"Pop" goes my calf, and Hyrox 24 along with it

I was elated last year when Hyrox first came to Singapore. However, that excitement turned to disappointment when I realized I would be overseas during the race date. When registrations opened in March this year for their second race, I immediately signed up with my brother to participate in the doubles. Since last year, we have been intensifying our training to prepare for the brutal race. We did long runs on weekends to build our aerobic endurance, strength training during weekdays to enhance our strength, and practiced components of the race like the rower and wall balls. Things were going well. I even attended a workshop by Erg Army to learn how to row more efficiently. However, everything changed with a "pop."

The ‘POP’

It was April 9th, one day before Hari Raya, a welcomed mid-week public holiday. After finishing my workday, I headed to the gym. I began with a warm-up routine of mobility and stability exercises, followed by skills training on the rower to dial in my ideal drag factor. The plan for the day was simple: rowing and strength work with the sleds. After rowing, I loaded 50kg onto the sled and completed two sets of 10m. Then, I increased the load to 100kg and completed two more sets of 10m. During the last 5m of my final set, I felt a twinge in my right calf, similar to the sensation when a guitar string snaps. That's the "pop" I often hear my patients describe when they tear a muscle, and I finally experienced it myself. My calf immediately weakened, preventing me from pushing off. I knew I had torn something. I limped to the side to assess the situation, palpating from the Achilles tendon up towards the calf. Tenderness was only present in the middle of the muscle belly of my medial calf. I performed the Thompson test, and thankfully, it was negative. My tendon was still intact. As a physiotherapist, I knew I wouldn't recover in time to compete in the race in June, and my dream of Hyrox 24 vanished the moment my calf popped.

Initial Emotions

Besides the physical pain that accompanies any injury, a rush of other emotions follows. First, there's regret: "If I had rested more between sets, it might not have torn." "If I had kept to 50kg, it might not have torn." Then comes guilt: "I have let my teammate down." "Will I let my clients down if I can't work?" And there's frustration: "I had to forfeit the registration fees for Hyrox." "I can't even walk, let alone train as usual." It's natural for these emotions to surface, but it's crucial not to dwell on them for too long. A different mindset and emotions are needed for recovery to occur.

Bye RICE, Hello PEACE & LOVE

Traditionally, the acronym RICE has been used to treat acute injuries:

Rest

Ice

Compression

Elevation

However, the latest approach is PEACE & LOVE, with PEACE used for the initial days after the injury and LOVE used thereafter:

PEACE:

Protection: Avoid activities and movements that cause pain during the first few days.

Elevation: Elevate the injured limb to reduce swelling.

Avoid anti-inflammatories: Refrain from taking anti-inflammatory medications as they can affect the natural healing process.

Compression: Use compression garments, guards, or taping to reduce swelling.

Education: Avoid unnecessary passive treatments and medical investigations; let nature take its course. Patients should be educated on diagnosis, prognosis, load management, and effective management strategies.

LOVE:

Load: As soon as symptoms allow, encourage gradual loading of the affected limb and return to normal activities.

Optimism: Stay positive and trust the process. Setting realistic expectations will prevent negative behaviors and attitudes and promote recovery.

Vascularisation: Engage in activities that increase blood flow to the area to aid recovery.

Exercise: Helps regain mobility, stability, and strength.

The "O" in LOVE wouldn't be included if it weren't essential. Without optimism, we may become stuck in anxiety and rumination, focusing on the 'what-ifs' and 'if-onlys,' diverting our attention from the present and the necessary steps for recovery. Acceptance is crucial before optimism can take root. accept the fact that the injury has already happened and time machines are not available at the current moment. Nothing we do can change that fact. Keeping in headspace of ‘if onlys’ and ‘what ifs’ demonstrates that acceptance has not happened. Healthcare professionals play a vital role in fostering optimism, understanding physiology, and the healing process. Seek help if you struggle to maintain a positive outlook during recovery.

Despite having to give up Hyrox 24 and shifting from training to rehabilitation, I look forward to regaining function in my calf and eventually competing in Hyrox when the time is right. For anyone recovering from an injury, know that you are not alone in this journey. Stay positive and optimistic so you too can take the next step in recovery.