How to Rehab and Recover Strong Like a Spartan World Champion
Thud. POP. Buckle. Crumple.
It was a crappy landing gone wrong. Way wrong.
On May 22, at Hildervat Jacksonville, to the backdrop of spectators cheering, sand flying, and bells ringing, Nicole Mericle, Spartan World Champion, Trifecta World Champion, 11-time U.S. National Series podium holder, and unequivocal OCR badass, suffered from what all athletes hope to avoid FOREVER: a torn ACL.
It was brutal. And there was nothing she could have done to dodge it. Sometimes, shit happens. Accidents just happen — even to the best in the biz.
But, true to her Spartan spirit (just short of dragging herself across the finish line), Mericle dug deep into her reservoir of grit, patience, and perseverance to power through surgery and focus on one thing: rehabbing her injury ASAP to stride out stronger than ever before.
We sat down with Mericle to get her firsthand intel on what it’s like to recover from a debilitating injury and return to OCR. Here, she shares how she got hurt, the mental and physical challenges synced with rehab, and life lessons she’s learning on her journey. Plus, rock-solid tips for any Spartan struggling with an injury. Think: how to eat right, train your mind, and recover like a pro. (It’s a pain in the ass, but doable!)
Related: Why Is Nicole Mericle So Good?
Q&A with Spartan World Champ Nicole Mericle on Injury Recovery for Athletes
How The Heck It Happened…
SPARTAN RACE: Let's start at the beginning. Can you describe how you got hurt? How was the race going, and what went wrong?
NICOLE MERICLE: I was competing in the Hildervat Battle on the Beach, an OCR event at the end of May in Jacksonville, FL. It was a semifinal that I was running tactically. I just needed to finish in the top two to qualify for the final, and I wanted to make sure Becca [Rebecca Hammond] also made it safely. So, I took the race out at a pace only Becca and I could handle.
We separated from the rest of the field and had a comfortable lead going into the final 100 meters. I got to the 3rd to last obstacle, a rig, about 10 seconds ahead of Becca. At this point we were easing up. I completed the obstacle, hit the bell, and dropped down.
Upon landing, I felt and heard a pop. My leg buckled and I fell to the ground. I stood up a few times trying to continue on, confused about what was wrong. Each time I stood up, my left leg would give out and I'd collapse. As I laid down the final time, I considered crawling to the finish. In my mind, I considered the final two obstacles: the logistics of doing a Herc Hoist with only one leg, and if I could climb and downclimb the truss to complete the last rig. I decided it wasn't worth it.
I knew something was very wrong with my knee and I didn't want to risk inflicting additional damage and jeopardize my ability to race in the future. It turns out this was a very wise decision because I suffered an ACL tear and nothing more. It's common to have meniscus damage with ACL tears and that would have been a likely outcome had I continued to try and walk on the leg.
SR: What went through your mind right after you got injured?
NM: The first thing that went through my mind was, "Can I finish the race?". Once it was apparent I could not, I accepted the help of OCR Pro Ryan Woods and physical therapist Mike Ryan, who had both rushed to my side.
My second thought was to find Becca, but she rushed back to find me first [she hadn’t seen me fall, and finished the semi in first place]. Becca and I were roommates and had approached this race as if we were teammates, so it was a big blow to not be able to compete together in the final. That said, Becca had historically come 2nd at several major races (including the Spartan World Championships and OCR World Championships) so to see her race to a dominant 1st place the next day made me very happy.
SR: What did injury triage in the field look like?
NM: I was very fortunate to have Mike Ryan's help from the second I got injured. Once he carried me off the course and onto a gator, he started the process of contacting a doctor and ordering an MRI. Manual tests indicated I tore my ACL, but I needed imaging confirmation. I was able to have an MRI that same day and know conclusively that I had torn my ACL. Surgery was very, very likely.
When it comes to injuries, the unknown is the scariest thing. Knowing what the injury was and a rough plan of attack moving forward eased my mind tremendously. It allowed me to relax the next day and enjoy cheering my friends on in the final race.
SR: What factors, if any, potentially played a part in your injury?
NM: I've been told that racing and landing in the sand could have contributed to the injury, as that offers a less stable landing. I also came down very close to the truss on the side. So close in fact, that I put my hand on the truss as I was falling so that I didn't fall into it. I'm guessing this caused me to land differently than I normally would have.
Women sustain ACL tears more often than men do, in theory, due to our anatomical differences and hormones. Weak hamstrings can also contribute to knee instability, something that women in general struggle with, and I, in particular, have had multiple hamstring strains.
The Road to Surgery (And Recovery)
SR: Once it was clear you had torn your ACL and needed surgery, how did you move forward?
NM: Once I returned to Colorado, the ball was already in motion. I saw three different surgeons and by the end of the week I had a graft, surgeon, and date selected. On June 7th, I would undergo ACL reconstruction using my quadriceps tendon as the graft. Dr. Armando Vidal at the Steadman clinic in Vail performed the surgery. Although the decision was made quickly, it was not an easy one. I knew there was no bad surgeon among the three I saw. They were all excellent orthopedic surgeons.
