Injury part 2: the psychology of fear

The physical challenges of recovering from an injury are just half the battle. Here I look at much trickier issue, the mental aspect

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THIS post was much harder to write than the previous one, it’s also more important. Recovering from an injury is hard. Physically it’s pretty simple: rest it, elevate it, regularly move my toes, ankle and knee to keep it mobile, and trust to modern medicine and my own body that it’ll heal properly. The psychological side is a whole lot more complicated.

Being in almost constant pain is incredibly emotionally draining. By the end of the day I’m exhausted. Some days I feel like I’m not coping very well. Saturday (10 December) was bad; Sunday (11 December) was much better. Monday (12 December) was up and down: from joking and laughing to sobbing in a matter of moments. I spent much of Saturday in tears, while the pain was exceptionally high.

And the smallest thing can set me off. The Chap has to bring my clothes down for me. He brought cycling socks by mistake and I said they were the wrong sort. He quite reasonably asked what difference it makes. It doesn’t, not really, but it did matter to me and I was in tears.

On top of that I’m worried that it won’t heal properly – that I’ll do something wrong and tear it open again or I won’t get full mobility back so I won’t be able to do all the things I want to. I’ve always been very independent and very active. As well as cycling, I go to yoga a couple of times a week and do a lot of walking. I’d be devastated if I could no longer do all of this.

I’ve already missed out on two things I was very much looking forward to: The Nutcracker at the Royal Opera House and Peony Pavilion at Sadler’s Wells. The first would have been my first-ever trip to the Royal Opera House and my first-ever traditional ballet. The latter was a production by the Chinese National Ballet and looked like it would be absolutely beautiful. I was to go with my mum and she went with my aunt instead, so the tickets didn’t go to waste, which I’m very pleased about. But I’m so incredibly disappointed that I didn’t get to go.

I understand that it’s unlikely that the wound will re-open or that I’ll never walk again; my mind is just being melodramatic. When I’m already feeling down and tired, though, it’s hard to fight off such negative thinking.

It was a pretty bad injury that’s going to take a long time to fully heal and coming to terms with that after being generally very fit and healthy is difficult

Physical activity is a big part of my life. I use it to stay healthy, fit and happy. Exercise helps keep my depression at bay. So not being able to do it is worrying. I’m also concerned about putting on weight. Not really the time to fret, I know, but I can’t help myself.

I love cycling. The thought that it might not be in my future worries me. It’s not so much the physical ability – that I can build up again. No, it’s the fear. When it comes to getting back on the bike, will I be able to? At the moment when I think about my bike I see that stretch of road where I came off. I shudder and wince. Fear goes right through me. What if I can’t get over that?

I’ve always been a pretty fearless cyclist. I cycle through London rush hour traffic every day; I’ve done 100-mile rides; I worked out a route and rode from Walthamstow to Windsor on my own. My bike gives me so much joy, and I am truly scared that I could lose that.

I suspect I’m suffering some sort of post-traumatic stress. It was a pretty bad injury that’s going to take a long time to fully heal and coming to terms with that after being generally very fit and healthy is difficult. We live in a world where we expect everything to happen instantaneously and that breeds impatience. I’ve got nothing but time in which to sit and brood about what could go wrong.

There’s no quick and easy fix. Telling myself to stay positive is all well and good, but how? Mindfulness meditations help as they keep me in the present, whereas these fears are all about what’s already happened, and therefore unchangeable, or the future, and therefore unknowable. Keeping busy also helps, and I’ve got on hand books, writing, knitting, free courses from FutureLearn, even designing a website. I know also that when I do climb back on the bike I need to take it carefully. Short rides on quiet roads with no time constraints and build up slowly to where I was before the accident.

