A long May day in Washington State awaited the soon-to-be-injured
welterweight rope-access rock-scaler. Rock-scalers are harnessed rock
climbers whose purpose is to remove unstable debris from cliffs and
reduce the area to bare hard rock. It is physical, dangerous work and
accidents, like falls, cannot always be prevented.
The 9:10 a.m. sun had
crested the tall Douglas firs and bent Western hemlocks, painting the
steep face with fractured light. Kory Brown hung there, suspended by
his gear, anchored to stable access points he had assiduously set
above and to his sides. His partner Jackie hung to his left, anchored
to different stable points. All this effort was to prevent complete
loss of rope tension and a splattering death via a long drop. He eyed
the glacially-tilled 150-foot-wide escarpment he currently set upon
with the crew to make safe.
A controlled rockslide
was the plan and a huge boulder was the focus. Two days before, a
portion of the cliffside directly adjacent to the road had slid onto
the thoroughfare below the pair. He was there on his ropes to reduce
the risk of future slides by direct physical means. Presently, this
meant undermining the boulder to unleash a controlled cascade from
beneath it – a common technique for rock-scalers and one Kory had
utilized safely many times before without guarantees. His intuition’s
whispering grew louder and told him it was time to try a different
vantage point.
He had tested the precarious-looking boulder directly above him from
many angles that morning; the crew had spent twelve hours the
previous day trying to undermine the behemoth with pry bars and the
45,400 psi air bags. It hadn’t budged. The uneasy crew was
experienced, and something about that boulder activated the sense of
danger that permeates the air on fateful days.
The predatory boulder perched on the cliffside like a leopard in the
bush waiting for the chance to strike. Kory, unaware of his doom, had
already decided the situation wasn’t safe enough to stay put. So he
intended to move laterally along the cliff to get out from beneath
the source of his trepidation.
Salish seawater
glimmered through the dense coastline trees. The San Juan Islands
slipped in and out of a passing marine layer’s precipitous white
blanket. The air was fresh, the smell of sea and forest, punctured by
the freshly-displaced earth which had been released without grace
into the pile on the road due to the resurfacing of the
cliff-beside-the-highway. Northbound Chuckanut Drive twists like a
sidewinder along the lip of Puget Sound after it rises from the
fertile Skagit Valley. Its nearby towns and cities are famed for
tulips and potatoes, for rockfalls and landslides, and for
drug-addicted diaper-hobos and snow geese in unequal measure.
Simultaneously, as Kory
and Jackie made the decision to change locations, that damned boulder
chose its moment to attack. Earth from thirty feet below him rumbled
and slid first, pulling Kory’s 90lb deflated airbag to the end of
its line and weighing the climber down. He attempted to pull up the
bag. In hindsight, he says he should have cut it free immediately
which would have allowed him to move out of harm’s way completely.
Alas, this is a learned-it-the-hard-way story.
Between heartbeats the rumbling earth suddenly roared. Kory Brown
heard it first and still feels it. It was 9:12am. Yelling to his
partner and with reflexes only experience can bring, Kory gave a
mighty leap with both of his wiry legs off of the cliff’s face. It
was the only act he could manage against the weight of his equipment
and the unanticipated landslide. Time slowed to a crawl in Kory’s
mind. After he reached the apex of his jump the tension from his
still-anchored ropes brought him back towards the sliding earth. At
the last moment before his feet touched down the previously solid
cliffside surface became a waterfall of twisted roots, dirt, and tons
of rock.
Fortunately, his left
foot landed where he expected it. Unfortunately, his right foot made
no purchase on solid earth and sank into the churning mass. His
perception that time was moving in slow motion was shattered as the
force of a titanic wallop greeted him on his right shin, just above
the ankle. His shank shot back out of the collapsing cliff, and he
felt his right heel slam into his right buttock. This was a literal
kick in the ass. His rope, still suspending him from his intact
anchors, began to pull him towards the dissolving cliffside. Debris
was now raining around him, blocking all light from his eyes and
raking against his hardhat. Between heartbeats he readied himself for
the horror of being dragged helplessly by harness and swallowed by
unfeeling and dispassionate geological detritus.
He didn’t dare look
up. For Kory, these few seconds passed like 3 minutes with his
eyeball on a hotplate. To his great surprise he didn’t die, and the
slide abated. Serenity returned to the countryside, while the
meandering expanse of the Chuckanut highway became a multi-agency
emergency response. His right lower leg was now a painful, floppy,
mess. Blood began to stain his pants. He remained conscious and
somewhat detached, wondering if his boot and pants were the only
thing holding his mangled leg to his body. Indeed, as it is with some
maulings, shootings, or car wrecks it is either painless at first or
agonizing. Agony eventually comes, but sometimes it takes the late
bus.
Hanging there he first
checked on Jackie, who was miraculously unharmed but stunned and
fighting her rope tension which wouldn’t allow her to reach Kory.
Rock-scalers are accustomed to landslides, fishermen are accustomed
to rough seas, airplane pilots are accustomed to turbulence. This was
the type of day that men and women accustomed to jobs in dangerous
environments fear most.
Kory knew the leg was broken as he continued to survey his queerly
angled limb. His foot, he concluded, was now suspended via tension
from his clothing and his right leg’s soft tissues. Though he was
able to communicate with his unreachable partner, he was also quite
helpless to move himself away from another slide as neurogenic shock
took hold. Foreman Patrick (Pat), the man who filmed the accident,
deserves a nod. Would-be leaders should take notes.
Cussing like a sailor,
the brass-balled foreman commandeered a bucket-lift from another part
of the site without even bothering to lower it. Legends are made of
his disregard for his own personal safety. To save time, instead of
lowering the machine’s arm, he just hastened up a hanging
high-pressure air hose and swung his body into the bucket. Then,
hollering orders to the crew and obscenities to the sky, he completed
a 180-degree rotation of the lift’s arm while raising it vertically
from the controls in the bucket. Because the lift could sense it was
now on uneven terrain, it lurched and halted in several dangerous
automated safety stops, each stop accompanied by a cascade of
expletives from Pat. He was able to get to Kory within minutes of the
slide, neither man can recall precisely how long it took.
Once together they
communicated clearly, without letting fear rule reason, as only
happens when competence meets life threatening consequence.
Adrenaline coursed through them both. Finally, they both looked up at
the unstable enormity above them and confirmed what they already
knew. Unspoken agreement, immediately reached: it was time to get the
hell out of there.
By this point Jackie
had been able to fight her lines and reach Kory and Pat. The
escarpment rumbled above them as Jackie stabilized Kory’s right
lower leg and Pat harnessed himself to Kory in the bucket. He made
sure to get close and rope them into a position which would allow him
to keep Kory secure and swing via rope tension 25ft in a last ditch
jump if the earth still proved homicidal. Fortunately, the episode of
geologic indigestion was just a lonesome burp, and the trio descended
in the bucket without added excitement from the cliffside.
Meanwhile, the
ambulance arrived with a transport crew completely unprepared to deal
with the surface conditions on the highway. As the ambulance crew
waited for the rock-scalers to transport Kory to them, one of the
EMTs wandered directly under the unstable cliff gawking upward like
the next victim. He scampered away after more obscenities from Pat
thundered across the terrain.
The rock-scaling crew
were able to use a folding spine board to bumpily carry Kory across
the uneven expanse of the landslide to the northern pristine highway.
All this thanks to that sedimentary sumbitch boulder nobody liked
anyway. By now, enough time had passed to allow the late bus of pain
to arrive as a wave of agony, and seconds rolled to minutes and
silence and shock and sirens and questions and vitals and more
questions and fear and nurses and physicians and surgeons and even
more questions.
Kory Brown’s colleagues cleared eighteen tons of debris from
Chuckanut highway underneath the slide that mangled his right leg on
May 25th, 2025. My first encounter with him was on 8/7/2025, as he
presented to my physical therapy practice 10 weeks out from his right
tibia open reduction and internal fixation procedure (ORIF). Open
reduction means that the surgeon cuts through the skin and
subcutaneous tissues to eyeball the fractured bone and align it.
Internal fixation is using hardware (plates and screws) to keep bones
aligned after injury and throughout healing as well as subsequent
life.
Our lucky fella was the
recipient of an intramedullary nail. The medullary space is the core
of long bones, where the yummy marrow resides and blood cells are
formed. The nail is forced through the entire length of this space in
serious long bone fractures to support and maintain anatomical
alignment. Think internal bone-splint. Devised nearly a century ago,
these are used routinely.
Fractures are named by
type since there are various ways to break bones. A comminuted
fracture type is common with high kinetic force injuries like
gunshots, car wrecks, falls, workplace injuries, building collapses,
and general disasters that inspire thoughts and prayers. A comminuted
fracture means the bone has been broken into three or more fragments.
Think splintered wood.
Due to having the
comminuted fracture type and the exact location of the break in
Kory’s tibia it was necessary to utilize a fibular “free flap”
procedure to ensure adequate blood supply to the distal tibia. The
last third of the shin closest to the ankle is notorious for
complications because of relatively poor blood supply. The fortuitous
gentleman climber had tibial and fibular bone fragments scattered in
the fleshy bag that used to be his solid shank. The force and damage
so compromised the anterior and posterior tibial arteries and their
constituents that a donor portion of Kory’s same-side fibula, its
vasculature, and a donor flesh skin-paddle from his thigh were
harvested. This is the procedure deemed a “free flap.”
The donor bone, blood
supply, and soft tissue was painstakingly anchored by a plastic
surgeon into the fragmented tibia and adjacent to the intramedullary
nail stuffed through the pulpy mess. The resulting limb isn’t
pretty; the potential complications are numerous. The biggest initial
fear is a failure of the vasculature that was painstakingly
installed. Frequent doppler readings to ascertain adequate blood flow
are necessary for several days. In the end, the free flap held. He
was home from the hospital after 11 days, weak but very much alive.
Kory’s bodyweight at the time of his accident was 156 lb, and a
little over two months later he weighed 144lb, with a low of 136lb during his convalescence. He is 5’ 8” tall. I was being generous
when I introduced him as a welterweight. Along with assessing sleep
habits, dietary measures for weight gain during his rehabilitation
have been implemented with the wholehearted support of his lovely
wife Mel. She had already stuffed him and their growing daughter with
calories while he was laid up. Smart woman. Young parents to a
toddler all united in effort warms the heart right up.
Psychologically, Kory
has demonstrated resilience from the outset. Two aspects of this
resilience are worth noting; first, he fearlessly understands that
hurt happens, and second, he wants nothing more than to get back on
the rock-scaling ropes. A man with a purpose makes for better
outcomes. His occupational strains and physical background are also
in his favor, rock-scaling hours are not regular, and the work is not
rewarded unless completed.
Kory is accustomed and
unafraid of these types of projects. Prior to his rock-scaling career
he had spent time in mixed martial arts, as well as between several
rocks and several hard places. When Kory was first offered a job as a
rope-access rock-scaler he was warned that he would either love it
for life or flee on the first day. The former proved true. Stars
alight in the man’s eyes as he espouses the joys of climbing,
ripping, wrenching, and freeing boulders to tumble down the
countryside on purpose. He is polite, friendly, honest, and genuinely
listens when others speak, determined now more than ever to live a
full life of hard work. Smart man.
Periods of non-weight bearing are always frustrating. Eventually the
initial feelings of relief and being forever grateful fade into anger
at the injustice of the predicament. Beaverish people tend to
overcome these feelings with much greater ease than lazy people.
There are no sure bets in recovery from injury, but there are ways to
level the odds. Outside of infections, falls, self-neglect,
self-abuse, malpractice, and plain bad luck, most humans will heal
from severe injuries. Kory lost weight but had already regained some
mass by the time he initiated strength training with barbells. As
previously stated, he is a motivated husband and father, and he takes
his responsibilities seriously. Time will tell how much healthy
tissue he will gain, but as of now his bodyweight is 155lb. He’ll
get bigger and stronger if he can. And he should.
Mass gained with
strength training is healthy tissue. Mass preserved during a 6-12
week non-weight bearing period will be physiologically compromised
but rebound quickly since there was no loss of tissue. Thus, if a
person is on his ass for three months, he gets dreadfully unfit, but
muscle does not spontaneously become fat. Muscle tissue atrophies,
named muscles suffer reduction in cross-sectional area, the size of
the muscle cells shrink, but muscle
doesn’t become adipose en masse. I’ll grant that
fatty infiltrates are observed in atrophied muscles but that’s not
the same as the widely believed fat alchemy that the general public
embraces.
Myosteatosis is the
accumulation of fatty infiltrates into muscle tissue and is probably
akin to the muscles “rusting” due to age, disuse, and injury. The
neuromuscular junction deteriorates along with its motor units, and
once-supple normally-toned tissue becomes flabby, not fatty. Every
individual has personal factors that influence recovery, but
generally there is no need to gain excessive mass with self-pity,
sloth, and/or gluttony. The merits of gaining or losing weight during
rehabilitation should be decided on a case-by-case basis. When
restrictions are relieved, strength training should begin. In cases
without weight bearing on the lower extremity for a healing period it
is still possible to train the bench press with some modification.
The processes of the body will only end with death, so the time to
train is now.
Kory had to deal with predictable resets in exercise selection,
intensity, volume, and frequency. Most resets were due to right knee
pain inhibiting his ability to push on a surface with his right leg
as well as a fibular donor site that complained like a wee child on a
long road-trip – constantly. His technique-inhibiting pains and
weakness in the surgical limb presented most often in the early
weeks. These pains, which manifested while initiating a deadlift from
the floor and amortizing the transition between descent and ascent on
his squat, were overcome with machines and variations on the basic
barbell movements.
Peak
forces inside the tibiofemoral joint were the enemy for a time. Leg
press allowed for load to be calibrated with a large ROM, but it did
not replace the squats entirely since tolerance must be trained.
Romanian deadlifts, due to the constant tension on the posterior
chain, avoided peaks in internal forces on the right leg’s joints
and were highly tolerable.
All
injuries cost some amount of time, money, and happiness. The majority
of recipients of free flap procedures have sustained polytraumas from
motor vehicle accidents. So, most free flap procedures are performed
in instances where the person has multiple injured body parts and
compromised systems. Thus, Kory’s case is not a cookbook for all
recovery from right distal tibiofibular open comminuted fracture
status post open reduction and internal fixation with intermedullary
nail and fibular free flap, and should not be treated like one. This
is an example of what can be accomplished by a motivated man who sets
no limits to be adhered to.
A
training log was started by Kory with the initial visit and continues
to be maintained. The contents reflect the resets often necessary in
the first 6 months after severe lower leg injuries. It is necessary
to apply great creativity in exercise selection and execution when
pain, precautions, and inadequate recovery completely derail a
planned training session. Kory’s first workout on 8/7/2025 began
with a 5-minute warm-up and progressed to the unloaded box squat to
18” height. Within two weeks this progressed to squats to depth,
and then barbell squats to depth with gradually increasing load.
His
ability to recover from applied stress and adapt while not mucking up
the surgical work exists as the North Star of his rehabilitation. A
key evolutionary feature of multicellular organisms is the ability to
improve healthy tissue while repairing damaged tissue simultaneously.
This is not to say single cells have no means to heal; they simply
must put nearly all their resources into healing while multicellular
organisms may still accomplish other vital activities in addition to
healing. Kory has chosen to get stronger while he heals. On
10/30/2025 his barbell workout was as follows: Squat 130lb x 5 reps
x 3 sets, Press 90lb x 5 reps x 3 sets, and Deadlift 180lb x 5 reps
x 1 set.
There is a widespread mythology in physical rehabilitation circles
that focuses on equalizing leg symmetry across one or several
measures prior to bilateral progressive overloading. The issue here
is not with unilateral exercises or their possible utility, but
rather the assertion that zombie-science and associated measurements
must precede overloading bilateral movements with barbells. As
absurd as this sounds, it is still generally accepted in various
physical rehabilitation clans.
Unilaterally-based
exercise is not useless because exercise on its own is a damn good
thing for the general public. But emphasis on outcome measures
comparing one limb to the other are a false prophet for restoring
symmetry. Can a teeter-totter be balanced if the children can only
load one side at a time? Even if the teeter-totter gets balanced,
what then? Can a human even be maximally loaded on one side without
tissue failure? To what extent do isokinetics matter outside of the
lab? Compared to progressively overloading normal human movement
patterns with barbells and addressing recovery while assessing
adaptation, most measurements of rehabilitation outcomes are paper
tigers.
Barbell
squats, presses, deadlifts, bench presses are the exercises needed
for progress. As of submission for publication, Kory’s ability to
perform a power clean is being explored. Progression in the basic
barbell lifts for as long as possible is paramount. On 11/25/25, six
months had passed since the day of the accident. Kory’s workout was
Squat 160lb x 5 reps x 3 sets, Bench 135lb x 5 reps x 3 sets, and
Deadlift 225lb x 5 reps x 1 set. Effort is being rewarded. Resets
will continue to be necessary as his right lower extremity adapts to
the stress, injury and hardware presence. The tissue adaptation
acquired after recovering from the stress of training is the outcome,
and the workouts are the applied measurements. The author is as
curious as the reader as to whether Kory gets out on the ropes again.
He’s wisely taking the opportunity afforded by his injury to obtain
an education in business so he can manage future rock-scaling
projects. I sincerely hope to see a photograph of the man out on a
cliff doing precisely what he wants, and where.
Recently,
I drove the northbound route of Chuckanut Drive for an autumn hike.
As my trusty old 4Runner writhed along the snake-like highway I
passed the location of Kory’s accident. The rock face still showed
signs of fresh displacement and hadn’t yet accumulated any moss. It
looked bare and bright in the sun. The smell of crisp, salty, sea air
stirred reflective thoughts in my mind. By next summer any clear
signs that the cliff had fallen recently will be gone, a consequence
of the pacific northwest’s geology and climate. A rapid change
back to unscarred earth.
The
stone jutted from the yellow-green tapestry of the autumn flora.
Against the towering evergreens, the deciduous maple trees were
showing burning colors upon leaves larger than dinner plates. A heavy
rain the night before and lingering dew in the early morning light
created a reflection on the rockface; darkness one moment, brilliant
colors the next.
Thoughts
about Kory and recovery intruded on my wandering mind. I briefly
imagined that the tons of rock and twisted roots suddenly lunged for
me as they had for him. I scornfully bemoaned the wasted time I’ve
spent merely measuring my patients’ progress instead of training
them. I pictured myself as a musician stopping his band in futility
to discover why his instrument played the wrong note instead of
trying to continue playing with quality. I wondered if a
process-based approach of strength training with barbells will ever
overcome the insidious allure of outcome-based testing in physical
rehabilitation.
An
answer hit me like a landslide – prove it! Write Kory’s story and
display what a motivated man can do after the weight of the earth
comes crashing down.
Special thanks to Kory Brown and Robert Birch for their help with accuracy and precision. The processes of the body will only end with death, so the time to train is now.
Credit : Source Post
