When stretching just isn’t enough: Acknowledging that you have an injury is the first step to recovery.
To deal with injuries and recover to full strength, you need more than just a bottle full of pills. You also have to understand the psychology of injury and how you can use it to cope with your downtime.
Most runners have a reasonable idea about what to do first when their knees moan or their hamstrings groan: Apply ice. Gulp a couple of ibuprofens. Get a massage. Maybe start some cross-training.
So why don ‘t all runners do that? Why is it that some running injuries drag on longer than a presidential election? Why do so many runners ignore the signs, disregard their better judgment, and try to continue running while injured?
When stretching just isn’t enough: Acknowledging that you have an injury is the first step to recovery.
The reason is simple. Too many runners overlook the most important part of injury recovery: the mental part. And that’s a big mistake. To make sure it doesn’t happen to you, here’s advice from a cross-section of the country’s top sports psychologists. Their experience and professional expertise gained from decades of running and training give rise to a simple, effective injury-recovery program. Follow it, and you’ll feel better when injured and return to action faster and healthier.
“Having this kind of mental road map can be extremely helpful for injured runners,” says psychologist James Prochaska, Ph.D., of the University of Rhode Island, a renowned expert on behavioral models used to help people quit smoking and lose weight. “It really helps people identify where they are on the map, where they are heading, and how to get there. It will also help you rein in your worst fears and provide reinforcement that you’re on the right path.”
So if you’re sitting there right now thinking you’re never going to heal, remember that a big key to recovery is your attitude. Make the following attitude adjustments, and get better faster.
1. Acceptance. Psychologists often say that acceptance is the most difficult step, especially if you’re talking about such things as serious illness, death, or extremely large tax bills. But hey, this is running, and your running injury is not the end of the world. That said, you still have to acknowledge the problem before you can solve it. If the pain you feel is sharp, persistent, lasts more than a couple of days, and is compromising your running, don’t ignore it, and don’t try to wish it away or run through it. Accept the fact that you are injured and move on.
2. Adherence. During your rehab, you need to show the same discipline you’ve demonstrated as a runner. If that means no running at all, so be it. If the prescription calls for physical therapy three times a week, make the appointments and do the exercises. If it’s a certain series of stretches your doctor wants you to do twice a day . . . well, then, down on the floor with you. Whatever the prescription, stick with it, even if it’s not as much fun as a leisurely 5-miler. The longer you delay, the longer you mess around, the longer until you’re back running.
3. Encouragement. Yes, it’s nice if your friends and family rally round and offer their support, but we’re talking about self-encouragement here. “Injured runners often tend to think and talk to themselves in ways that limit them,” explains psychotherapist Deborah Lee Greenslit, Ph.D., a marathoner from Paxton, Massachusetts. “If you’re constantly feeding yourself discouraging messages, it’s going to be difficult to stay with the recovery plan.”
So give yourself a pep talk now and then. “Look for some concrete evidence to substantiate your comeback capabilities,” says Dr. Greenslit. “This might be that you overcame an injury in the past or that you were able to solve other vexing problems in your life.”
Or it could simply be that you, unlike a lot of people, were able to start and stick with running in the first place. “That is a very big accomplishment, and now is a good time to acknowledge it,” she says.
Another important message you can send yourself is that you can control your situation. “Rather than say, ‘Geez, how long is this going to take?’, think about what you can do today to further your recovery,” says Dr. Greenslit. On this day, at this moment, you can make a difference. Maybe it’s a session in the gym or simply making an appointment with your doctor to get a better handle on your injury. Whatever it is, get to it. Which brings us to . . .
You’re injured. You know you shouldn’t run yet, but you also know you should take action. Check out some running-injury books, look at back issues of Runner’s World magazine, or better yet, go to www.runnersworld.com, click on “Mind & Body,” then “Injury Index.” You might also check the injuries forum on our site. Many of the veteran runners on the forum will be eager to share their experiences with you and to explain how they coped with injuries exactly like yours.
Also, dial up your coach, a veteran runner you know, or a sports medicine professional. There’s plenty of information out there about running injuries and plenty of experts who can offer informed opinions. These people and resources will help you plot your course back to healthy, pain-free running.
4. Redirection. What to do with all that pent-up energy now that you’re not running? Channel it elsewhere. Take that aggressiveness you had on the track and take it out on the elliptical trainer in the gym. Instead of pushing the pace on a tempo run, push those weights in the gym for a while. All of these activities will burn calories, make you stronger, and help maintain your fitness until you’re back on the roads. Perhaps most important, they’ll keep you from going crazy.
Another option: Redirect your energy back into the sport. Maybe this is the time to heed the perennial call from your local race director. Sign up to volunteer at a water stop, registration table, or the finish line. (Just resist the temptation to stick out your tongue at the runners because they can run and you can’t.)
“Too many runners overlook the most important part of injury recovery: the mental part.”
5. Separation-Engagement. These may sound contradictory, but they’re not. First, separation: It’s Sunday morning, and you know your regular training partners are out on a long run . . . while you’re at home, sitting around bored. You may be tempted to join them. Bad move. Peer pressure—real or imagined—is a force to be reckoned with. Chances are, you’ll be sucked into trying to keep up with them, which could aggravate your injury. Instead, separate yourself from your normal training environment. You’ll be back soon enough. Now is not the time.
But while you’re keeping your training partners at arm’s length during your injury recovery, you also need the support of others in your life to help you through.
“Be aware of the helpfulness and contributions of others in your social sphere as you move through these recovery steps,” says David Pargman, Ph.D., professor of education psychology and sports psychology at Florida State University in Tallahassee. “Stay engaged with your friends and loved ones, and ask for their support.” Just don’t dip into this well of support too often. Even your mom will get tired of hearing about your plantar fasciitis after a while. “There is a fine line between sharing with others and whining,” says Dr. Pargman.
6. Patience. This is the common thread that underlies every step thus far. “The importance of patience can’t be overemphasized,” says sports psychologist Michael Sachs, Ph.D., of Temple University in Philadelphia. “Injury recovery takes time.” Yes, it does. The diagnosis takes time. The healing effects of the icing, anti-inflammatories, and stretching take time. Getting fitted for orthotics takes time. The swelling, the microtrauma, the strains, the sprains . . . they all take time to heal and they shouldn’t be rushed.
The good news is that there’s a cure for practically every running injury, and most injuries heal with time. Unfortunately, no magic pill will instantly cure you. Nor is a simple change of shoes the likely answer. Instead, be confident that regardless of how bad your injury may seem, it’s only temporary. You will run again, if you’re patient enough to allow the healing process the time it needs.
7. Persistence. You can’t run your usual weekly miles, but you can do something every day to get your running health back. While injuries can be markedly different, most of them respond extremely well to rest and self-treatment. If there are things you can do—see a chiropractor or podiatrist, get a massage—make a point of doing them.
If all you need is a few days of icing the injury and taking anti-inflammatories, don’t get lazy and forget to do these things. Stick with the program. Make it a priority. Similarly, your injury might have resulted from a lack of flexibility. If so, be sure to do gentle stretching exercises twice a day. They aren’t as much fun as running, but they will help get you back where you want to be.
When you’re not running and burning the number of calories you normally do, you have to concentrate even harder on good nutrition. Don’t start bingeing just because you can’t run. Instead, organize a specific injury-nutrition plan that fits well into your lifestyle. Often, grazing is the best strategy—eating five or six mini-meals throughout the day. You won’t go hungry, and you can eat healthy amounts of fruit, vegetables, low-fat dairy products, and other low-fat protein foods.
Don’t attempt to diet while you’re injured. The loss of your regular exercise program is enough stress to deal with. You don’t need more stress. On the other hand, if you decide to use your extra time to learn new cooking techniques and to sample new foods, that’s a great idea. You’ll particularly enjoy the new choices when you have returned to your regular training and can eat without worrying so much about your daily calorie burn.
8. Here and Now. Focus on today. Don’t set an arbitrary deadline for when you’ll be ready to run again and then start whether you’re healthy or not. With any luck, you’ll only be out of action a few weeks, but you never know how quickly you’ll heal. An injury that took 4 days to heal last time won’t necessarily take 4 days to heal this time. The older you get, the longer it takes your body to heal.
You may also have to forget about that upcoming race (particularly if it’s a marathon) you’d planned on running. Just because you signed up for it doesn’t mean you’ll recover by then. And if your injury does heal before the race, be prepared to lower your expectations on race day.
9. Reaffirmation. Once you’re back to running—and you will be back—embrace it for all it’s worth. Savor the simple act of being able to put one foot in front of the other. Revel in the ability to run 2 miles, or 4 miles, or 6 miles pain-free. You did the hard work of recovery. Now it’s time to celebrate. One last thing before you go: Promise yourself that you won’t repeat the behaviors that got you injured in the first place.
“During your rehab, you need to show the same discipline you’ve demonstrated as a runner.”
Q : What’s the best way to avoid depression when you’re injured?
A : First, do what you need to do to get over the injury—icing, meds, stretching, strengthening, and so on. Don’t get lazy. Second, work on other areas of your fitness. Introduce a couple of new, nutritious foods into your diet, for example. Or read a great book about an inspirational athlete.
For authoritative medical and health news, you can’t do better than this Web site from the U.S. National Library of Medicine. For the latest news stories, organized by date, click on “News.”
Three things to remember about this chapter:
1. Listen to your body. You can avoid many running injuries if you’ll simply take several days of rest at the first sign of an unusual pain or soreness. You wouldn’t have the pain if something weren’t wrong, so acknowledge this as soon as you feel the first twinge or two. You know the old saying: An ounce of prevention is worth a pound of cure. This certainly applies to running injuries.
2. Injuries go away. Most running injuries resolve themselves in a week or two if you allow your body to heal itself. Take whatever time you need, and then spend a day or two walking instead of running. When you can walk without pain, you’re ready to step up to running again.
3. Learn from your mistakes. The bad news: All runners get injured eventually. The good news: Ninety-nine percent of injured runners return to healthy, pain-free running after some rest, recovery, and rehabilitation. When you get injured, make sure you understand how and why you got injured, and then plan to avoid this problem in the future.