One thing I’m going to try is ‘silver lining’. This is something I came across recently and it involves looking for any positive outcomes from bad experiences. Not in a pseudo-spiritual ‘everything happens for a reason’ or ‘the universe made this happen because …’ way, but rather identifying concrete examples of good results. It’s a bit too soon right now, but one possible upshot could be unlimited amounts of zen-like patience …

Injury part 1: the accident and the aftermath

I wasn’t going to do this, but writing is therapeutic for me and I feel the need to get it all out. In part one of my examination of my recent accident I look at the physical aspect: what happened and how I got fixed

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A note on photos: the first photo is just my leg in a bandage. It’s suitable for all. At the very end of this piece there’s a photo of the knee after the stitches came out. This is more 12A than U. If you’re squeamish you might not want to look. The photos of the open wound are definitely not for putting here, but I’m happy to share them if anyone wants to see them …

AS some who read this blog already know, a couple of weeks ago – on 22 November – I came off my bike. I’ve fallen off a few times before, but nothing like this. I’m not entirely sure what happened. One minute I was cycling along going onto the cycle path from the road (surely a safety-conscious move?) and the next I was sliding along the pavement unable to stop myself.

I hadn’t hit the curb (it was a drop curb) or a rock or wet leaves. I wasn’t going overly fast. I wasn’t weaving in and out of traffic. The bike just went from under me. All I can think is that I hit a patch of diesel. Part of me wishes I had been doing something stupid or dangerous; at least then I could look to what I’d done and not do it again.

I hit the ground hard and my momentum dragged me along on my left knee. A woman taking her kids to school stopped and offered to call an ambulance. A couple of police officers offered to call their van to take me home. I declined both. I wasn’t far from home and was sure I could easily get back. Some schoolgirls even stopped and offered me a drink of water. Walthamstow really is lovely sometimes.

So I walked for a bit and then got back on the bike and cycled home. I honestly thought that all I’d done was skin the knee and knock it about quite badly. I even sent a text to my boss saying that I’d just fallen off my bike and I’d be a bit late for work. It wasn’t until I got my cycling leggings off that I realised how wrong I was. There was gaping hole in my knee about 13cm across, 5cm wide and almost down to the bone. “I need to go to A&E,” I told The Chap, in a somewhat understated manner. He took one look and panicked. He tried to phone for an ambulance but couldn’t remember the number …

He did manage to get through but they wouldn’t come out, so we had to call a cab. We also needed to wrap the wound somehow, but have any bandages so had to rip up a T-shirt and tie that round my leg, Rambo style. The drive was awful. We were in peak drive-the-kids-to-school time and there were roadworks; every bump in the road jounced my leg, causing me agony. I didn’t cry, though.

A&E was much like you’d expect: lots of waiting around while I was seen by a succession of nurses and doctors. I was given some codeine for the pain. The wound was x-rayed and properly bandaged. We also took some photos so that different doctors and nurses could see what had happened without removing the bandages every time. I’ve still got the photos; they’re grim.

Eventually we got to see the orthopaedics doctor, and that’s when the bombshell was dropped. The wound was too big to sew up under a local anaesthetic, I was going to have to have surgery. “And I want to keep you in overnight,” she concluded. This was when I started crying. Up to this point I was convinced that they were just going to stitch me up and I’d be back at work within the week. It didn’t occur to me that I might not be going home that day. I’ve never had surgery, never even had local anaesthetic never mind a general, and never spent the night in hospital. I was terrified.

My bandaged knee after the surgery. You can see the bruising and where they had to draw an arrow
to make sure they operated on the correct knee.

The doctor added that she would be happy with me going home if we promised that if there was any change or if blood came through the bandage we would come straight back. She left the room to give us a bit of privacy. I was sobbing. “I just want to go home,” I said. So that’s what we did. It wasn’t my best decision. I settled down on the sofa, had some lunch and was about to turn on Netflix, when I thought I should just check the bandage, just in case there was some blood, convinced there wouldn’t be. You can probably guess the next bit. The bandage was soaked.

“I think we need to go back to A&E,” I said. So for the second time that day The Chap called a cab and off we went for more sitting around. When we saw the orthopaedic doc again, she looked at me and asked “Can I keep you in this time?” I could only nod. So we waited in A&E for a bed to come available. It took hours; apparently there’s a shortage of beds across the whole of the NHS.

It’s weird being in hospital overnight. Lights go out at 11pm, but it’s never truly dark. It’s never truly quiet either and I’m so very grateful for a friend’s advice to take earplugs. The nurses were also taking blood pressure readings and so on at regular intervals through the night. They’re very careful but it’s hard not to wake up. Another thing I’m grateful for, as it meant I was awake at 2am, the last time I could eat anything in order to have the surgery that day. I had a banana.

