For those of you who don’t already know, two weeks ago I had an arthroscopic labral tear repair, osteochondroplasty, and capsule repair on my left hip. In English, that means I had a minimally invasive hip surgery with a looooooong recovery period. I’ve got 1-2 more weeks on crutches and about 16 more weeks before I’ll be able to run again. I’m planning a series of articles about this for later, but for now what this means is that I have TONS of time on my hands for reading like the #FitNerdPhysio I am!
My latest kill? “One More Step” by Bonner Paddock. I picked this book up at the beginning of summer semester; what I’d come to Barnes and Noble for was actually Kelly Starrett’s “Ready to Run” (more on that to come!), but One More Step caught my eye. Huh, this dude with cerebral palsy climbed Mt. Kilimanjaro? AND finished the Kona Ironman? Umm I’ve seen a good deal of CP in clinic and this seems somewhat ridiculous why have I never heard of him?
BUT REALLY WHY HAS NO ONE HEARD OF HIM??
Bonner Paddock was born with mild spastic hemiplegia; so mild, in fact, that it took the first 11 years of his life to diagnose him. For the better part of his adolescent, collegiate, and adult life, he was able to disguise it well. He doesn’t talk about treatment much in his story, but certainly makes it sound like he never really had physical therapy or gait training, even in preparation for Kilimanjaro or Kona….and did just fine (I know, I’m cringing too).
As most of you are aware, the vast majority of cerebral palsy patients are not able to “disguise” their condition. I spent my first two clinical rotations at Duke’s outpatient neuro-pediatrics facility and I saw only one child who was as high-functioning as Bonner. Most children had severe spasticity, few could walk on their own, and some were unable to speak.
Cerebral Palsy is really a blanket term for “brain damage” that occurs in utero in birth. The degrees of damage vary, as do the locations. This is why we see so many varying degrees of cerebral palsy. In Bonner’s case, he was reportedly born with the umbilical cord wrapped around his neck, restricting oxygen to the brain – much like ischemic stroke in adults. Other children may experience head injuries during birth, excessive pressure due to positioning in utero, cell death due to infection, or simple genetic disruptions to myelination, neuronal proliferation, or synaptic connectivity. The child will present a little differently depending on the location and degree of damage, but there are a few characteristic hallmarks of cerebral palsy. Most children present with spasticity in their limbs; “hemiplegia” most often refers to lower limb spasticity (it is rare to see spasticity of the upper limbs only, though this is indeed a possibility), and “quadriplegia” implies that all four limbs are affected. Flexion, adduction, and internal rotation at the shoulders and hips, as well as supination of the feet, are quite common. “Spasticity” means that the muscles (namely, the flexors, adductors, and internal rotators) are firing excessively, or have high tone. It is, therefore, extremely difficult to get someone with CP out of this position, especially if their impairments are severe.
Bonner Paddock dealt with this kind of spasticity, however mild, every step of the way towards the summit of Mt. Kilimanjaro. Every step of the way towards the Kona Ironman. And he was victorious in both attempts, something that most “normal” people can’t claim. HOW?
Bonner’s explanation, and my main point, is that he worked WITH his disability rather than against, around, or through it. He took two years to train for the Kona Ironman to allow his body to recover and adapt at it’s own pace, altered his cycling mechanics, and raced HIS race. That’s what allowed him to finish. In fact, if he had tried to work against his CP, mold his body into something it wasn’t, attempted to keep up with “neurotypical” athletes – he would have surely failed.
The message? . No one should place limits on themselves. One can argue that this is unrealistic, that of course there are limits – but I think that the true limits of our bodies are not as low as we tend to set them. Bonner’s point is key here:
We must ACCEPT our flaws, work WITH our bodies, and find SOLUTIONS. We cannot succeed by ignoring our problems, working around weaknesses, or grinding through.
This is an empowering idea. For me personally, I have always wanted to run marathons. The idea of an Ironman doesn’t sound like torture to me, it sounds like fun. I love gutting it out for hours on the bike, I love every step of the long run. But, I tore my labrum. And after that, I tore my other labrum! I’m in the early stages of rehab following my second hip surgery, and I might be facing a third. I’ve had surgeons, PTs, and other runners tell me that “running is hard on your hips”, “your body is clearly not built for running” and the kicker:
“you will probably never run a marathon”.
I don’t say this to compare my body’s issues to the pitfalls associated with cerebral palsy. Not at all. My problems are purely orthopedic and I know how lucky I am in that respect. But reading this book has me all kinds of :
“I’m gonna prove ALL Y’ALL wrong. Get at me, marathon!”
Bonner Paddock’s story gave me the idea that maybe I don’t need to fight my body anymore. I don’t need to grind through injuries like I have been the past ten years of my athletic life. I can work WITH my body, train ACCORDING TO my hip joints, and I can PROBABLY run a marathon someday.
The keys are ACCEPTANCE and PATIENCE. I’m actually writing this from my continuous passive motion machine (LOL), so I don’t expect to be running that marathon anytime soon. I’m a relatively normal, healthy 27 year old, but because of what my hip joints have been through, my training will likely take longer. It will probably look a lot different than “traditional “ run training. I will need to be on my A-game with soft tissue work and especially with strength and conditioning. I will not be able to do it alone. I will need an awesome coach, and a killer physical therapist (or at the very least, my own physical therapy education).
But I’ll probably be able to do it.
Moral of the story? Your limitations aren’t what you think they are. Find yourself a world-class coach, and a physical therapist, who understands the concept of working WITH the uniqueness of your body. Have patience, be okay with trial and error, and find YOUR flow, no matter what your condition, medical diagnosis, or roadblock is.
To find out more about Bonner Paddock and his foundation, which funds health care initiatives for children with disabilities around the world, visit: