Lauren Nethery has never been one to sit still. She’s packed more into her 32 years than many people accomplish in a lifetime. She’s evented through intermediate, ridden race horses, schooled dressage through third level, and competed in the jumpers. She has ridden bulls. She’s trained feral rescue horses and 2-year-old Thoroughbreds. She did an Ironman triathlon, represented the United States as a pentathlete, and coached the Canadian pentathlon team. She’s well on track for her goal of visiting 80 countries by the time she’s 40, having made it to 65 before COVID-19 hampered her plans.
It’s not surprising then, that when a biking accident left her with an upper arm fracture that threatened her athletic future, she wasn’t ready to meekly accept her fate.
Nethery has spent much of her life in the saddle, having ridden throughout boarding school and college.
“My family is Tennessee dirt-floor poor,” she said. “I was not one of those kids who had packers or any money. I was just really fortunate to be able to ride, and I guess I was smart back then, before a good number of head injuries.”
In college, she took many of her classes online so she could travel where the horse bug took her. She worked under a number of top-name Thoroughbred trainers, including Tom Proctor and Steve Asmussen, before taking out her own license and specializing in starting young horses. Her dance card grew to include coaching the University of Kentucky’s eventing and dressage team, as well as basic training for feral horses corralled and sent to the Lexington Humane Society. Eventually, Nethery reached a tipping point—she could continue growing and compete with multi-million dollar racing operations from a seat in the office, or she could switch industries.
“It was going to turn into an amount of work that made it not fun anymore, and I wouldn’t be able to be with the horses,” she said. “You have to delegate things, and it was hard to do that. You can’t delegate a feel of a baby about whether or not they’re ready for you to put the second leg over.”
Nethery transitioned her clients to other trainers, sold her racing tack, and made horses a hobby. Without the 24/7 schedule of the racetrack, she had time to pursue new interests. She completed an Ironman triathlon in 2015, and as she says, “You really only need to do one Ironman.”
She went to work for medical financial consultant High Speed Alliance as the chief operating officer in 2017 and moved to Huntsville, Alabama. She got into criterium bike racing, in which competitors race on pavement in a drafting line, usually around a town square before sprinting at the end.
Last summer, Nethery was training for a race with a group, using a borrowed bike. She noticed the bike wasn’t shifting properly but powered through until it was her turn to sprint. The chain broke, tangled in the back wheel, stopping the bike and pitching Nethery in a “very spectacular” cartwheel before she faceplanted onto the concrete. Her helmet protected her from a serious head injury, although she did come away with broken teeth and a black eye. The most devastating injury resulted from landing on her elbow. The impact dislocated her shoulder and pushed her upper arm backwards and upwards against the shoulder socket. Surgeons said in most cases, the rotator cuff would’ve torn as part of that motion, but because Nethery’s didn’t, the force broke off the greater tuberosity of the humerus—the bony bump at the top of the upper arm bone.
“Not funny at all, by the way,” Nethery joked of the injury’s name. “Total misnomer. 0/10 would not recommend.”
Emergency room physicians reset the dislocation, but due to the complex nature of the fracture, they were reluctant to do more than put the arm in a sling. They advised Nethery to seek out her own orthopedic surgeon whenever she could get an appointment and not to be too ambitious. They told her she’d lose the ability to raise the arm fully; no more climbing, no more swimming, and working with horses could be in doubt too, if she went the safe route and let a surgeon put in a plate and screws.
But Nethery wasn’t ready to give up.
“I was really aggressive about, ‘I need radiographs and the MRI images now. Put them on a disk,’ ” she said.
The first surgeon she saw wanted to open up her arm and make a plan once he could see the injury more closely. Nethery, who knew she had 14 or 15 pieces of bone floating around the site of the fracture, wasn’t comfortable with the notion of winging it. She emailed her images to doctors around the country, looking for someone who could repair the damage to her arm without using a plate and screws. And there was another catch—her fall happened in early July, and by July 21 she needed to be on a plane to Peru to coach the Canadian pentathlon team in the 2019 Pan American Games.
After an extensive search, Nethery connected with Dr. John Kuhn, director of sports medicine and shoulder surgery at Vanderbilt University Medical Center (Tennessee). Kuhn used a type of exoskeleton-like mesh that would hold the fragments in place until they could heal. Nethery explained the mesh was originally used to help with Achilles tendon tears and is being adapted to other high mobility injuries as well.
“It was really scary for a long time because the surgeon couldn’t say it would be 100 percent,” she said. “They don’t see these fractures very much, and this one was really bad.”
Nethery remembers Kuhn telling her, “I know I put you back together, but I’m only 30 percent of it. You are 30 percent of it, and your physical therapist [John Goltz] is 30 percent of it. If you don’t want it really bad, and you’re not compliant with what your PT says, it’s not going to work.”
After surgery, Nethery did her exercises religiously. Her post-operative pain was significant, but when she got discouraged, she would get out in the sun and walk up the steepest hill she could find. She read that the use of muscles in one arm will stimulate parasympathetic nerves in the other without moving it, so she exercised her good arm. She spent eight weeks in a brace that kept her arm 90 degrees out from her body and coached her team from the sidelines in late July.
Nethery was climbing one-handed before her first follow-up and was back in the saddle three months later, taking her horse Tarzan novice at the Middle Tennessee Pony Club Horse Trials. Nethery found riding horses was the easiest of her sports to return to since it requires such focus and clear communication with a partner. She left behind any notion of racing bikes on concrete, but with the help of a sports psychologist, she switched gears to racing over bike trails instead, where a fall isn’t quite as high stakes.
For Nethery, the experience is a real-life example of the old adage that differences of opinion make horse races.
“Even if it’s down to your day-to-day care, your dental care, your reproductive health, whatever decisions you’re making from a medical standpoint, they’re all just doctors practicing,” she said. “They call it practicing for a reason, I’m pretty sure. I really feel that everyone needs to stand up for themselves or have a partner or spouse or relative that will stand up for them and say, ‘That’s not what we want to do. That’s not what we have to do.’ Stand up for yourself like you would for your horse.”
Do you know a horse or rider who returned to the competition ring after what should have been a life-threatening or career-ending injury or illness? Email Kimberly at firstname.lastname@example.org with their story.