Born to Perform

by Gerard Hartmann

  He went back out on the lava fields on the eve of the event, test riding his newly acquired Cannondale, hurdling along Queen Kaahumanu Highway when he should have been resting up.

  Hartmann would go to the start-line the following day.

  “This wasn’t about the race,” he said, “this was about myself and the course. I think this was about facing my demons head to head and closing a chapter for me…” […]

  Inevitably, the 112-mile bike section of the race caused the most discomfort.

  “The accident of the bike cracking was unfortunate, but having to get on a totally different bike was both a mental and physical challenge. Over a 25 mile bike ride, I’d ‘wing it’ but straight on a new oversized bike for a full 112 miles – that poses a big ask. It wasn’t until after thirty miles into the ride that I started to feel sore. I had to stop three times and each time pull over to the side and lie down on the blistering hot tarmac and stretch myself out. At one stop a motor bike with a Course Marshall pulled up and asked, ‘Do you need medical help?’ I snappily replied, ‘No, Sir’ and I jumped back on the bike and rode on. So I had to call on a lot of past experience to get through that.

  “Having worked with great athletes, someone like Paula Radcliffe, for example, [I see that] she draws on a huge reservoir of psychological and emotional strength. All I kept saying to myself during the event was, ‘Okay, get off and stretch for five minutes. The day will end. It doesn’t matter how long it takes to do this event. Forget that you were a competitive athlete. I’m a Joe Smuck, just trying to finish the Hawaii Ironman.

  “I kept repeating to myself, ‘I’m here to finish this sucker.’ That is what I came for. I didn’t come to do a nine or ten hour race time; I didn’t tune in to what anyone else was doing. It was just myself and the event, and on that day I drew on more mental strength than on physical fitness.”

  Hartmann came back from Kailua-Kona not just with closure, having completed the Ironman against all the odds and closing a traumatic chapter in his life. He also returned with fresh challenges.

  18

  Overcoming Injury – Kelly Holmes and Seán Óg Ó hAilpín

  Day in day out, I get asked about the Olympics. In my teenage and young athletic years, I dreamed about competing in the Olympic Games, and wearing the green singlet with the shamrock emblazoned on it. I thought that my legs and athletic talent, along with training like a zealot, would surely secure my entry into the world’s greatest extravaganza.

  In 1991, when I won a seventh National Triathlon title and was considered a world-class triathlete, I was sure I would get to compete in the first-ever Olympic triathlon event. The Olympic family observed how triathlon had become a truly global sport and it looked like the inaugural Olympic triathlon would be staged at the Centennial Games in Atlanta in 1996.

  Indeed, when I broke my hip in 1991 and retired from competitive sport, I fast-forwarded my participation in the Olympic Games: in 1992 I was the physical therapist to a dozen Olympic medallists in what was to be the first of five Olympic Games I have served at to date.

  As it turned out, the first Olympic triathlon was staged in Sydney at the 2000 Olympic Games, and I observed the race with delight, seeing that the sport I had been a pioneer of had come of age and was part of the Olympic movement – yet, I felt a tinge of disappointment that I was not participating on this historic day. My athletic talent gave me so much, but it was to be my role as physical therapist that would allow me to participate as a member of national Olympic teams. Yes, it would have been a wonderful experience to have taken part in the Olympic triathlon, but I get so much joy and satisfaction working with and assisting athletes to compete at their best in the most unique sixteen days of sporting glory that only comes around every four years. As long as my talent allows, I want to contribute and be part of the Olympic Games, because this is something I will always cherish.

  Throughout my 21 years working as a physical therapist, I have often become a source of salvation for many sportspeople whose career has been brought to a halt by acute or chronic injury. For some, I am actually the last resort, and when they come knocking on my clinic door after having tried everything and everyone else, they pin their last hopes on me. Sometimes they are looking for a miracle.

