The Diagnosis

I am a scientist. As a scientist, I thrive on answers to problems, and when one is not available, I am uncomfortable until one is found.

My injuries in November were numerous, but the clavicle fracture received top billing since surgical intervention was required. The healing from that was seamless. The true issue at that time, the one that has lingered, was my ribs. I had excruciating rib pain from the outset and I was informed by all that ribs heal slowly and all that was needed was time.

Seven months is a lot of time to wait. Certainly, I have been training and over the few weeks prior to the Rev3 race in Quassy I had amassed enough consistency to feel like racing was a good idea. I was not completely free of pain or breathing problems, but it seemed more of a bother than anything else.

The outcome at Quassy, another DNF due to rib pain and an inability to breathe, forced me into crisis mode. I will detail the events that occurred between Quassy and the diagnosis in another blog. Today, I am going to focus on what the tests revealed.

In short, I have a significant amount of costal cartilage damage around my sternum on the right side including separation of the cartilage from the xiphoid process. There is also cartilage damage on the left side around an area I affectionately refer to as my “third boob” (it sticks out when I lie down, hence the name; it is around ribs 6-10). Additionally, the third boob is probably being caused by vertebral rotations in my thoracic spine. The abnormalities have affected the mechanical function of my rib cage resulting in impaired respiration.

All of this is directly related to the impact of the crash. By the way, you can view the aftermath of the incident tomorrow on NBC when they air the Clearwater race. Apparently they have primo footage of me bawling on the side of the road. Hopefully they removed the f-bombs I kept dropping.

I have been able to execute the training because the hard efforts are doled out in manageable doses with built in rest. A race, on the other hand, requires hard, consistent breathing from the gun to the finish and the faulty mechanics of my rib cage induces the musculature to function overtime. As a result, fluid builds up in the area making the breathing even more difficult and leaves me with swelling and pain.

As coach Phil commented on Sunday, the only way to know that you cannot race is to race.

Cartilage is tricky. It is connective tissue that is found throughout the body. There is no blood supply to cartilage, so growth and repair is slow. Sloth-like. It explains why, after 7 months, things are still not right.

I am uncertain as to what the future holds in terms of racing. I am allowed to train “to tolerance”. I will have to learn patience. I will have to learn how to let go of the anger I still feel. And even though I am teary eyed as I write this, my mind, is at ease for the first time in many months. The scientist in me has been satisfied. Yes, knowing is better than hoping.

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8 Responses

  1. Luis Oliveira says:

    Hang in there and thanks for writing, it's all I can say.

  2. Daniel says:

    Wow… So sorry to hear this. But Luis is right on. Hang in there, train smart. And reading your story has been very helpful. 7 months after Clearwater, my foot still isn't right either. My injuries are minor compared to yours (I was able to finish the race) but it's been difficult not to train for this season the way I'd planned. I have to admit that I still haven't completely adjusted my expectations, but every time I read your blog, it helps. So thanks very much for writing.

  3. misszippy says:

    Sorry! You've had such a long, long road. Better days are surely ahead.

  4. ultimatestamina says:

    Thanks for writing, it helps. As a competitive distance runner I understand. I had major spine surgery in Jan 2010 where they put in 14 screws, 4 rods and 2 plates and fused L3-S1. Yes, I am back running 40-50 miles per week, the intensity increase has been FRUSTRATING. Hang in there.

  5. cwunderle says:

    Joanna – You are an amazing athlete and always will be one! I am so sorry to hear that the rib pain is still present, but am glad that you have been able to find out more information on what is causing it as well as your inability to breathe normally. Regardless, let your body and mind rest and be happy for all the things you have accomplished so far. Be proud of yourself – I know that you have lots in store for the future! Thanks for keeping us updated and take care of yourself!

  6. Mike Greer says:

    Joanna: Thanks for the report and now that you know exactly what the problem is, you can center your positive thoughts for recovery right to that area. I promise to send some positive vibes your way and hope for a speedy total recovery soon. The sport needs you and you are missed.

    Go girl!!


  7. Anonymous says:

    great website!

  8. Anonymous says:

    Sorry to hear about this. I am in the same boat. Bike crash on shoulder has left me re-building my NCAA Div. I swimming fitness from scratch. Leg no better. On the positive side, I'm doing pre-hab so like you – we can hope to race strong well into our 40s.

    Fast, healing vibes.