Learning to Walk Again

Recovering from a broken pelvis (and broken ribs) has been one of the most challenging periods of my career, both mentally and physically.

On stage 5 of the 2011 Giro d’Italia I crashed in a mass sprint 100m from the line, my injuries included a broken pelvis in two places. This was the medical description of the primary injury; Rochelle sustained a linear fracture of the acetabulum (roof and anterior wall) at the right hip and an underrated fracture at theright pubis bone. MRI also showed a bone bruise at the right ischio-pubis branch and acetabulum.

After the accident I stayed the first night in a nearby hospital (Firenzuola) and had X-rays of the hip and back, and an ultrasound of the hip. The next day I was sent home (to Northern Italy) after just one night in that hospital. The hospital gave a misdiagnosis; possible broken ribs and no broken bones in the hip or back region.

During the next two days at home I developed a fever, nausea, dizziness and severe pain in the hip and ribs. I was very scared. Maybe I had a slight concussion. I felt that I should have been in hospital. I was lucky that my personal doctor from Belgium was able to monitor my condition over the phone and give me confidence that I wasn’t going to die 🙂

6 days later I still couldn’t put any pressure on my right foot without severe pain in my groin, I couldn’t even take one step. Everyday after the accident I tried with determination to walk- as I was assured at the first hospital that nothing was broken. On the 6^th day I took a taxi to the nearest hospital (Feltre, 1hr away) and demanded a CT scan on my hip. You can see in the attached images that the fracture is very clear. You can imagine how upset I was with the first hospital for the misdiagnoses.

I’d lost 6 days of healing time as trying to walk was delaying the healing process.

The specialist in Feltre advised that I stay immobilized at home for 20 days, this meant that I needed fulltime care and couldn’t even move from the couch to the toilet, the only unfortunate, uncomfortable alternative was a bed pan!

Fortunately my mum (someone I’m comfortable around) offered assistance and FULLTIME care during this period of immobilization, what a generous and considerate act. Seriously, I couldn’t do one thing for myself during this period. My mother couldn’t have a moment to herself. I was impressed. That job, 24/7 for 20 days was a massive commitment! I’m so grateful that I was not cared for by a stranger offered by my insurance company.

I can not express how tough this period was mentally; not knowing if I could walk, wanting to attempt a step, looking at my bike wanting to try a little spin. It was so tempting and difficult to resist – but I did it!

During the first 20 days of immobilization I believe the EXOGEN Ultrasound bone healing system/device really increased the rate of my healing.  I used it for 20-40 minutes a day on the site of my pain (in the groin). It’s difficult to know how effective it was but in the end, I healed in record time!

20 days after the crash I was transferred by medics to Milan in order to start fulltime rehabilitation at the PhysoClinic (www.physioclinic.it) The MRI scan to the right shows my scan on day 20.

The next 10 days was an amazing experience. I had a serious, committed and confident specialist controlling my rehabilitation and progression, Dr Gianluca Melegati. I believed in my specialist and followed his orders to the T.

During my recovery post accident I kept constant communication going with my personal doctor and orthopedic surgeon in Belgium for reassurance. Fortunately for me, all doctors agreed on my plan, program and progression.

Rehabilitation Day One

22 days post crash; I was asked to walk into the pool with my crutches and then pass the crutches away. I stood there unassisted (ok, a little assistance from the water). I was then asked to start walking in the chest deep water. My mind was going crazy, I wanted to step forward but fear was stopping me. I felt like a two year old anticipating his or her first ever step. I wanted to but I wasn’t sure if I’d fail and crumble. I was scared. What an immense feeling and emotion. After moments of hesitation I did it! The right leg was very unstable and wobbly but I was making a small step without any pain. As I gained confidence and momentum I started to walk! I walked forwards, backwards, sideways and marched through the water for 30 minutes without any pain – I was smiling the entire time.