  One of my colleagues and friends is Alan Kelly, the Tallaght-based physical therapist, and better known in the business as “the Great AK”. He has treated many of Ireland’s top GAA players, and when a sportsperson attends Alan with a serious injury, he usually sits them down and says, “I’m going to give you my very best shot at fixing your injury. If I can’t fix it I’m sending you down to Limerick to see the best there is. And if he can’t fix it, I’m sending you to Lourdes.”

  When an athlete is injured, the physical implications are obvious – but fellow athletes, friends, family members and colleagues will be also concerned, wondering how painful the injury is, how the athlete is recovering and how soon they will be back to their sport. So it is always more than the injured part of the body that is hurting; the person inside is also in pain – and that’s an aspect that an athlete is rarely asked about. With injury comes grief, which could consist of anger, depression, fear or frustration. There is a sense of loss. The injured athlete is backed into a corner, and their very identity is rocked and threatened to the core.

  Sport not only forms part of an athlete’s life – it is their life. This is not just in terms of time invested in training and competing, but often their friends and support structures are based on the athlete being fit and physically capable. Sport and training forms a part of the athlete’s everyday life, and without it the routine is broken. Suddenly their main source of stress relief or escape from the world disappears, and the athlete misses the positive daily experiences gained through the act of physical training or competing. That element of the sporting injury is often overlooked.

  The athlete who is injured is like a bird trying to fly with a broken wing. The emotional rollercoaster that some injured athletes experience includes feelings of denial, anger, bargaining and depression. The final stage of the emotional process is acceptance: only when the athlete truly accepts that they are fully grounded and in trouble can they hand over the responsibility of the injury to the physical therapist or other specialist medic.

  The great Irish middle-distance runner Noel Carroll completed an ironic circle by turning to me for treatment after he had once guided me with my various injury problems. He summed up my contribution to injured sportspeople in an interview with the Irish Runner magazine in May 1993:

  Gerard possesses a rare combination of qualities. He inspires trust. He has an almost missionary zeal for what he is doing. He also contributes an additional philosophical basis to the various disciplines he brings together. When the average medic sees figures, Gerard Hartmann sees an athlete. He has been through it himself. You don’t just see him once; he manages the injured athlete through a condition looking at everything, your weaknesses, strengths how you sit and stand. He is providing a service that very few others offer.3

  A number of years ago, an old man stopped me as I exited my practice. “I see all these foreign athletes visiting you for treatment,” he said. “Can I tell you, you must be doing something very right or you are fooling the bloody lot of them.” He made me think. Success in anything in life is probably down to 50 per cent of what you’ve got and 50 per cent of what people think you have got. Perceptions create reality.

  Irrespective of what treatment protocol is employed, perhaps the most important requirement for healing is a relationship between patient and therapist whereby the patient has total trust and confidence in the therapist. This human element cannot be underestimated. Healing takes place the moment the patient fully believes and trusts the practitioner. Doubt creates a blockage, in terms of healing in the mind and at a cellular level. Belief creates a flow of healing. The mind is such a powerful force in terms of healing that, while a therapist must never mislead a patient, persuasiveness as an
ingredient in treating injury can be effective.

  It is well recognised that athletes who think positively and are motivated to do as well as possible in their life and rehabilitation recover more quickly than those with a pessimistic or negative outlook. There are other tools, of course: imagination, creating positive pictures of healing in the mind and repeating affirmations that the injury or illness is healing. These are inner healing aids that all work.

  Research using imagery and relaxation on medically incurable cancer patients demonstrated that 41 per cent of patients showed improvement, with 22 per cent showing total remission and 19 per cent tumour regression. Research has proposed three kinds of imagery that can be used for rehabilitation. First and most effective, healing imagery involves you seeing and feeling the injured part getting better. Second, physiotherapy imagery involves imagining the treatment working, for example, the physio’s deep friction therapy realigning the scar tissue, or the rehab exercises making the muscles bigger, stronger and more functional. Third, performance imagery, involving the patient imagining the experience and sensations of becoming more physically active or returning fully to playing or competition, provides a motivational edge.

