced her to deal with lingering pain into the World Cup season? Well, they've vanished.

Nesbitt, bad wing and all, is destroying the best middle-distance skaters in the world. She won both of the 1,000-metre World Cup races held so far, and made it 3-for-3 in the 1,500 last weekend in Norway.

"It's been a real surprise because of the setback in the summer," Nesbitt said. "I feel like I struggled in August and September to get my strength back."

Now that she's off to a perfect start, maybe Nesbitt ought to consider fracturing her elbow every summer?

"Uh, I don't know about that."