The graft choice proved to be the most nerve wracking. Cadaver tissue was out of the question for me given my high level of activity and the higher rate of re-tear that's seen with cadaver grafts. [And there are many pros and cons to taking from different tissue locations around the body.] The graft options I was given were patella tendon or quadriceps tendon. My surgeon had done tons of quad tendon graft ACL reconstructions, and he felt this was the best option for me to make a full return to my sports of OCR, trail running, and rock climbing.
When I walked into his office just days after racing with cuts and scrapes all over my lower legs he asked, "Is this normal for you?". When I said, "yes", I think that's when he confirmed I should get a quad tendon graft.
SR: What was your mindset going into the surgery journey?
NM: When I found out that I would need surgery there were so many decisions and plans to be made that I was very much in an action mindset. I didn't have a lot of time to dwell on why this happened, what I would miss, or any of those unpleasant realities. I work better moving forward and solving problems, so that's what I focused on.
I weaned off crutches and immediately started physical therapy in anticipation of surgery. I swam and aqua jogged every day in addition to the mobility exercises I was assigned. Going into surgery, I had full range of motion, a normal walking gait, and great quad strength, which all contributed to better surgical outcomes.
SR: How did the surgery go for you?
NM: ACL surgery involves a surgeon cutting out a piece of tendon from another area. In my case that was my quad tendon near my knee cap. They start by removing the piece that will become the new ACL. Then, they went in and cleaned up the torn ACL. In this phase, they were able to confirm I had no meniscus damage, which meant way less time on crutches. They then have to drill into bone on the tibia and femur. The new ACL is anchored to these sites with some hardware. The new ACL is tested with a quick and slightly disturbing yank on the leg before everything is closed up.
The surgery went great. Dr. Vidal said it was "perfect". My surgical report actually states my new graft has "beautiful orientation" and when it was tested at the completion of surgery, the new graft was "rock solid”. At my six-week post-op appointment, my doctor said everything looked great and it couldn't be going better.
SR: Did you have a support crew to help you out?
NM: My parents flew in from Texas to join my boyfriend and me up in Vail, CO for the surgery. My dad even stayed two weeks after the surgery to help me with daily tasks and driving around to appointments. I'm also very lucky to have a lot of close friends who stopped by the first couple weeks when I was especially immobile.
SR: ACL recovery is a slow road — where are you in the process right now, and how does that look in the grand scheme of your injury rehab plan?
NM: Recovery from ACL surgery is a long process. I was told this over and over again by each surgeon. The first three months are focused on recovery. The bone needs time to heal around the anchor sites, swelling takes time to subside, the graft site needs time to heal, and the new ACL slowly integrates and develops its own blood supply. Goals at this stage are to regain full range of motion, regain muscle activation, and slowly build strength.
I'm still in this beginning stage. My new ACL is actually at its weakest point right now. The body degrades the new tissue somewhat from about 6-12 weeks post-op. From 12 weeks on, the ACL becomes stronger and stronger as the body lays down new tissue and a new blood supply. This growth isn't finalized until 9-12 months post-op, which is one of the barriers to fully returning to sport. If an athlete comes back before this time, the chance of re-tear is much greater, and re-tearing my ACL is my biggest fear…
SR: Can you say more on that?
NM: I should clarify, it's not that I think I will re-tear my ACL, I'm just motivated to do everything in my power to prevent that from happening. Regaining strength and returning to activities at the appropriate time will be key to that success.
SR: What are some of the toughest mental challenges in having to stop racing and start healing? How are you working to overcome them?
NM: I love racing, so having to step back from competition means letting go of something that makes me feel most alive and brings a lot of meaning to my life. I've been through some major injuries in the past, so I know how to approach rehab and how to look for value in other aspects of my life.
When facing an injury, I recommend asking yourself, "What is it about training and racing that I will miss the most?". For me, those things are community, working towards a goal, and the endorphins and satisfaction that comes from doing something physical.
So I know that finding other ways to stay connected to the OCR community will be important. This was easy to fulfill for me since I can focus my attention on the two projects I founded this year: Elevate OCR, a community group for women in OCR, and the OCR Dream Team, a small team of up and coming female athletes.
Training is typically very social for me as I run and rock climb with others often. Injuries can be isolating in how they tend to take us away from our training groups. Because of this, I make a bigger effort to see friends in other ways — for lunch, a swim, or an indoor bike. While I can't work toward a racing goal right now, I can remind myself that physical therapy is integral in returning to sport, and, in a way, is my most important training right now.
I set different physical goals for myself too, like pull up and grip objectives.
There are financial consequences of injury that weigh heavily. Surgery is costly, for one, but I also rely on prize money to make a liveable wage. I have some amazing sponsors who have stuck by me through injury, but the reality is that I'm only able to be a full-time professional athlete if I'm performing well and making money at races, too. This injury is a huge blow financially, and is a push to do something else in addition to training and racing.
SR: What works really well, from your experience, to recover faster?