  Spirituality is also powerful. I define spirituality as an inner sense of something greater than oneself and recognition of a meaning to existence. Spirituality connects us to our deepest values, beliefs and feelings. It gives meaning and purpose to our lives and affects not just the way we feel, but how we cope with adversity, injury, illness, death and also what lifestyle choices we make. Great champions are balanced in mind, body and spirit. Irrespective of race or religious denomination, all great athletes call upon their beliefs and feelings. Prayer and meditation are an integral part of their success.

  Minutes before athletes step out onto the track at the Olympic Games, they go into what is known as the “call room”, where they wait to be summoned to the start line for what may be the most important race of their lives. I have worked at five Olympic Games, and my impression of the call room is a place where I have witnessed some of the giants of sport humbled and silenced by tension, stress, fear and anticipation in their final waiting moments. Athletes always feel better when the race gets going, because those minutes waiting in a confined room, with the strong smell of liniment and the razor sharp tension, can be painfully and often detrimentally long.

  In a place so quiet – yet full of coiled energy – I tend to the final needs of the athlete and observe every movement. Be they African, European or Asian, the majority of athletes spend those final moments before the race in prayer in request for the perfect performance. I know that if I were taken into a call room and told that I had only minutes to live, my final request would be to get down on my knees to pray for forgiveness and to give thanks.

  When the best athletes in the world are injured or ill, they draw on their spirituality and pray to their God. When they win, they give thanks.

  When Ronnie Delany won the Olympic 1,500 metres in 1956, he immediately fell onto the track in thanksgiving, praying and proudly sharing his faith with the world. When Noureddine Morceli of Algeria won the 1,500 metres 40 years later, in 1996, he too knelt down on the track in thanksgiving prayer.

  We all know how to pray in our hour of need, but it is vital to pray in thanksgiving for the many talents, gifts and blessings bestowed on us. When Portugal’s Fernanda Ribeiro, the Olympic gold medal winner in the 10,000 metres in Atlanta in 1996, visited me for treatment in 1998, she was delighted to see I had a statue of Our Lady of Fatima in my clinic. She explained to me that, after she won her Olympic gold medal, she returned to her home in Portugal and walked the 207 kilometres from her village to the Our Lady of Fatima shrine in Fatima in prayer and thanksgiving.

  As a physical therapist, I am regularly confronted with debilitating musculoskeletal injuries, some sidelining athletes for years and others threatening careers and livelihoods. Healing has to take place from within. Numerous international scientific studies have identified the therapeutic value of prayer. It is also recognised that “non-local healing” – a healing induced by others praying for the sick or the injured – positively works. The idea that you can transfer healing energy through prayer or through faith is, in my opinion, very real, especially where the recipient has genuine belief.

  When the sportsperson puts their trust and belief in me, they unburden themselves of their troubles and hand over the responsibility to me. When I had my own injury troubles as a young teenager, I had a poem that I wrote into my training diary at the start of every year. It was very simple, but it gave me great strength. I hand out the same poem to many of the injured athletes. Written words are powerful, but spoken words are more so. Sometimes an injured athlete only needs a word of encouragement to hang on to.

  Don’t Quit

  When things go wrong, as they sometimes will,

  When the road you’re trudging seems all uphill,

  When the funds are low and the debts are high,

  And you want to smile, but you have to sigh,

  When care is pressing you down a bit,

  Rest if you must, but don’t you quit.

  Life is queer with its twists and turns,

  As every one of us sometimes learns,

  And many a fellow turns about,

  When he might have won had he stuck it out;

  Don’t give up though the pace seems slow –

  You may succeed with another blow.

  Often the goal is nearer than

  It seems to a faint and faltering man,

  Often the struggler has given up,

  When he might have captured the victor’s cup

  And he learned too late when the night came down,

  How close he was to the golden crown.