The doctor who was to perform the surgery visited me on his rounds that morning. He assured me they would try to see me in the morning, but they couldn’t promise anything. I was also seen by an anaesthetist who turned out to be a cyclist too – the first thing he asked was if the bike was ok – and the pharmacist, who was pretty hot, so that cheered me up somewhat.

I spent most of the day in a blind panic about the operation. I even had to do an emergency calm mindfulness meditation, which really helped and I’d recommend it to anyone in a similar situation. I use the Calm app and it really does work. I’m currently working through the 21 days of calm meditations. In the end I went down for surgery at 3pm, by which time I’d not eaten or drunk anything for 13 hours.

I was totally blown away by the professionalism, compassion, respect, patience and kindness demonstrated by everyone with whom I came into contact

The anaesthetists put in a drip, which was an odd experience. I’d been feeling very dehydrated but almost immediately that went away. They also asked how I was feeling. “OK,” I said. “Just very scared.” They reassured me that they would look after me, and they really did. In fact all the staff were fantastic. I was totally blown away by the professionalism, compassion, respect, patience and kindness demonstrated by everyone with whom I came into contact. It might be self-evident that people in caring profession are likely to be, well, caring, but it’s not until you actually experience it that you realise just what that means.

After I’d come round, the cycling anaesthetist came over and agreed that it was indeed a very bad injury. Then I was wheeled back to the ward. The Chap was already there. My notes said I could go home if safe, but there was no way that evening. So I had another night in hospital. And the next morning brought more sitting around as I waited for orthopaedics to release me. One nurse: “I’ll phone up to them again. I’m so sorry – I wish I could do more.” I went home around lunch time.

So now, almost three weeks later, I’m confined to the sofa, being looked after by The Chap. I’ve had the stitches out; the knee is constantly painful and I’m on all kinds of painkillers. I still can’t walk without crutches, but I’m trying to keep bending my knee, ankle and toes just to return a bit of movement. It’s not easy. It hurts and I’ve been very emotional; I’m going to talk more about the psychological aspect in part two of this post.

Below the line is a photo of the injury after the stitches came out. If you don't want to see, turn away now.

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It's not that bad, but you can see the extent of the wound and the bruising around it. 

London to Paris day 3: Arras to Compeigne, 16 September 2016

Currently confined to the sofa with an injury, I look back to the third day of September’s epic London to Paris challenge

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Distance: 122km
Average speed: 17.1kph
Maximum speed: 48kph
Elevation gain: 875m
Biggest climb: 193m
Time: 7:03

THIS was the most enjoyable day for me. Body and mind were prepared for another day’s riding, and it certainly helped that this was a shorter and flatter ride. The wind had dropped, too, and importantly after lunch we would be out of the monotony of the agricultural landscape and into forest.

But what made the most fun, the most pleasurable, was the best descent I’ve ever experienced. We were warned that there was a challenging climb straight after the lunch stop at Hallu. But maybe I was getting more used to ascending, because it just didn’t seem that difficult. And the reward, the descent, was simply amazing.

The road itself was super smooth – as were most of the French roads – making it easy to really pick up the pace. It wound gracefully through the forest, zig-zagging nicely, and was just about the right steepness. It was so much fun - at the next rest stop everyone, even the mechanics, asked how much we’d enjoyed it. The answer? Very, very much!

The most fun, the most pleasurable, was the best descent I’ve ever experienced

The landscape was much more inspiring on this day. We cycled through some gorgeous little villages, while going through the forest was amazing.

It wasn’t all great, though. That pain in my thigh had migrated to my left knee. It wasn’t prohibitively bad, but it was almost constant. I was also tired - I noted that my recovery time following climbs had increased. I hadn’t really got any slower on climbs, but getting back up to speed after them was definitely taking longer.

Our lunch stop at Hallu was right next to this very picturesque church.

