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Breaking up with Burpees

The above photo (borrowed from F45 Training’s instagram account) may remind you of the ol’ Sesame Street days. As in, one of these things is not like the other. Even though this workout was done in groups, it’s probably clear that everyone in that middle group is in some mid-burpee position. All except one…

Yeah, that’s me, the one sticking out like a sore thumb.

Now why, you may ask, do I seem to have confused horizontal and vertical when deciding the direction this was supposed to go? Well I wasn’t confused. This was a conscious choice:

Because years ago, I quit burpees.

Not because I wanted to. But because not all surgeries go well, and some go kind of terribly.

My issue started with a bunionectomy gone wrong on my right foot. During the surgery they cut my big toe into two pieces with the intention of pinning it back together internally. Well, someone cut off too much bone and they had to pin it externally…so I woke up from surgery looking kind of like THIS:

NOT MY ACTUAL FOOT (but in those days no one had a camera on their phone. My pins were green and stuck out of the top of the foot.)But while I don’t have a photo of my actual foot, I do still have the actual pins, seen below:

This was definitely not something I would have signed up for had I known it was a possibility. To make matters worse, I was supposed to have this pin cushion thing going on for a month…but in less than a month I was also supposed to walk across the stage at my graduation from medical school.

Yes, that’s right, the moment I’d been waiting for for YEARS and I was going to be partially out of commission for it?

Not on your life.

So I called the podiatrist and said something like “Um, yeah, so about those four weeks…” and I recall quite well his response. “You’re young and healthy, maybe it won’t take four weeks to heal. We’ll remove the pins in three weeks.”

Phew. What a relief. I’d be able to walk at graduation like a normal person.
Or so I thought.

The day came for them to take out the pins. I was stoked, and the first thing me and my pin-free foot did was head to Target (this was before Amazon, you had to go to Target like every other day). But while walking through the parking lot back to my car after the Target-ing, one of my steps with the right foot was met with a pain like no other. “STAB STAB STAB!” went the pain. I fell to the ground. It felt like my entire foot had exploded.

So what did this genius do? NOTHING. I hobbled back to the car with my ‘ignorance is bliss’ firmly in check and went home. Nevermind that I definitely couldn’t walk painlessly. I told myself this was normal. Again, I had some graduating to do and nothing was going to stop it.

So graduation day comes around and said foot is about twice the size of the other foot. It was so large that I had to wear my mom’s shoes for the ceremony, which were an entire size larger than my own. I managed to cram footzilla into this low-heeled shoe and hobbled off to the symphony hall.

After hours of waiting around, the ceremony began and finally they called my name. It was one of those times I swear you could hear a pin drop as my entire family held their breath hoping I would make it across the stage without collapsing or screaming out in pain.

The following week the pain continued, and I finally ended up chatting with an old friend of mine who had been a doctor longer than I had (meaning longer than 6 days…). I told him about the foot pain and he asked a question I’ll never forget:

“Can you dorsiflex the big toe?”

Dorsiflex means to flex it upwards towards the head. I tried. I could not.
Now had I been thinking, I would have tried this on myself a week earlier, but again, doctoring yourself is hard. So when I told him I couldn’t move the toe, he broke the news to me:

“That means your toe fell apart.”

Ugh. So without so much as an appointment, I limped into the surgeon’s office the next day and showed them my lack of dorsiflexion toe, which earned me an insta-xray and almost as instantly, a diagnosis:
“Your toe has separated. You’re going into surgery tomorrow to fix it.”

Great. I was supposed to be dancing Bollywood at two of my closest friends’ weddings in the next month, which would no longer be possible. I would spend yet another month with pins sticking out of my foot. Awesome.

Now you’d think this time they’d be extra-careful in getting it right, seeing as how the pins were due to their error in the first place but no, I later found out through follow-up x-rays done at the Mayo Clinic that the toe was re-pinned in a rotated position!

You had ONE JOB! Pin the toe STRAIGHT back like it was!

Now I only know this because the toe never recovered. Months of physical therapy and no one could figure out why it still wouldn’t dorsiflex much. But the x-rays cleared that up. The toe is shorter, rotated, and now, thanks to all those months of me trying to rehab a rotated toe, full of arthritis.

So it’s like I’m 40 years old, but my toe is 140.

To make matters worse for my poor right foot, years later this happened:

The (almost) hilarious part of that is that when I got x-rays taken for the pinky injury, the doctor (who saw them before seeing me), walks in and starts talking about what to do about all my big toe arthritis, including … wait for it…

A TOE REPLACEMENT!

I chuckled and told him I was there for a DIFFERENT injury and that he could keep his fake toe, but thanks.

So what’s the result, these 13 years later? That toe doesn’t do the motion that it’s supposed to do when you lunge forward with the opposite foot, or, more appropriately for this article, the motion that is required to propel you back off the ground from the bottom of a burpee.

Have I tried? Yes. Has my foot told me exactly what it thought about those tries? Also yes. Just ask my Costco-sized bottle of ibuprofen.

It does still affect my ability to ginga and esquiva in capoeira, my ability to do crescent pose and a ton of other yoga poses, and at this point walking lunges are a torture to which I no longer subject myself.

But in 2014 I signed up for a free month of this online workout called the Daily Burn. In it one day they had us do something they called “handstand burpees.” I saw the online fitness goddess do the traditional burpee jump up to start, then she put her hands on the ground, but then instead of shooting out into a chest-to-the-ground position (my nemesis), she shot up into a handstand.

Whaaaaa? What is this awesomeness?! A burpee I can actually do?!?

So I tried it. And then I tried it again. Trust me, it took more than a few tries to get it to look like the goddess’ burpee, but eventually I got it.

Now, not being able to burpee is generally a fairly private battle…unless you do group fitness. So my ‘deficiency’ first came to light at a CorePower class where we were asked to do burpees.
To paraphrase the now infamous quote, when the rest of the class went low, I went high. Like vertical. No one seemed to judge me negatively (note: all anyone wants in life it to not be judged negatively, let’s just admit it and move on, k?).

But then I joined November Project, a morning workout group of generally awesome athletes, and the number of people witnessing my abnormal burpees went from 16 to 160, and with it, my self-consciousness about them also increased ten-fold.
Because here’s the reality. If you can’t do a handstand, they look hard. If you can do a handstand, which I’ve been able to do since the age of about 4, they are extremely not hard.

Burpees are hard. My version of burpees are, dare I say, fun. Not hard. Not easy, but on a scale of 1 to actual burpees, it’s about halfway.

However, they definitely elicit a response. Well, two responses.
1. Wow. That’s impressive. Or…
2. Show off!

The first is sweet. Unwarranted (again, cause I’m working only half as hard as everyone else), but sweet. And supportive. I feel unjudged.

The is less awesome. Because I then feel forced to stop and explain that I have a defective toe that had two surgeries and now is arthritic and won’t dorsiflex and that if I want to still be able to walk later in the day, that’s the only option I have.

Now my friends know that one of my biggest challenges in life is to convince myself that no one is judging me. But guess what, when someone calls me a show-off, it’s really hard to feel not judged. It’s much more likely that I’m going to feel like I did back in grade school when I got teased for being a nerd who knew stuff. Not exactly my favorite feeling.

Now I’m well aware we all have our injuries. Especially those of us who are 1. older or who 2. do crazy sports like capoeira. I bet most of the people in November Project could print out their own shirt with a list of the injuries that impact them on a daily basis and yet they still do 100% of the exercises we’re given.

However, as a sports-medicine doctor, I’ve seen what happens to people as they age when they don’t listen to their bodies. It’s not pretty. And since I plan to be training capoeira in my retirement home, I’m gonna go ahead and respect my body…by breaking up with burpees.

So see you in the upside down! 🙃

Not All Quits are Created Equal

I met with a friend last night who was contemplating a job quit. And not because there was anything necessarily wrong with the job. More so because when he wasn’t at his best or most efficient, there were no actual repercussions, which allowed time for his mind to wander and for him to often feel bored. And also because he wanted to do the same type of work, but with the freedom of being able to do it wherever and whenever he wanted.

So while some of us get anxious or stressed because parts of a job are causing us grief, he was suffering from a different sensation, one I can only best describe as restlessness. A feeling of “there could be more.” I appreciated him bringing this to me, because that’s a quitting situation that generally only those really in touch with their true desires approach.

Like Maslow’s hierarchy of needs, there is also a hierarchy of quits. There are the basic quits that can save a life — for example, quitting a relationship that involves abuse. Then there are the quits that can save one’s health — like quitting a job that causes ulcer-inducing levels of stress. But somewhere near the top are the quits that aren’t due to decreasing health or happiness…they’re due to knowing that on the other side there’s even more happiness and fulfillment.

In the hierarchy of needs, a person has to fulfill the basic needs of food and shelter before moving on to fulfilling the desire for love, and eventually, self-actualization. Similarly, quitting something that isn’t harming you in any way assumes that nothing is currently jeopardizing your life or physical/mental health. It’s the goal to which we should all aspire.

But it’s not where most of us start, so let’s start at the beginning. Is there something threatening your life? Start the quitting there. Please. Like immediately. With a call to 911 or a visit to a local shelter or to a medical professional. And if not (which I sincerely hope is the case), then ask yourself if there’s something jeopardizing your physical or mental health. If so, then make that your quitting priority.

However, if none of these describe you, well, first of all — congratulations! You’re at the level where you can evaluate whether there’s more that life can offer you. So take a look at your relationships, your job, your career, your living situation. If any part of it could be more fulfilling, more rewarding, more aligned with your goals and mission, then perhaps it’s time to consider an upgrade.

Quitting Clients (aka Ditching the Diamondbacks)

I always stress that strategic quitting differs from regular-ol’ quitting in many ways, but one of the most important is knowing what exactly you should quit. Very often people know they’re not happy with their situation, but they’re not exactly sure why.

Unstrategic quitters at that point quit either everything, or random things. Like “Let’s randomly move to a new city, or quit a relationship. Maybe that’ll help.”

I mean, maybe it will, but it’s a gamble.

What’s more strategic is deciding exactly what isn’t working and then quitting only that.

This quit is a great example of a small one that can make a big difference: quitting a certain type of client.

I know CPAs who quit doing taxes for individuals and instead only focus on businesses. I know coaches who stopped doing group coaching sessions. And I know doctors who stopped seeing insured patients and now see cash-only patients.

If you’re in any of these fields, the reasons why my friends made the above moves probably jump out at you immediately. But if you’re not, just know that in every field there are going to be clients who take more of your time and energy than others, or who in some way or another lead to less return on investment than others do, or who just happen to rub you the wrong way more than others.

Quit them.

Unapologetically.

But first, apologize.

Let me clarify. If you’re servicing a certain type of client and you want to stop doing so while there is still a relationship, that’s going to take some artful finagling. Especially doctors and lawyers and CPA-types who have a fiduciary duty to their clients must take special care that you let your clients go in the most legal and ethical means possible. Ensure you have someone else ready to take your place as best you can, and do apologize for the inconvenience.

Some more examples of this include an attorney friend who quit civil cases and decided to focus only on criminal because they are a lot more cut and dried and they’re shorter from start to finish, which allowed him to better plan his schedule.

I also quit a type of client: high maintenance athletes and their staff. I’ll never forget the time I was a sports medicine fellow and I was called by whomever was working for the Arizona Diamondbacks at the time they were in Tucson, Arizona for spring training. My fellowship, at the University of Arizona in Tucson, had me working with the team, which probably sounds really exciting, right until the calls start. I’d get calls in the middle of the day to go to their facility and do physicals on the latest round of new players. Were they emergency physicals? (Is that even a thing?) No. They were just requested by people not used to anyone saying no to them.

One day they called and said they needed me to come give a player an allergy shot. Now, I won’t debate the efficacy of the shots I was asked to give, but let’s just say this wasn’t a “dude ate a peanut, now needs an epic-pen” situation…this was for seasonal allergies. They make this request in the middle of a full clinic day. Yet I go over there, leaving my patients to sit in the waiting room while I get this shot ready. I go to give it to the player and I can’t find him. “Oh he’s batting,” they tell me. ARE YOU SERIOUS? I interrupted my day but he can’t skip an at-bat, during an intrasquad game, by the way, for me to give him this shot he apparently needed RIGHT NOW!

So I waited. And after whatever time period an at-bat should have taken, I asked again if he was ready. “Oh he’s in the outfield now.”

Oh no he didn’t….

At that point I lost what little patience I had and headed to the field with syringe in hand, declaring if they wanted a steroid scandal I was going to give them one cause I was going to inject him on the field because I HAD PATIENTS WAITING!

He came in.

But moral of the story is that if a client or group of clients gets you to the point that you’re about to shove sharp objects in a left fielder while dodging a line drive, you may want to consider quitting them.

Just my two cents:)

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