Before moving onto exercises in a warmer pool I asked if I could try a few steps on dry land. I passed the crutches away and experienced all the same feelings; mainly the fear of failure and hesitation. Eventually I took a step then another one and another one until I was walking. After about 10 normal steps my fun was ended by the physio saying ok, that’s enough… back on your crutches for another 15 days! Errr, 15 more days on crutches? I had no pain and I could walk! I respected and obeyed my physio’s and doctors instructions.

My program at the rehab clinic for the next 24 days was very similar to day one, only the exercises became more difficult until the point where I felt like I was in a full-on gym strength training phase!

Each day I’d start in the pool for 1hr to gain range of motion through the hip and to do some warm up exercises and stretching. Then I’d move into the gym to increase muscle function, size and strength of the right leg. I was then able to take a short nap in the clinic and grab some lunch before my afternoon session of physio/massage/ultrasound/electro stimulation etc… The day always ended with an appointment with my specialist.

My days became more and more challenging but it wasn’t long before I could start doing rollers before and after rehab. My first spin was in the water 25 days after the accident on an ergo designed for in pool training/rehabilitation. I then commenced with roller training just 27 days after the accident. 31 days after the accident I was doing 1hr on the rollers pre and post rehab. At this point I felt ready to start on the road.

I was transferred out of Milan and onto the lake in Varese so I could do my first rides on a flat quiet road that I knew well.

Once again I was excited but scared. I was still walking on crutches but ready to attempt a one hour ride on the road. My first ride on the road was 33 days after the accident. The ride went well, no pain! (I had to ask my mum to hire an electric bike in order to accompany me on my first 30km trip around the lake!) On the 34^th day I rode for 3 hours without pain. I was finally back in training – until, day 37…. I felt some pain in my right knee.

I jumped on a plane and flew to Belgium immediately to see my knee specialist, Dr Dirk Petre. I didn’t want to risk anything and as he is also an Orthopedic Surgeon I wanted him to check out my hip ROM and stability etc..

He gave me a lot of confidence by ensuring me that my knee was fine (a normal feeling post crash, immobilization and return to training) and he also confirmed that I had completely recovered from thefractured pelvis and would be ready to race on the 20^th of August. I combined my quick overnight trip to Belgium with an interesting Honda Motocross PR event in Antwerp. (web update coming soon)

My training until day 45 post crash (18^th of July) was slow flat riding as I was still not permitted to ride out of the saddle. I’d been riding to gain base fitness only. O’ on day 39 post crash I was allowed to throw the crutches away- yay! (Originally I was told I’d be on them for 45 days minimum).

This was also the day I flew to London for the pre Olympic Games test event, in order to review and study the Olympic Games circuit. The city was closed off to traffic on the Sunday for a men’s official test event/race. Women from most countries travelled to the event to take advantage of the closed circuit and ride thecourse before the men’s official race.

I returned to road training one month after the accident and due to strict orders from my specialist – I rode for the first 15 days in the saddle only! It’s such a relief to now be standing up on the pedals!

My specialists all approved me to start racing at Trophee d’Or this week but given I had only just started riding out of the saddle – on the day the tour started, I decided toskip the race and build slowly into intense training.

I’ve regained and improved on my original strength and stability through the hips, core and quads. I’ve worked extremely hard throughout this period of rehabilitation. I enjoy racing and I’ve really missed it so I can’t wait until I race again at Holland Ladies Tour (6^th-11^th of September).

So, there’s my long detailed story about returning to training after a heavy fall that cracked my pelvis in two places. Whilst it was the toughest 45 days of my career I can confidently say that I made it back, I’m healthy, somewhat fit and injury free – sooner than anyone predicted. The key was staying positive and believing in my body’s capabilities. Nothing was going to stop me from having a shot at this year’s World Championships on a perfect course with a perfect finish!

I’m happy, mentally fresh and extremely motivated. Looking forward to being back in the bunch soon.

Posted in Recovery on August 25th, 2011