Defining Moment The Power of Goals They're important in hockey. They're vital to empowerment in life. By Karen Thatcher, PT, DPT | November 2018 Listen to 'Defining Moment' February 18, 2010: It's our third game at the Olympic Games in Vancouver. I'm flying through the neutral zone with the puck, like I have a million times before, when suddenly I'm soaring through the air. Crash. Pop. Lightning down my legs. I don't know it at that moment, but this is the start of what will be the most challenging 15 months of my athletic career. Imaging revealed an L5/S1 ruptured disc. But this was the Olympics. So, I was on crutches for 2 days, in the training room 24/7, and then, only 4 days after the injury, I was back on the ice for our semifinal game against Sweden with a modified brace over my sacroiliac joint. I skated in the gold medal game 2 days later. We came home with a silver. Later that summer, after physical therapy that did not yield desired results and after multiple ineffective epidurals, I underwent an L5/S1 microdiscectomy—surgery to remove part of the herniated disc. The lessons I'd learn in the ensuing months would shape who I am as a person and how I now practice as a physical therapist. Injuries can be devastating to an individual's identity, particularly an athlete's. The back injury I experienced and the sequela that followed forever altered my life, leading me to a career in physical therapy because of the profound influence that my physical therapist (PT) had on me after surgery. My journey to recovery and the lessons it instilled in me drive me every day to help my patients. After surgery in July 2010, I was completely dependent on others for even the most basic needs. I was in no way prepared for this. Five months before surgery I'd been a world-class athlete, competing at the highest level and representing my country. After surgery, I was a 25-year-old woman who needed her mother's help to use the toilet and roll over in bed. I'd gone from celebrating an Olympic medal to throwing a (figurative) party the day I finally was able to walk, with my father's assistance, to the mailbox and back. The experience utterly and completely humbled me. It taught me never again to take my independence for granted. The months of rehabilitation were tumultuous. I experienced the difficulties I would later see my patients face when they get mixed signals about what to expect and experience communication gaps across disciplines. My biggest challenge was bridging the gaps between the expectations of my physical therapist, those of my hockey coaches, and the goals I'd set for myself. My PT was pleased when I could walk around the block and sit for 30 minutes at my desk without pain. My hockey coaches, on the other hand, always wanted to know why I wasn't skating yet and when I could participate in training. And somehow I became the messenger between these 2 groups. In the process, no one thought to ask me what my goals were. Welcome to rehab purgatory! I've wondered ever since how many of our patients dwell in this same uncomfortable space along their journey from injury to rehabilitation. It felt as if my PT was rehabbing me to get back to the life of my mother—an office worker, then in her mid-50s, who enjoyed an occasional yoga class and walked her dog for exercise. Not that there's anything wrong with that life, but I was a young athlete seeking to return to international competition. So, strike 1 against having a satisfying rehab experience. My coaching staff, for their part, did not understand the extent of my surgery or the timeframes and limitations of my recovery. That was strike 2. All the while, I was experiencing the daily pain—physical, psychological, and emotional—of being caught between 2 groups seeking to place very different demands on my body. Strike 3? This arrangement was destined to fail. And it did. So, after some very frustrating months, I found myself a new PT. This time around, my rehab was coordinated with my strength and conditioning coach, which facilitated realistic goal- setting and enhanced my overall rehabilitation. My rehab exercises aligned with the demands of ice hockey. My conditioning program was appropriately adjusted to take into account the biomechanical loading of my healing spine. Most important, I at last felt heard. I started to feel like myself again. Fifteen months after surgery, I returned to my home on the ice, to international competition. Reunited with my teammates on Team USA, we won the gold medal in the Four Nations Cup in Nyköping, Sweden. Although I wish I could say that was the end of my rehab voyage, and my career played out naturally thereafter, that wasn't how it went. In February 2013 I sustained my third loss-of-consciousness concussion. It forced me into retirement from ice hockey and toward pursuing academic goals I'd set aside when I chased my athletic dreams. I'd always intended to return to graduate school, initially to pursue a career as an orthopedic surgeon. However, my experience with rehabilitation after my back surgery (and for many other injuries over the years) fostered a passion for physical therapy. I enrolled in a dual-degree DPT/PhD program at The Ohio State University and graduated with my DPT in May 2017. I have continued at Ohio State since then, working full-time as a PT in sports medicine while continuing to pursue my PhD in health and rehabilitation sciences on a part-time basis. My goal once I complete my PhD training is to contribute to the progress of the physical therapy profession through clinical practice, research, and teaching. My path has not been traditional, direct, or easy. But the route I took was formative. “Adversity is the stage upon which character reveals itself,” a mentor once told me. The many and varied obstacles I've faced to get to this point undoubtedly have shaped my character. They've also primed me to make a positive impact on the lives of the patients with whom I'm fortunate to work. My story serves as an illustration and reminder of the need for PTs to approach each patient with compassion for that individual's unique journey. We must always remember that no 2 individuals are the same, that no 2 rehabilitations are identical, and that a little bit of empathy can make all the difference. Karen Thatcher, PT, DPT, works at the Jameson Crane Sports Medicine Institute at The Ohio State University. She was a member of the US Women's National Hockey Team for 8 years.