Is an injury ever a good thing?
How can you turn an unwelcome injury that forces you to have time out of the sport you love into an opportunity? In this blog post I’ll discuss some of the common causes of, reactions to, and ways to minimise the risk of, sports-related injuries, and how to cope with them when they inevitably arise.
How do injuries happen?
Sometimes we’re just unlucky and have a traumatic event during a race or training session, or even just in our daily lives which mean we can’t exercise for a while. Most running related injuries however are due to overuse - increasing mileage or intensity too soon, not considering overall training volume (all the other stuff we do as well as running), and not having enough rest or “deload” weeks.
I’ve currently got a hamstring injury that means I can’t run at all- it just hurts too much. I did a very common thing that many athletes do when they love working out and when the hard work is being rewarded with great race results - I trained harder and harder, didn’t take enough rest when I was tired, pooh-poohed the warning signs of overtraining (weird niggles, insomnia, agitation, tiredness) and ended up with a full-blown injury that has meant taking time out for rehabilitation.
How do we react to injuries?
When you invest a lot of time and effort into improving at your sport, an injury can be devastating-not just physically, but emotionally. Sports psychologists noted that many injured athletes reacted similarly to people who had been told they had a terminal illness- following recognised stages Elisabeth Kubler Ross’s “grief model”, namely denial (it’ll go away…it’s nothing, ), anger (why me? why now? ), bargaining (I’ll never do that again if I get over this…), depression (you realise the injury is serious and feel progressively lethargic and negative) and acceptance (I’ve got to get on with life- what can I do about it?).
Of course your reaction to injury will depend on how much it means to you- if you are flexible with your training and don’t take it too seriously, you will react differently to someone who has followed a relentless high-mileage training schedule for years to achieve a sub-3 marathon and now has an injury that means they may not run again.
How to cope with injury
Have a mourning period: Have a 48-hour pity party. Wallow in the doldrums and be as obnoxious as you need to. But after this you must switch to a positive mindset, even if you’re faking it. Forcing yourself to think positively even when you’re not has been shown to help people pull themselves out of a negative funk (Garland et al., 2010).
Don’t panic! Psychological stress can interfere with the healing process by elevating heart rate and blood pressure, intensifying pain, and promoting muscle tension. It can also interfere with sleep, and it is during sleep that the body heals itself. Practise meditation and positive visualisations- the mind is a powerful thing! A recent study found that injured athletes had increased pain tolerance and positive mood, and decreased stress and anxiety following a programme of mindfulness-based stress reduction (Mohammed et al., 2018). This will undoubtedly help recovery.
Be proactive: Get a good diagnosis of your injury from a trusted health professional, and don’t be afraid to get a second opinion. Work out why your injury happened (weak glutes, anyone?) and how to recover from it (strength training!). Research your condition- this doesn’t mean consult Dr Google and diagnose yourself- get your diagnosis from a professional first! But use the internet to arm yourself with sound knowledge and see what other athletes have tried that has worked for them. Throw yourself into your rehabilitation programme, but don’t over do it and end up going backwards! Listen to the professionals. At one point last year the only exercise I was adding to my training diary was my rehabilitation programme, but it made me feel like I was still training towards something, and before I knew it I was back hitting great times on the track.
Grasp the opportunity to do other things: Although it may be hard not to run and join your friends at the club, you can still be involved in social events or help out at track sessions/support your friends in races. While you might not be able to run, you can probably do a whole host of other things. Work on your core strength and flexibility, perfect those handstands you’ve always wanted to learn, try cycling or rowing for a cardio hit to maintain your fitness. What about CrossFit? You’ll soon see your fitness weaknesses if you try a class and now have an opportunity to work on them- you might, like me, even find you prefer it to running relentlessly!
How to prevent injury happening in the first place
Keep a training diary: Note what you did, how you felt, your resting heart rate, how you’re sleeping, any strange feelings or sensations, niggles, muscle tightness. Review your entries regularly. Persistent increased resting heart rate indicate stress and could be a sign of overtraining- often a precursor to injury.
I am guilty of ignoring niggles as you can see from the entries above. I write quite openly about being sore and tired but don't always heed these huge red flags until it is too late! However it is all very useful to look back over and has really helped me deal with my injury more humbly this time round. When I look through my training diary, I can take solace in the fact that the injury I had last year that felt like it would never resolve actually only hung around for a month at most and didn’t really stop me training for that long, or hitting many unexpected great results only a few months later.
TAKE A REST! You should schedule at least one rest day a week, and every 4 weeks have a “deload” week where you decrease the volume and intensity of your training (running AND cross-training). By all means do some gentle stretching or walking on your rest day, but this is the day you let your body recover, so don’t kid yourself that you can have an easy 5 mile run in the hills, or do some weights instead of running and still count it as a rest day.
Bear in mind that training itself can become a stressor. Adding a stressful job or life event to a hard training regimen can tip the balance and lead to injuries. I experienced this during training for my second marathon- my job was stressful at the time, and training was relentless. Then my beloved horse died suddenly and traumatically, and over the following weeks I wasn’t sleeping, couldn’t hit my training paces, started to hate running and ended up injured. Sometimes we just need to cut ourselves some slack and not worry about the effect it will have on the training schedule.
Strength train: Many overuse injuries are due to congenital or occupationally- acquired problems such as weak gluteal muscles, leading to overworked hamstrings or quads, and resultant overload lower down the chain (knee-ankle-foot). Adding some specific strength training to your schedule will help injury-proof you and should help you be stronger and faster too. I could help you with that…
In the grand scheme of things, injuries come and go and are part and parcel of being an athlete- choose to see them as an opportunity for increasing your strength, fitness and knowledge in other areas, and know that you will be back at the sport you love at some point… enjoy the journey getting back there rather than focusing on the destination.
Garland, EL; Fredrickson, B; Kring, AM; DP, Johnson; Meyer, PS; Penn, DL. (2010). Upward Spirals of Positive Emotions Counter Downward Spirals of Negativity: Insights from the Broaden-and-Build Theory and Affective Neuroscience on The Treatment of Emotion Dysfunctions and Deficits in Psychopathology. Clin Psychol Rev. Published in final edited form as: Clin Psychol Rev. 2010 Nov; 30(7): 849–864. Published online 2010 Mar 12. doi: 10.1016/j.cpr.2010.03.002 Access full article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908186/
Mohammed WA, Pappous A, Sharma D. (2018). Effect of Mindfulness Based Stress Reduction (MBSR) in Increasing Pain Tolerance and Improving the Mental Health of Injured Athletes. Front Psychol. May 15;9:722. doi: 10.3389/fpsyg.2018.00722. eCollection 2018. Access full article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963333/