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.  

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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.  

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