It was at this point that I – a confirmed atheist – was thanking God for my Threo cycling shorts. Almost everyone was complaining of pain and rawness ‘down below’, some even had the most awful-sounding sores and blisters. I was feeling about as comfortable as is possible after three days of seven hours in the saddle. I’m not in any way affiliated with Threo, but I would highly recommend checking the company out. The shorts really were good - excellent fit, comfortable to wear and with a chamois that really did the job.

The day ended in the town of Compeigne. Tomorrow would bring the final day of the challenge.

London to Paris day 2: Calais to Arras, 15 September

And so the challenge continues. Day 2 brought its own difficulties, but by the end we were well over halfway to Paris

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Distance: 136km
Average speed: 18.6kph
Maximum speed: 49.9kph
Elevation gain: 1,159m
Biggest climb: 205m
Time: 7hrs 19 mins

Following a substantial breakfast and the morning’s briefing we set out. In many ways this was the hardest ride for me, both physically and psychologically. It was the first time I’ve ever had to get back on the bike after a long, challenging ride the previous day. I’ve done longer rides in a single stretch, but always had the next day off. On this occasion I had the prospect of another long challenging ride ahead of me.

It was also quite a big distance with a significant amount of climbing – though less than the route down to Dover. What’s more, the landscape we were riding through was less than inspiring. We were in agricultural country – big flat fields stretching from horizon to horizon with little in the way of hedgerows or copses to break up the monotony. Add to this a head wind that was so strong at times that I wasn’t picking up any speed on declines and all in all this was to be a difficult day.

The flat, agricultural landscape was less than inspiring and didn't distract from the head wind at all.

Quite early on I developed a pain in my left inner thigh. Well, more of a niggle than a pain, but I could feel it on every down stroke with my left leg. I suspect it was mostly caused by tensing up the previous day due to feeling somewhat stressed. The fact is that while I do love cycling and taking part in these challenges, I get very nervous about the task in hand and about meeting lots of new people, which tends to stress me out. It’s just the way I am and I accept it. I won’t let it stop me doing the things I want to.

This was the hardest ride for me, both physically and psychologically

Lunch was at Westrehem, and I’d like to take this opportunity to say how impressed I was with the lunches provided. The food was pretty carb-tastic (not a criticism!), with lots of pasta and potato salad. But there was also greenery and tomatoes, cold meats and veggie quiche. For afters there was cake and fruit, plus snacks in the form of energy bars and packets of crisps. There was even tea, coffee and hot chocolate. I often find that veggie choices are lacking on events like this (and even in London restaurants at times), but that really wasn’t the case here. And all of this was served from the back of a van!

We arrived at the hotel with time for a shower and a rest before having dinner as a group. This was our first opportunity to properly get to know some of the other people on the challenge. This isn’t my strong point, so I let Biking Buddy Claire do the talking. Everyone we met was lovely, though, so it wasn’t too hard for me.

After a celebratory glass of wine, I headed off to bed for an early night in preparation for the next day.

London to Paris day 1: London to Dover, 14 September

My epic 300-mile charity ride from London to Paris started from the Hilton in Croydon. Here’s how it went

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Distance: 133km (including the ‘missing’ 32km)
Average speed: 17.9kph
Maximum speed: 50kph
Elevation gain: 1,239m
Biggest climb: 194m
Time: 5hrs 41 mins (not including the missing 32km)

My London to Paris adventure began a day early. The ride was to leave at 7am on 14 September from the Hilton London in Croydon. So rather than try to get there first thing in the morning, I decided to stay overnight in the hotel. A good move, as it meant I could register that evening, have a hearty pasta meal followed by an early night and be nicely rested for the ride. I also picked up Biking Buddy Claire’s welcome pack as she wasn’t due to arrive till much later.

Getting ready to go. That's my Felt bike, Florence, in the background and Biking Buddy Claire's Specialized at the fore.

After a 6am alarm call, we packed up and went down for breakfast. Lots of breakfast – we had to cover 40 miles before lunch. Then we retrieved our bikes and listened carefully to the briefing, before heading off in a group.

Each day’s ride had a lunch stop and two water and snack stops, one before and one after lunch. Our welcome packs included a very useful little booklet that had a breakdown of each ride and a description of the route and areas we would pass through.

