Injuries, injuries, injuries

It’s raining here today – great for the garden and a fair reflection of what my current mood had been over the last 3 days.

I picked up a left calf niggle last Wednesday, finished my run and felt tightness in my calf that triggered a memory of something very similar when deep in training for Boston this March. I then spent time considering what to do, how to manage and where to go with this. I made the decision to not run on Thursday, as a preventative measure. This was the sensible decision and one (which is so common amongst runners / cyclists / active people) that I then went back on by Thursday evening. I decided to trial a 15 minute workout I was interested in giving to athletes. 5 mins in the messages from my left calf where clear – IF YOU CARRY ON I’LL TEAR AND YOUR LEG WILL BE FUCKED. So I stopped, as the last time I ignored that message it resulted in me being unable to run, 6km away from home and having to get Jen to come and pick me up – which she was more than willing to.

I then went through the process of being slightly frustrated / annoyed / confused as to why it had happened (it was on a side of my leg that was feeling strong and seemed to have no reason to go). I sat down and then reviewed my training, using previous ideas and guides to help me gain some control over what was to come – I guess the future offering more hope than the present.

3 days of unhappiness and internal grumbling done I’m more at peace with what has happened and have been thinking about the various things that help me when I’m injured. What I’ve settled upon – and writing this is as much as anything a check list for me in how to deal with injuries – is the following:

1. Injuries are inevitable – if you move a lot, push your body, wear different shoes, play with your movement at some point you are going to get hurt. The why’s / ins / outs may be clear, may not be clear. Ultimately it doens’t matter at the point of injury. It has happened, you get hurt and this is a message to listen to. Your body was trying to keep you safe and it couldn’t cope with what you asked of it.
2. Where you are hurt may not be what you need to look at next – We are closed loops, unless you slip / fall / hit something more often than not what you hurt has been doing the work of something else. What isn’t carrying the load is as important to understand as what has broken down.
3. Injuries heal in 2 parts – Firstly the injured area in the body heals, then it strengthens. Loading needs to take this into account. Achilles strained – let the tendon heal before putting huge load back through it, otherwise you’ll break the newly mended area and this more frustrating than the first impact.
4. With point 3 above in mind how can you move & safely load an area of the body whilst it is healing. Doing nothing isn’t going to help something heal. This is a time for positive adaptations. Non weight bearing exercise can be key here, as can strength work (especially with running injuries). If something in the lower legs this is a chance to change tack, maintain and build aerobic fitness whilst you have to let your injury heal. By the time it is ready to go again fitness is still there if not improved. Think – what can I now do as opposed to what I can’t do, a short cut to resentment & alienation from your own body.
5. On that note the body will heal, it is incredibly resilient and left to it’s own devices will get everything back to full working order. With that in mind we can either support and foster that healing process by mobilising / investigating what moves too much or too little / gently strengthening and progressively loading the area OR we go in the other direction of doing far too much too soon & putting yourself further back than the initial injury or do absolutely nothing and draw the healing process out – potentially reinforcing avoidance of what caused the injury in the first place.
6. There is a huge amount of advice to be had around specific recovery protocols. Ask a range of people for advice and you’ll more than likely get a wide and varied response – some of which will contradict other pieces of advice. Some of it will be right for you, some not. Some of it will be supported with anecdotal evidence, some with science and some with nothing. I like to use advice that I can see has support in various different realms (anecdotal, science, a professionals feedback) as this feels more likely to suit me. Once I have settled on the course of action to take I’ll then stick to following this regularly. I have been told by more than one physio that the biggest hurdle they see in recovery is people just not doing the rehab consistently – or at the first sign of improvement (so healed but not strong) they jump ahead and get re-injured. So decide on how to get back to running and then stick to this – simple but not easy.
7. Allow some grief / sorrow for the injury for a short period of time. If there was no sadness there would have been no sense of loss of what you enjoyed doing. However don’t wallow in this. Frustration causes stress / anxiety and this is counter productive in allowing the body to heal. I’ve found meditating on the specific body part I want to heal a really helpful way of engaging with my injury and drawing my bodies attention to where I want blood to flow, to help accelerate healing.
8. Pain is a valuable message – as you heal listen to this, as opposed to trying to block all and any pain out. Pain that stops sleep is never good and I can understand why people would want to avoid this. And we all have different pain thresholds, some people far more able than others to withstand pain. However I know of too many people who reach for painkillers at the slightest ache, trying to block it out and ignore the pain. Reframing pain as neither good nor bad, but physical feedback letting you know what you can & can’t do is invaluable in my mind. When looking at progressive loading of an injured area how can you know how much is too much if you’ve blocked your pain receptors with medicine? How can you tell where your healing is if you never listen to the signals your body is giving you on the road to recovery? Use the feedback your body gives you to build your rehabilitation.
9. What was I doing in the weeks leading up to the injury? Is there a pattern I am ignoring? Is there something I need to change / avoid / adapt to help me move when fully fit again? A good example for me would be hill sprints & not enough time (minimum 2 days) between harder sessions to be aware of. An injury is a time to learn, to move forwards. Something failed – if you don’t use the learning opportunity this presents there is a higher chance it will happen again.
10. When you heal and are back to exercising again (running in my case) enjoy it, don’t take it for granted. Look at every session / run as a blessing to be embraced and enjoyed. This is why – I guess – so many of us grieve when we do get injured. Which is why it is so key to really, really love the chance to run / move when you get to do it fit and injury free.

I’ll no doubt think of other things that I believe are important for injuries. For the moment these seem upper most in my mind. Maybe I’ll add to the list as I go. Hopefully I won’t have to come back and read this for quite some time.