Having been injured now for over three months and likely to be off running for another three, I thought it might be an idea to do a little piece on coping with injury for all you fellow runners and athletes out there. Let’s face it injury is part and parcel of sport. We’ve all been there and unfortunately are likely to be there again! It can be devastating when it happens, especially if you’re in top form and building up for a big event. Mind you, there really never is a good time! How an athlete copes with injury varies significantly from person to person and scientific evidence on how to mentally cope with injury is hard to find. Most of us feel anger and disappointment initially, frustration generally crops its head up intermittently during the recovery process , possibly accompanied by depression, tension and general moodiness 1 . Many , especially full-time or professional athletes suffer from a loss of identity, low self-esteem, as well as stress, anxiety, and fear of getting injured again. I’m sure most of you can relate to many of these – I certainly can! Sports psychologists seem to agree however , that the range of emotions seen with injured athletes appear similar to those seen in grief i.e. denial, anger, bargaining, depression and acceptance 2 . Not all athletes go through these stages but, take ‘denial’ for example, how many times do we see athletes consistently limping or hobbling during training, yet denying that they’re injured… “It’s just a little niggle” , until eventually it becomes so painful they are forced to rest and have probably aggravated their injury considerably by persisting! We can however , take control of our mental state when we are injured and perhaps fast-track or even avoid many of these negative emotions. Instead of wallowing in self-pity we can focus on the positives, be constructive. What can we do? Not what can’t we do! We are athletes i.e. competitive, energetic, determined, goal-focussed individuals. We can still use these qualities and come through our injury period stronger and happier than ever. We just have to change our focus!
Here are some of my tips:
Remember, it happens to everyone.
Remind yourself of all the highly successful athletes in your sport, and others, who have suffered major setbacks and come back to their sport stronger than ever. Think Tiger Woods and his amazing comebacks, most recently after two years of injuries and surgeries wondering if he’d ever play again, let alone win, going on to win the PGA tour in 2018 and the 2019 Masters! Rafael Nadal has been plagued with injuries over the years and one particularly notable comeback of his was after being off from Wimbledon 2012 until February 2013 and proceeding to make 2013 his best season, reaching the final of 13 out of 14 tournaments and reclaimed number one ranking for the first time since 2011. And very recently we had Ciara Mageean whose Tokyo Olympic campaign was derailed due to calf issues, failing to progress from the heats , then having to cut short her Indoor season this year with another calf tear, but what an outdoor season she had – double Silver in the Commonwealth and European’s 1500m, a win in the Diamond League 1500m in Brussels with big PB, running well under 4 minutes and breaking the longstanding Irish National record set by Sonia O’Sullivan, followed six days later with a second place to Olympic champion Faith Kipyegon, in the stacked, final Diamond League race in Zurich!
Make your own list and take a look at it whenever you need a boost.
Accept your situation . I have found that the sooner you accept the fact that you are injured the easier it is to move on. It is possible to avoid or fastrack through those early stages (denial , anger etc) and just accept your situation “It is what it is” and as you have already established, it happens to everyone! Relax! Sport, or exercise in general, is a major stress reliever for many. Research indicates that physical activity can have a positive effect on overall mental health, as well as both the prevention, and treatment of depression 3. While you are injured you may be more at risk of mental health issues, so it is important to find other means of staying mentally healthy, whether it be through cross-training if you can, or other forms of relaxation such as walking, cycling, yoga, meditation, mindfulness, deep breathing techniques, or whatever works for you. Remember a relaxed you is a healthier you which in turn will facilitate the healing process! Several different relaxation techniques are covered in our online Stress Management Training Course, which may also help you when you get back to competition, in coping with nerves, anxiety, focus etc. so if you feel your mental health is suffering because of your injury, now may be the time to try it; https://www.outcomecoaching.ie/outcome-coaching-stress-management-courses. Focus on the positives. It could have been worse. Remind yourselves of all the positives of your situation. Can you walk? Can you cross train? Your injury could have been more serious. You will get back to your sport eventually. Practice gratitude. Make a list of all the things you are thankful for and appreciate all the things you can do! Set some Goals. Goal setting is an integral part of competitive sport. It is now time to use these same goal setting skills in a different context i.e. your rehab and return to competitive action. Talk to the experts; your doctor, coach, physio etc and find out exactly what you need to do , get a realistic timeframe, know what resources you will need (Equipment? Pool, Gym? Extra supplements to accelerate healing? Finances to fund all this?). Once you have a realistic end goal you can break this down into mini-goals, or milestones, which makes it must less daunting. Then you work out your tactical plan. Athletes thrive on progression, and seeing progress in your rehab is highly motivational. It is important to remember to set goals in all aspects of your life. Think of the Wheel of Life ( https://www.outcomecoaching.ie/resources) and set goals for yourself in the relevant areas. Imbalances in one or more aspects of your life can have a detrimental effect on your performance. Perhaps this contributed to your injury in the first place – over training , stress and anxiety, poor diet, financial strain etc? My last blog (https://www.outcomecoaching.ie/blog ) covered the area of goal setting if you need a little reminder of how to set effective goals and the importance of balance in your life. Change your focus . As athletes, we are highly energetic and often find it hard to sit still. The focus now, however, has to be on rehabilitation and rest. I find that the rehabilitation part i.e. the physio exercises , cross training , and strength and conditioning aren’t a problem. It is the rest that I find difficult. It is unquestionable however , that rest is just as important as the rehab! If in doubt, ask a trusted expert or do a bit of reading! View it as an opportunity. What can you do now that you didn’t have time to do when training flat out? Extra cross training? Strength and conditioning? Household projects you’ve been putting on the long finger? Take a holiday or mini-break. Educate yourself on your sport or in other areas by reading, or listening to Podcasts , watching relevant videos , webinars…., doing a short course? What about your mental skills ? Can you work on some psychological training that will hone these skills so that you will come back mentally as well as physically stronger? Now is the time do these things. No excuses!! Control the controllables! Focus only on what you can control. What can I do? This is a constructive, positive and healthy approach. We can all fall into the trap of wasting time and mental energy on things we can’t control… Thoughts such as ‘what if I don’t recover’, ‘what if this injection doesn’t work’, ‘if only I hadn’t done that speed session so soon after that race, ‘I shouldn’t have listened to….’ ‘I could have…’ , What if I get re-injured as soon as I get back to action?’ . The fact is, the injury has happened and you dictate how fast or how slow you recover. Take control of your rehab, your rest, your diet, your attitude. Make a list of all the things you can control that will help you get back to action, and work on these. Tune in to your self-talk and change it when negative Your mental skills and attitude are critical when trying to cope effectively with injury. We all have that little gremlin inside our head bombarding us with negative thoughts. Have you a habit of catastrophising? Consistently blaming yourself for everything? Concentrating on your weaknesses rather than your strengths? Using negative terms like “I never”, “I Should”, I must” These are just some of the common negative thinking habits (or cognitive distortions ) that we are all guilty of to a certain extent. We can control this negativity however. Don’t let that gremlin take over! You need to listen to your thoughts and start noticing when that negativity is creeping in. You then need to refute and replace them with positive statements and beliefs. Write them down if it helps, this will reinforce the positivity Stay connected. Maintain the contact with others, both inside and outside your sporting bubble. Sport is part of your identity and you may be feeling a bit lost without it. Research highlights the huge benefit of social support during the rehab phase. Communicate your feelings i.e. make sure you avail of any emotional support you need. Don’t be afraid to vent with someone you trust, partner, friend, coach, sport psychologist, physio, family……..but vent and move on – don’t wallow in self-pity!! Maintain a routine Emulate , for example, your running training schedule with your rehab and cross training and try as much as possible to stick with a similar time schedule. YouTube, Podcasts, Social Media can prove useful. I have found YouTube particularly useful by exploring how other athletes cross train when injured. There are lots of useful videos up demonstrating a variety of cross training options and workouts, and plenty of useful tips as to how to make your cross training that bit more interesting. Podcasts and audiobooks can be great to get you through some of those less exciting workouts! So remember, it’s your choice as to how you deal with your injury. The sooner you move to the acceptance phase and plan your recovery, the sooner you’ll be back in action. Stay positive, and remember , you’re not alone! I’ll leave you with some wise words from Michael Jordon “If you’re trying to achieve, there will be roadblocks. I’ve had them; everybody has had them. But obstacles don’t have to stop you. If you run into a wall, don’t turn around and give up. Figure out how to climb it, go through it, or work around it.”
Refs.
Walker, Thatcher, and Lavallee. “Psychological Responses to Injury in competitive sport”. (2007) Elizabeth Kubler-Ross, On Death and Dying (London: Macmillan, 1969) Cooney, G. M., Dwan, Greig et al (2013). Exercise for depression. Cochrane Database of Systematic Reviews, (9) https://doi.org/10.1002/14651858.CD004366.pub6