By Stephen Miwa and Gina Pongetti
Our focus this month is on one of our most tenacious, driven and dedicated patients to date: Ariana Grymski. She is an elite-level figure skater, with hopes and dreams to, one day, not only make our national team, but also vie for a spot to represent the US at an Olympic Games. In the meantime, majoring in Physics at Loyola and having a small, personalized cupcake baking business on the side fills the hours that she is not at the rink. We have had the pleasure to stand by her in her darkest days and support her to rise to her greatest success, all in the year that we have known her. Through two hip surgeries, over a hundred hours in PT, and countless reps of rehab exercises, she has made an impression on each of us… and will for you, too.
For Grymski, the love of her sport of figure skating did not start from being a natural on the ice. In fact, her love for the sport started when she was two years old at Navy Pier and could not even stand up on the ice without help, but she loved it! Ariana was excited to finally be able to take classes after she turned four, and at first it was just to try and see if she wanted to continue with them. However, it did not take long for her to know that she wanted to keep pursuing skating. Ariana tells us, “I always wanted to get to the next skill level, then the next, and then the next.”
This drive has gotten Ariana to an elite level, but it also cost her a couple hip injuries. Ariana admits, “I was not very good to my body when I was younger.” She continues, “I would work on the same jump for three hours in a row, and the repetitive pounding probably contributed to or caused my injury. This repetition along with not strengthening my muscles before I worked on a skill to prepare my body well was my downfall.” In January of 2014, Ariana’s hips started to hurt chronically. After waiting for almost a year hoping that the pain would go away, she decided to visit one of the best physicians/surgeons in the Chicagoland area, Dr. Sherwin Ho at University of Chicago, to get an MRI. The MRI revealed that Ariana had a labral tear and that she would inevitably need surgery. Often with labral tears, people choose to treat conservatively, or the physician may recommend various PT and exercises pending the location and severity of the tear, the intensity of the athlete, and the sport-specific demands. In this case, for a high level figure skater, often taking up to 8x body weight (according to researchers at Brigham Young University in 2014), surgery was needed. So, Ariana’s hip needed to be prepared to re-enter a sport that was not going to allow her to tread lightly…
After having surgery to repair her torn labrum, Ariana was referred to Achieve for her physical therapy. “At Achieve, the therapists are focused on getting you stronger overall while getting you better,” Ariana says. The physical demands of figure skating are unique compared to other sports, especially in the hips and back due to all the twisting, jumping, and landing while on ice. “Gina and her staff are specialists in skating and performing arts, which is why I found a home here really trying to strengthen my hips and the rest of me specifically for skating.” Ariana continues, “I have now also strengthened my glutes, my hamstrings, and all my other muscles so that I don’t have to put all that stress on just my hips, which may have helped to cause this in the first place.” Weeks into rehab for her first hip, as soon as it could handle demands of being the new “strong” side, Dr. Ho performed surgery on the second hip to combine rehab and overlap recovery time. For a small amount of time, there was no working out… at all. Literally getting from point A to point B was the challenge of the day. Not pushing the first hip too hard to be the stable one was a test of patience for a determined athlete. That patience paid off.
All of the staff at Achieve often take on “helper” roles- in addition to physical therapy- including some psychology, personal training, coaching and more. This involves anticipating and knowing the psychological state of an injured athlete, from fears to boredom, from controlling nervous energy to curiosity. This often includes explaining tolerance of pain through return-to-sport, through rehab exercises, and anticipated small relapses as one return to their sport. While she has been rehabbing with Achieve, Ariana’s way of thinking about pain has also changed. Ariana explains:
“I know better now the difference between a ‘bad’ soreness and an ‘okay’ soreness. An okay soreness could be that I’m working the muscle and it’s a little bit mad at me right now, but if I take some rest it will be fine. Physical therapists always say to take 24 hours. If it feels better in 24 hours then that’s okay because it is just the muscles working. If I can tell that something is going to make me sore for a very long time if I keep doing it, that’s really when you have to stop because that is the ‘bad’ soreness that can cause injuries. I have learned that pain is the body talking to me, and that a smart athlete actually listens. Pushing through it, stubbornly, may give you instant gratification now, but it may also ruin you for later.”
The return to the ice for Ariana wasn’t as easy as she thought it would be. “When I came back, everything was different.” Ariana explains to me that her coaches used to tell her that she jumps with her hips. This means that she was overusing her hips and not engaging the rest of her body, including her posture muscles, core, and arms, when turning her horizontal speed into vertical speed/jump height. “Now I am jumping the right way, but that comes at a cost.” Ariana continues, “I had to relearn the jumps, and that takes time. Gina and the PT’s at Achieve literally broke down every movement, from double leg squatting, to single leg squatting, to jumping and landing…over and over again.” Now for Ariana, her training is about efficiency. “I make sure that every move that I practice, I do with really good form.”
Ariana can now be an example and mentor for others. She is a great example to so many younger skaters at the rink, both under the direction of her coaching staff and others. She tells me that she tries to teach the younger kids to work smart not hard. “You can work hard and skate for six hours just pounding and pounding on yourself, but you could easily injure yourself doing that. You could skate smart for 3, be less beaten up, recover better, and get more out of it with off-ice training, prevention exercises, and rest,” says Ariana. She explains to them that pushing through pain is not the way to train. “Look at what happened to me,” says Ariana. “You don’t want that to happen to you.” For her, spending less time physically on the ice but instead developing her mental skills has been a huge part of her recovery. She finishes our talk with a great summary. “I know my stuff. I do train. But now, I don’t over train. I’m smarter, and I’m healthier. I’m ready for what 2016 will bring me, and beyond!”