  Success is failure turned inside out –

  The silver tint of the clouds of doubt,

  And you never can tell how close you are.

  It may be near when it seems afar,

  So stick to the fight when you’re hardest hit –

  It’s when things seem worst that you mustn’t quit.

  (Author unknown)

  So often I’ve experienced situations firsthand where the best sportspeople overcame adversity. The story that stands out for me is that of Kelly Holmes. It’s one that any injured sportsperson should know.

  When Kelly Holmes was sent to me by UK Athletics in 1998, it was one of those last-hope visits. She had good athletic talent in the early 1990s, but then year after year she got various career-threatening injuries. When she attended my clinic for the first time in 1998, she had torn her Achilles tendon, and was hobbling when walking, never mind running. The Achilles tendon is the curse of many a great athlete and has forced some of the finest talents into an early retirement. Kelly Holmes’ visit to Limerick was scheduled for ten days to fully avail of my expertise. The ten-day visit lasted six weeks, and she regularly visited me thereafter for six years. In 1999, Kelly was back racing, although well below international level.

  The Olympic year in 2000 was to put her to the test. She trained on the cinder river path along Plassey by the Shannon River, doing 400-metre interval runs because I did not want her training on the synthetic track. She was race rusty coming into the track season, and then came her worst nightmare: she tore her right calf. It was not just any tear. It was a massive twelve-centimetre tear, and the orthopaedic specialist who examined the MRI and Kelly’s leg explained to her that it would take twelve to fourteen weeks to heal. The UK Olympic Trials were on in nine weeks, so medically she had no chance. But Kelly Holmes had read the poem “Don’t Quit” and she had an inner belief that her body could heal. It was a challenge I was only too excited about.

  Two to three times each day, I treated Kelly. Progress was slow, and the UK Trials drew nearer. Three weeks beforehand, Kelly resumed light running, and the following week she improved more. Then she had a test track session of 4 x 400 metres on the University of Limerick track. Kelly huffed and puffed, bu
t completed it. On the Thursday before the trial, which was set for the Saturday, Kelly was dejected. She was back running but was far from race ready; she needed a qualifying time of sub two minutes for 800 metres, yet there was little hope of that. I convinced Kelly to run in the trial, and after much arguing she agreed. We travelled together to Birmingham and it was pure sports psychology that got her to the starting line. She won the UK 800-metre championship in two minutes and four seconds, but was well off the required qualifying mark.

  It was six weeks to the Olympic Games in Sydney – what option had she? The Olympic Games only come around every four years. Time waits for nobody, and there was no way the date could be changed. I rang various people in the UK Athletics and British Olympic Association and tried to convince the authorities to give Kelly a special chance. She deserved that. Rules are there for a reason, but they can be bent. Kelly penned a letter to UK Athletics where she outlined that she was slowly getting back to form through training and treatment and asked to be given a chance to be included in the Olympic team.

  As it turned out, Kelly Holmes was given a late selection for the Olympic Games in Sydney 2000. It was one of my most memorable moments in sport to witness Kelly, who had struggled so much, fighting her way onto the Great Britain Olympic team, and then, with true Olympic spirit, running to achieve a bronze medal in the 800-metre final.

  It was a true argument for never underestimating someone’s drive, talent and determination. A few months before the Olympic Games, UK Athletics refused to pay Kelly’s medical expenses, stating to me that she was a bottomless pit, costing the system way too much money, and she would be best off retiring. Satisfaction does not come any better than working with someone through adversity, and being part of their achievement by assisting them to overcome injury and go on to win a medal in the Olympic Games.

  Even more satisfying is the appreciation that can follow, such as a hand-written letter from an athlete who you have put your heart and soul into helping. The following letter from Kelly Holmes is a special one, and it is framed and displayed in my clinic at the University of Limerick’s Sports Arena: