Accepting Injury

I've spent more days like this than I care to mention.

I’ve spent more days like this than I care to mention.

It’s been a few weeks since my last entry.  Well really it’s been a few months.  On Sept 22 – 23 at the Georgia Jewel 100 I injured or aggravated the heck out of my IT band.  I was out for the entire month of October.  During that time I was consumed with the fact that I was injured, spending every waking thought on finding some means to recover in time for my “A” race of year in early November.

A quick Google search on injuries & running will return a multitude of lists and articles describing the five mental states of an injury: Denial, Anger Bargaining, Depression, and Acceptance.  The articles read as if each phase has a concrete start and end and, once through, one does not return to a previous realm of mental anguish.  In reality, the injured person moves back and forth from one stage to another, like waves on a beach.  Progress is made; setbacks happen.  One day the runner has accepted the injury and the next he or she is wallowing in despair – days pass vacillating between denial and reality, anger and compassion, bargaining and demands, depression and hope.

I learned something from my time on the couch:  Acceptance is your best friend.

Denial starts before the injury – maybe discounting the ‘twinge’ or that feeling that something ‘just isn’t right’ and continuing to train, perhaps even for weeks prior to the injury.  In my case, I had some IT band tightness just as I started my taper but, instead of seeing someone or using the roller, I assumed it would heal before the race.  High mileage runners are going to have some aches and pains, and for every one that turns into an injury the runner will have a hundred more that don’t.  The point is to recognize that there is not a way to tell if what you are feeling is a precursor to an injury or just another ache.

Injury brings depression.  It is as much a part of the recovery process as swelling and ice. There were days I felt like I was on the verge of tears, beating myself down for causing the injury and missing my race.  Daisy-chained to depression are guilt and shame, for being so self-absorbed and missing the time I now have with my family.  My advice? Ignore things that minimize what you are feeling.  Skip articles that talk about looking on the bright side.  These suggestions miss the point, failing to understand the importance the sport plays in our lives.   A better approach is to accept the self-absorption and the depression.  They will clear in their own time. Accept the process. Think about it as a race and just get to the next aid station.

An injury shows you who loves you…well, who likes you enough to stick around.  My mouth ran nonstop about my injury and I managed to turn every social interaction back around to me.  For the folks on the periphery it’s not such a burden, but for those on your inner circle it’s a much bigger deal.  I’d open my mouth to say one thing and out would come something about my knee.  I apologized to my wife and kids over and over again.  I just needed to talk.  It’s OK.  Your friends and family will understand.  They want to help.

Getting a Cortisol injection into my knee

Getting a Cortisol injection into my knee

Depression breeds Anger. I was always on that edge of snapping out, and my temper was pretty short. I had to work really hard to not take it out on everyone around me. As for Bargaining, once I agreed that I was actually injured, the most bargaining I did was with myself.  I would read up on physical therapy exercises and do them to exhaustion.  By the injured runner’s math if it takes 8 weeks to heal by doing this exercise once a day, I’ll do it 4 times a day and be ready to go in two weeks.  Life does not work this way.  With healing, often less is more.

Lastly, get some help.  All my blabbing about the injury lead a running friend to suggest ART (Active Release).  I had tried stretching, RICE, massage, strengthening, and cortisone injections.  Nothing helped.  I started working with an ART therapist known in the local running community, which worked wonders. I improved quickly. While I did not improve enough to participate in my “A” race, having a therapist knowledgeable with the physiology of running (and with running long distances) helped me address the root cause of the problem.  After a month, he has been able to make subtle changes to my running form and I am back out on the trail with my sights set on a 24hr run in Dec and a 100k in Jan.

So Like I said Acceptance is your best friend, but I am by no means a master. I suffered mentally for weeks about my injury and fully expect to do it all over again the next time.  I just hope I learned a little something this time around that will make the next time a bit easier.

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