I was somewhat concerned to learn that there would be no ride guide – we were to follow the yellow route markers and the GPX routes on our Garmins and phones if we had them. I was convinced I’d get hopelessly lost, despite having all the routes on my Garmin. My fears were totally unfounded. The routes were exceptionally well marked and while most of us went wrong at some point we quickly righted ourselves.

The first day was the most challenging. This section was the longest and involved the most climbing – much more climbing than I’d previously done in a single day. Which meant I got a new personal record on Garmin Connect. Yes, these things do matter to me. Unfortunately, however, my Garmin froze so the first 32km or so of the journey weren’t recorded; I had to add them manually.

We cycled on quiet lanes through quaint villages, passing several of Kent’s famous oast houses

We were quickly out of London’s suburbs and into the Kent countryside. The route took us to Dover via the North and South Downs. We cycled on quiet lanes through quaint villages, passing several of Kent’s famous oast houses. Lunch was at Chart Sutton. I was seriously impressed with the food on offer on each day. There was plenty to choose from even for vegetarians.

The pace we stuck to was quite a lot slower than I’m used to and had I been on my own I would have gone faster. But it’s not a race and it was probably a good thing to not overdo it at the beginning. The weather was fantastic – sunny and warm and most importantly dry and still.

At Dover we waited for the whole group to arrive so we could board the ferry to Calais. We had dinner on the ferry; some of the group took the time to indulge in a well-earned beer. At Calais it was a short ride to the hotel, where we left our bikes with the support team, grabbed our cases and went straight to our rooms for a shower and bed.

Dover! BBC is keeping everyone up to date with our progress.

I was tired, shattered in fact, but feeling good and strong. The next day was to be our first ride in France, leaving at 8am.

The joy of group cycling

Usually a solo cyclist, I’ve recently been going on some group rides. Here’s why, and a look at some of the benefits I’ve noticed

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I do most of my riding on my own. Try as I might I just can’t get The Chap interested in cycling. Or at least not cycling as much as I do. I’m fine with this. I’m not the most outgoing of people so I’m perfectly happy to ride alone. I’m happy to go out for 100km or more; I’m happy to cycle to a local coffeeshop and have a quiet drink and read of my Kindle.

But even I sometimes think it would be nice to have a friend along. Or several. To share the ride, the scenery, the cake. Well, maybe not the cake. They can get their own. So when a group ride from London to Brighton – a route I’ve wanted to do for some time – popped up on Twitter I had to follow the link.

At the top of Ditchling Beacon. I did walk right at the end, but I'll be back to conquer it. 

It took me to Dirty Wknd. There I found a fully guided ride to Brighton, including train ticket back to London, for just £30. I signed up and almost immediately the fear set in. What if I couldn’t do the distance? What if I couldn’t keep up? What if none of the other riders like me? How would I get to Richmond Park in time? How would I get home afterwards?

All these fears – and others that I haven’t mentioned – are unfounded. Getting there? Well I could just ride, or I could I use the very efficient and friendly taxi service that’s right on our doorstep and which has transported me and my bike several times before. The distance? It’s not even 90km and I’ve done 160km with no trouble. Keeping up? That’s the point of a no-drop policy.

My confidence has grown and grown – I’ve even applied to be a Breeze Ride Champion

As the ride got closer, my anxieties increased. Luckily I have a really good group of friends who knew exactly the right thing to say. Thank you – you know who you are.

When it came to it the ride was, of course, fantastic. Everyone was friendly; it was totally professional yet totally fun; no one got left behind and I had no issue keeping up or finishing. Although I have to confess to walking the very end of Ditchling Beacon. But that just means I have to try again. Since then I’ve done London to Cambridge and several evening rides to Epping with the Dirty Wknders. Those anxieties still surface, but that’s just the way my brain works and I’m not going to let that negative worrisome part of me stop me doing the things I want to do.

The end of the ride: Brighton Pier.

Change of pace
Walthamstow has got a pretty active cycling club, the Waltham Forest Cycling Campaign. They run several rides during the month and I’ve been meaning to go on one for ages. I always manage to come up with an excuse not to, though. But when the August rides appeared on Facebook, there was one to Wallasea Island, an RSPB reserve in Essex, which I thought would make a great training ride for London to Paris.

It turned out to be a great exercise in how experiences shape expectations. The website said “a train-assisted ride to Wallasea Island”. I assumed this would be a case of riding to Wallasea and then getting the train back; a ride of around 65km. It turned out to be a ride to Stratford station, train to Rochford and ride from there. Then a walk around the reserve before returning to Rochford and catching the train back to Stratford and finally riding back to Walthamstow – a total of about 40km. Not quite the training ride I had in mind!

But you know what? It was still great fun. The riding was lovely: great views, great weather, great people. Wallasea Island is very much a work in progress but will be a fantastic reserve one day. It was a complete change of pace from the Dirty Wknd rides and I’ll be going on more WFCC rides.

There are so many positives to group riding. I’ve met a great bunch of people who love cycling just as much as I do. But it’s more than that. In just a few weeks I’m faster and fitter. On the Brighton ride I stayed with the slow group. I don’t know if I could physically kept up with the fast group (I suspect not), but psychologically definitely I couldn’t have done. By the Cambridge ride, though, I was more than happy to go with fast group. I kept up and more importantly had the self-belief to know I could. I’m also a more considerate and aware rider, with a greater understanding of where I should be on the road and where others are.

The mudflats at Wallasea Island. 

My confidence has grown and grown. I’ve even applied to be a Breeze Ride Champion, something I’ve wanted to do for a while but been too scared to actually go for.

I’ve also picked up some great tips. Like if you’re putting your phone in a jersey pocket, wrap it in a plastic food bag first to protect it from sweat. Mount your Garmin so it’s in line with the stem so it’s easier and quicker to access. I even realised I’d been putting my saddle bag on upside down for months.

So for all my introvert ways, I love group riding. I want to do more of it. There are plenty more Dirty Wknd rides to get involved with. Then there’s weekends away, including what looks like an amazing trip to Sardinia. I can’t do the October one, but there are plans for one early next year.

Training plans

Preparation for my London to Paris challenge is about to kick up a gear as I take on two long(ish) rides this weekend

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London to Paris is six months away. How do I feel about this? Pretty confident at the moment. I spend a lot of time on the bike, so I’m OK with my general fitness. But that doesn’t mean I don’t need to train. So for this coming weekend (18-19 June), I’ve decided to up my game a bit.

Because I commute I’m used to riding across multiple days. Recently I’ve been doing around 32km per day, but this is nowhere near the distances of 100-130km per day I’ll have to do for Paris. It’s time to spend the whole weekend cycling. I have signed up to a London to Brighton ride (86km) on Saturday and the Tour de Waltham Forest (40km) on Sunday. These distances are still way short of Paris, but they’re a good start.

This is me starting off The Only Way, a 100-mile ride through Essex last year.

London to Brighton is organised by a company called Dirty Wknd. It costs £30, which includes full support and a train ticket back to London. They’ve also booked lunch at a fish ‘n’ chip restaurant, but it looks like there’s no veggie option, so no good for me.

The ride starts from Richmond Park, so I’ve got to get myself across to west London, but this should be simple enough as there’s an overground train from Highbury & Islington. I think it’ll have to be a case of getting a taxi back. I should have a couple of hours to spend in Brighton, which can either be mooching around on my own or sticking with the group. Guess it depends on the group …

The Tour de Waltham Forest is a free ride and cycling event organised by the London Borough of Waltham Forest. There are three rides: Bronze, an 8km ride for families; Silver, a 13km ride for families; and Gold, a 40km ride for the more experienced cyclist. Obviously I signed up for Gold. It starts from the Olympic Park at noon and should take two to three hours.

There’s still just about enough time to sign up for either of these events if you’re interested

The weather for the weekend is currently looking good – cloudy but warm, which is perfect cycling conditions. Riding is fun, but it’s not so great in the wet. I’m looking forward to this challenge. It’s great training for London to Paris and will be a real achievement.

If you haven’t sponsored my London to Paris ride, please remember that any donation is very much appreciated. You can donate here.