Exiting the Pain Cave: Checking in on Courtenay McFadden’s Post-Op Recovery

Sometimes Commitment Means Sacrifice

Picture this. You have an emotionally and physically draining job that you’re relatively new to, but you’ve dedicated to and put your everything into it. You blow your goals out of the water. That makes sense, because you’re not only passionate and talented, you’re a darn hard worker. And because of your commitment, you’re now toe-to-toe with the absolute best in the field — those that you’ve admired for years. You’ve come further than you ever expected, and anticipate another year of strong returns ahead.

But something terrible is clawing at you. Every time you go to work you experience (or on the best days only anticipate) crushing stress. You know that something is very, very wrong, and try as you might, you can’t ignore it. It affects your ability to concentrate, limiting your productivity and putting doubts in your mind about how long you can continue performing at this level.

Do you temporarily give up your success to address it, or do you continue pushing onward?

The Decision of a Lifetime

Elite racer Courtenay McFadden faced this decision last year, as a nagging hip pain affected her racing, training, and everyday life. McFadden had reaped the benefits of committing her energy to racing full-time: it was a breakthrough season in the elite ranks for the PNW racer, and she racked up an impressive number of UCI points in the 2016/2017 season, and finished 15th at the 2017 World Championships.

But it wasn’t without more than the normal amount of pain and suffering that comes with ‘cross racing. Last April she beautifully and heartbreakingly shared that her suspicions were confirmed: the hip pain she had experienced for years was a labral tear. At the top of her ‘cross career so far, McFadden explained why she opted to have the “minimally invasive” “elective” surgery to repair the injury.

“I should be able to run across the airport for a tight connection and not be limping 5 minutes later and then pay for it for 3 days after the flight. I should be able to be a tourist in a city like Rome and be able to walk around on cobblestones without grabbing, pulling, sharp hip pain. I shouldn’t have to think about my hip before I step up onto a tall ledge. I shouldn’t have back pain at 31. I shouldn’t have to put my car on cruise control on the freeway because the simple act of pushing on the gas pedal irritates my hip.”

But more than that, McFadden was warned at her consultation appointment that if she did not have surgery she was likely to develop arthritis due to wear at the joint, which would likely require hip replacement at an early age.

McFadden has shared a lot of her racing and recovery triumphs and tribulations on her blog and Instagram pages (including photos of the tear itself), but CXM caught up with her to fill in some of the details and see how she was hanging in there:

Cyclocross Magazine: Had you been through surgery before? Or cared for anyone who had been through a surgery? How was it easier or harder than you thought going into it?
Courtenay McFadden: Up until this, I had never had surgery before, I’ve never broken a bone, and I think the longest I’ve ever NOT been active my entire life was three weeks back during my freshman year of college. I haven’t ever cared for anyone who’s been through a surgery either. My Dad has had bilateral hip replacements, but I never took care of him. The weeks leading up to surgery I wasn’t nervous at all, I was actually really excited to get my hip fixed.

It wasn’t until I was lying in the bed waiting to go into surgery that I started to freak out and get really nervous. I had heard from a lot of people how difficult the surgery, rehab, and recovery would be. I don’t think anyone really could have prepared me for how hard it’s been so far. Much like when I had [a dye injection to check for the tear] I heard the dye hurt, but it was, at the time, the most excruciating thing I had ever experienced. I was in pain for days. I don’t think we can fully understand something, until we experience it ourselves.

CXM: Where are you in your recovery?
CM: I’m just over three weeks post-op. I still can’t do a whole lot, I can’t actively move my own hip yet, so all my range of motion comes passively from someone else, like my husband or PT or awesome neighbor, moving my leg in circles. As of Thursday, March 2, I’ve been able to put 50% weight down on my surgical side, so that’s opened up some doors for me. I can stand in the kitchen now and prep my food, but need someone to bring it to me once I’m situated. On Thursday the 9th I get to learn how to walk!

It’s wild to think that just over four weeks ago I was racing Worlds, running up the steep hills in Luxembourg, and now I have to learn how to walk again. What’s been pretty cool is the surgeon said the best thing I can do for rehab and recovery is ride the bike, so I’ve been on the spin bike since day seven post op, twice a day. Today I rode my bike on the trainer for the first time! That was pretty big!!

CXM: People who have surgery often feel guilty for how much they rely on their friends, family, community — are you experiencing that, and how are you working through it?
CM: I haven’t felt too guilty (yet) relying on people. My husband has been my primary caretaker. He’s a firefighter, so he works 24 hour shifts and then has two days off. For the first 12 days post surgery he was home, except for 1 day, and my mom came to help on that day and cooked a lot of meals for the freezer, to make both of our lives easier. So I had 24 hour help for nearly two weeks. I have some awesome neighbors that have helped out with rides to PT and Acupuncture appointments — I can’t drive since surgery was on my right hip — awesome friends and clients that have brought over meals for me, and friends and family that have come over to help when Chris works. From running my own cyclocross program, I’ve learned that if you don’t ask for something you don’t get it, and people always want to help, and if they don’t, they’ll say their busy. I think it’s important in the end, that you say thank you, and when it’s time, you pay it forward.

CXM: What do you expect from the upcoming cyclocross season in terms of race attendance, results, etc.? Any favorite races that you wouldn’t miss? Similar question… You have done plenty of cross country and trail racing in summers past — what’s on the agenda for this year?
CM: Of course I would love to answer this with “I’m going to be just fine and crush the next cyclocross season.” But it’s very unknown. My surgeon told me people typically don’t feel normal again for one to two years post surgery, but you can go back to full activity at six months. I don’t really know what to expect for the upcoming season, I’m going into it as I would every year with my eyes on the same races—U.S. World Cups, select European World Cups, C1 races, and select C2s—I’m just mentally preparing myself that I might not be in the best shape at the beginning of the season, but hopefully come into better form for an end of the season peak.

Most cyclocrossers are now back on their bikes prepping for whatever spring season they’re going to have, and I’m currently lying in bed asking my husband to move my leg for me and spinning on a spin bike in my slippers twice a day. My all-time favorite race is Jingle Cross, I kind of wish is was in November/December again, but it’s cool that it’s a World Cup, so I’ll take it anytime of the year!

“Most cyclocrossers are now back on their bikes prepping for whatever spring season they’re going to have, and I’m currently lying in bed asking my husband to move my leg for me and spinning on a spin bike in my slippers twice a day.”

I’m pretty bummed to say, I’m not sure what kind of cross country season I’ll have. My surgeon told me he would most likely dismiss me to ride outside at two months post-op, but only on my road bike. He didn’t mention when I could ride off road again, he just said it has to wait because of the vibrations from riding single track, you don’t want to that ruining the surgery. I’m hoping after four months I’ll be able to ride off road, but who knows, time will tell. I’m hoping that come June or July I’ll be able to get out to some cross country races, which could really help with some base building for ’cross. As for what races I’ll do, who knows. Right now I’m focusing on healing, smiling, and being positive on the toughest of days.

CXM: What kind of conversations did you have with your sponsors, if any? Do you have many of the same sponsors this year?
CM: I’ve been very clear with my sponsors that I’ve had hip issues, they know, I told them I was having surgery, I’ve updated them on the process. It’s the time of year where we start to discuss next year, so next year is still in the works. [smile]

CXM: How have you been spending your recovery time, aside from PT — any book/movie/TV recommendations?
CM: My recovery time consists of lots and lots of lying in bed! I can’t do much, and when I leave the house my hip gets really uncomfortable, so I haven’t left the house much except for my appointments. I’ve surfed through the first 2 seasons of “Girlfriends Guide to Divorce”, the 3rd season the “The Royals”, I’ve started watching “This is Us” and will probably get through it soon! I’ve started the HBO series “Big Little Lies”, it’s morphed from a book from one of my favorite authors. Of course I’ve been keeping up with the usual sitcom shows on Hulu, I love “Modern Family”, “How to Get Away with Murder”, “New Girl”, “The Mindy Project”, and other shows on those lines. I’ve whipped through a couple of books “Three Wishes” by Liane Moriarty. I love all her books, easy to read, author of Big Little Lies. I’m currently reading “The Perfect Girl” – it’s eh. I’ve spent some time playing the Wii, our neighbors come over and we play Mario Party to pass the time.

I’ve also met a couple of other people who have had the same surgery around the same time as me. It’s nice to chat with people who are going through the same experiences as me. It’s like being a part of a secret club, like I said, until you experience something, you truly don’t know what it’s like.

It’s nice to chat with people who are going through the same experiences as me. It’s like being a part of a secret club, like I said, until you experience something, you truly don’t know what it’s like.

CXM: Do you have a comedic (dark comedy or not) story or two you’d like to share, from your race season or surgery?
CM: I don’t think I have any funny stories from the season, aside from racing the Fiuggi World Cup. Did you watch it? That was like the cyclocross circus.

As far as from surgery, I have a couple good ones! Since I’ve never had surgery, I’ve never had general anesthesia, when I woke up after surgery (literally dreaming of cyclocross) a nurse was hovering above me and asked my pain level. I didn’t know how to respond so I said 5 and then she jammed something into my IV. She transferred me from one bed to a chair, and then to another bed, where another nurse asked me my pain level. I looked at home and told him I wasn’t dying, but it hurt less than it did the first time I was asked, so maybe a 5, and the other pain was a 7. So then he jammed some more stuff into my IV. At this point I was feeling awful and nauseous and kept thinking I was going to throw up. After sitting there for over an hour, I decided I felt a little better and I could get dressed and leave. So my husband and I went to the bathroom to change (I was put in a wheelchair) and once he was wheeling me out, that horrible vomiting sensation came back, so they handed me a ziplock bag and I threw up in the middle of the recovery room in front of all the patients recovering. The nurses started panicking and spun me in circles because they didn’t know where to put me and didn’t want the other patients to start throwing up. Sorry that was graphic, but I found it hilarious.

On post op day four I finally decided (upon being prompted from my husband) that I should shower. I was all doped up on pain meds that made me feel awful and dizzy, so showering sounded scary, plus I was only 20lbs weight bearing, so I would have to mainly stand on one leg to shower. Towards the end of the shower I started to get to the point where I was going to pass out. My husband sat me down on the tub, grabbed a couple of towels and carried me sopping wet to the guest bed (where I’ve been camped out) so I could lie down. It was very very eventful. Needless to say, after that I got a shower chair.

Also, going through surgery is pretty humiliating! After having surgery, I watched video of what my surgery looked like for seven minutes before I was grossed out. OMG, I’m SO glad I didn’t watch it before! In order to get to the hip capsule they have to dislocate your hip, and they do that using what’s called a traction device, so they put you in these stirrup looking things, with a pole between your legs and then they go into surgery. So embarrassing!!!!! I don’t know if I can look my surgeon in the eyes again!

CXM: Most importantly… How do you think your cat will recover from all of this? Snuggle deprivation is a real thing!
CM: Oh Nugget. I think some days she’s sick of me, and some days she can’t get enough. I’m sure after being being gone so much from racing, she’s been making up for all the lost snuggles! In the end, I think she’ll be okay, she has over six months to enjoy my company before the next season! I think I might be the one missing the snuggles the most!!!

Best of luck in your recovery from the whole CXM team, Courtenay!