NM: My biggest tip for getting through an injury is to think small, but believe big. By that I mean focus on what you can do, and do that to the best of your ability, knowing it's going to get you back to your ultimate goal. For me, this is what that looks like: I'm grateful for the ability to swim, stationary bike, and work on my upper body right now. I look for little progress daily and get excited about those little wins, like being able to walk down stairs, have my hamstring pain dissolve, squat normally, or kick in the pool for the first time. When I see progress, I know I'm one step closer to racing again. I won't dwell on what I can't currently do or what I'm missing out on. I'm looking forward to starting to run in about two weeks, but that's about as far ahead as I think.
SR: What’s your relationship with cross training and how do you reframe any negativity or resistance to it?
NM: In my previous injury experience, it has been easy to see cross training as a punishment. It can be hard to motivate yourself to get in the pool or on the bike when all you want to do is run. Sometimes cross training can even feel pointless. Over the years, I've learned to value and enjoy cross training. So now, I turn "I have to" into "I get to" swim, bike, etc. And I remind myself that doing this is important and will make me a better athlete.
SR: What are you doing for PT right now? Can you give us a list of winning exercises?
NM: My physical therapy right now looks like this:
- Kneecap mobilization
- Using a muscle scraper to break up scar tissue and increase blood flow to my quad tendon
- Massaging the surgery scars to break up adhesions and underlying scar tissue
- Quad activation, extending knee
- Standing leg extension with a resistance band
- Downward dog
- Walking drills (walking on heels, marching, marching with leg extension, walking backwards, sideways marching — like a hurdle drill)
- Wall sits
- Step ups
- Double leg squats
- Step back lunges
- Step downs
- Hamstring sliders
- Prone hamstring curls with ankle weights
- Single leg Romanian deadlifts
- Quad chair stretch
- Bike up to 30 minutes
- Lie down with foot elevated and a weight on knee for 3-5 minutes to assist extension
SR: What was your top life lesson from this experience that could help all Spartans as they recover from tough injuries and return to sports in a smart way?
NM: You can't rush the process. You can eat well, you can rehab, and you can improve other aspects of your life. Get curious, look for progress (however small) and be kind to yourself. I'd recommend keeping a progress log (what you can do, where you have pain, etc.), especially if you're having a hard time feeling like you are getting better. Sometimes progress is so slow it's hard to see unless you are detailing it daily.
Mericle’s Top Injury Recovery Tips
SR: What are your best general tips to recover from an injury, from a physical perspective?
NM: Nutrition and sleep are paramount. In training, adaptations come when the body rebuilds. Injuries are the same. Make sure you are not deficient in any nutrient because that is key to recovering. I've found the new Honey Stinger Rapid Hydration Mixes to be super valuable, especially when I'm in the pool on hot days. I also love the gluten-free Cinnamon Waffles. As I ramp up my activity with more biking and returning to running, I know I'll be consuming plenty more gels and chews.
Approach rehab as you would your most important workout, because that's how important it is. Stay active. As much as you can, try to find cross training options that you enjoy.
SR: How can injured athletes bolster their mental game?
NM: Stay positive. During the two weeks after surgery when I was in the most pain, when I couldn't move well, when my energy was low and I couldn't do much training, I reminded myself: "this is the worst part. It only gets better".
SR: What are some good ways to deal with the inevitable emotional rollercoaster that goes hand in hand with injury?
NM: I think it's normal to have fluctuating emotions throughout the injury process. It's ok to grieve the lost time, mobility, finances, whatever else. Be real with yourself. You can say "this sucks," but try not to stay in that mindset too long. I think my coach said it well. "What, were you just going to keep winning races? That's boring. This is a new experience and now we get to see a major comeback. This is a more exciting story."
I want to embrace today and live today well. "Enjoy the process" is thrown around often to suggest athletes shouldn't be all-consumed by race day. There's value and enjoyment to be had in the daily grind. In the same vein, injury doesn't have to be a hiatus on living. I don't feel like my life is on pause until I can race, or even run again, and it's because I've fully embraced this experience. I'm intrigued by my body's healing ability. I've become a student of a different sport (swimming), and I have new and different goals to pursue. Look to get something out of the experience and you will.
Getting Back in the Game (One Step, One Day at a Time)
SR: How do you plan to get back into OCR and when is your re-entry debut?
NM: The plan is to start running soon, in the next 2-6 weeks. That's the first major step back towards OCR. From there, I will continue to work with my physical therapy team to strengthen my knee and get back to jumping movements. I will need to be able to pivot and jump in order to return to OCR, which will be two things that come in later in the recovery process. Since I will be allowed to run in a straight line first, I may be able to participate in some running races sooner. I plan to start racing OCR again sometime next year.
SR: What advice would you give to other Spartans preparing to race again post injury?
NM: Returning to racing after an injury can be scary. After you're cleared by your medical team, I'd recommend doing a race simulation or picking out a relatively low key race, both as a physical test and as a confidence-booster. I don't just mean confidence to push the pace, but also confidence in your body to run, jump, roll, and climb without hesitation. Athletes can even be at a higher risk of injury if they are worried about getting injured, so having confidence on course is no joke.
