The Psychology of Injury

I've had injuries before but nothing quite like this one.  There seems to be more of grey area, more "wait and see" with this vs. other things I've had.  Probably because it's joint related and joints are finicky creatures.  I have a difficult time with grey areas.  I like action, I like answers, I like forward progress.  I'm not a big fan of "let's wait and see" and I think that's why I'm struggling with this injury so much.  There is no concrete timeline as to when I'll be able to start regularly running again.  My body will let me know when it's ready and I can't rush it. 

Did I mention that patience is not one of my strong points?

Suffice to say this injury is doing a number on my head.  Yes, I have good days where I can run up and down stairs pain free, where I can swim without my patella strap and ride my bike but none of these are a substitute for getting outside and running.  I've even had a couple of short, slow pain free runs, which is a small miracle.  Of course I have bad days where I question if I'm ever going to be able to run fast again and I start to wonder if this is going to be something I deal with for the rest of my life.  I then think about how hard I worked to get to the level I was at and how it's all slipping away and I end up in a big puddle of tears like I did the other day.  I know I'm going to have bad days but the trick is to try to turn them around.  Or, at the very least, not let them get so bad that I'm a blubbering mess. 

I've been doing a fair bit of reading on the psychology of sports injuries in the hopes of finding some techniques or advice to help me get through this.  I've experienced a wide range of emotions ranging from frustration to sadness to anger.  Some of the things I've read say that an injured athlete can actually experience 5 stages of grief:  denial, anger, bargaining, depression, acceptance and re-organization.  I'd definitely say I've experienced a few of these things over the last few months.  I feel like I've almost made it to the acceptance and re-organization part.  My injury journal has helped.  It helps me keep track of what I've been doing and when I have pain so I know what I can and cannot do.  Some days there doesn't seem to be any rhyme or reason as to why my knees hurt but if I look back, I can usually find something.  I've actually had to eliminate a pair of jeans (skinny jeans with no lycra, what the heck was I thinking?!?)  and shoes from my wardrobe rotation right now because they both bothered my knees.  This has helped keep my head in check somewhat and it also serves as a reminder NOT to do something.

Another thing I experienced early on was anxiety and fear due to the expectation of pain.  I would dread walking down stairs because I knew that it would hurt so I started to adjust the way I went down stairs.  The same thing would happen when I started running - I would change my gait until my knees stopped hurting.  That was one of the many things that finally drove me to get myself checked out.  I'm sure that just added to my issues.  Nothing like a little compensation to throw things even more out of whack.  I've also become almost hyper aware of pain.  I notice every single little twinge or niggle in my knees.  It's almost like I'm in permanent taper mode but without the excitement of an impending race.  It's not terribly pleasant.  It is, however, making me much more aware of my body, how I'm moving and what is happening (or not happening in some cases).

Most injured athletes know that a certain amount of physical work is required to rehab an injury.  Rehabilitation work is often tedious and somewhat boring but it is a necessary evil on the road to recovery.   What a lot of people don't think about is the mental aspect of rehab.  An injury can mess with your head big time.  You worry about losing fitness and gaining weight (oh hello tighter than normal pants and slowly atrophying legs)  You lack an outlet for stress relief so you become a bit more irritable.  You lose your mojo.  Running is so much a part of me that I feel more than a little lost without it.  It's my ME time.  It's time for me to get lost in my thoughts, to work through a problem or to unwind from a stressful day.  Or come up with a blog post or two.  I've had some of my best ideas / stories come to me in the middle of a run.  And, as you can see, my blog has become a bit quieter since I haven't been out there pounding the pavement.

One of the most important things to do according to what I've been reading, is to stop negative thoughts and replace them with positive ones, which is much easier said than done.  Positive self talk is important in not only in every day life but especially when dealing with the diminished self confidence that arises from an injury.  Instead of worrying if I'll ever run again, I need to focus on what I'm currently doing to get better.  Focus on the positive things that you can control.  I am doing my exercises every day and while things may be slow going, I am seeing progress.  I have to remind myself of that when I start to get down on myself.

I'm doing my best to listen to my body and not set a deadline for anything in regards to my return to regular running.  I go out and test the waters every so often to see if I'm making progress and my body lets me know when I've overdone it.  I was lucky enough to have two pain free runs this week and I tried for a third but that seemed to be a bit too much.  All three were short and they were slow but they were better than nothing.   I'm slowly accepting that this is going to be my new reality for a while.  As I like to say, even a slow run is better than NO run.