Coming Back From Injury
One of my weirdly favorite experiences is when I go to a new doctor, massage therapist, chiropractor, or other healthcare person, and they ask me to fill out an injury history. I look at the form, and there are somewhere between 2 and 5 spaces for listing the times I’ve limped or been carried away from some sporting environment. My dad joke for that moment is to say, “well, how much time you got!” which is both totally cheeseball and also a legitimate question given that I’m usually paying hourly and they usually have a client after me; 2 to 5 slots isn’t nearly enough. It’s not even enough for my right ankle, or my left ankle, or my shoulders, knees, fingers, or, unfortunately, my head. Being an active person and former competitive athlete have left me, at 42 years old, with the need to stretch/foam roll/lacrosse ball for a solid 25 minutes almost every evening in order to stay pain free throughout the next day.
And: Outside of a couple “stupidity injuries,” I wouldn’t change a thing.
The possibility of injury exists when we step outside of our front door in the morning. It increases significantly when we step onto a court, a field, a trail, or a mountain. More contact with other people? More likely to get hurt. Moving faster, cutting, jumping? Ouch. Oh, you want to strap on some sticks made of wood and metal, or jump on an unbalanced two-wheeled death machine, and huck yourself off the side of a mountain? Get used to pain. And yet, we still do these things. We LOVE them, can’t live without them, use them to stay sane and feel accomplished, to prove ourselves and define ourselves to the world, and I’m not even talking about the pros. Death, taxes, and if you’re an athlete, injury.
So what do we do when it happens? Speaking from experience, it can throw our world into a dark place. It disrupts our routines, arrests our progress, sets back our fitness, robs us of seasons and fun and relationships. We can feel isolated, decrepit, worthless, robbed, pissed and helpless and hopeless and deeply, tangibly, viscerally uncertain and afraid. Plus, it fucking hurts! Most of all, it can put us face to face with an existential crisis: Who am I without my sport?
Before we go further, I want to distinguish between hurt and injured. Most athletes will say that they can play hurt; most athletes will feel that they can contribute, compete, help the team. When we as fans see an athlete “sacrificing their body,” we celebrate their courage and dedication to the team. All athletes play hurt at some point; many athletes play with small hurts most of the time. And, the line between hurt and injured is blurry. There is a saying: “You can play hurt,” the implication being that only something acutely serious is a reasonable excuse for not going out there and putting it on the line “for the team.” I used to buy into that ideal; now, I’m really not so sure. If I’m hurt, when does it cross over into injury? When do I become a detriment to the team if I play? Am I putting myself at unacceptable risk for further damage? What even is “acceptable” when it comes to my health?
I don’t have the answers, because the line for each person is different. I do know - from experience - that the expectation that athletes will play hurt is a slippery, slippery slope with some sharp rocks at the bottom. Ok, let’s continue.
The concept of “athletic identity” may be unfamiliar to you, but if you’re an athlete, you most likely include that – maybe very early on – in the list of what makes you, you. When we lose the ability to play or perform or participate, that identity is deeply challenged or even (usually temporarily) lost. When we lose this (big) piece of ourselves, it can be more devastating than the physical injury itself. A knee can heal; what about my soul? There are things we can do to help ourselves come back stronger physically AND mentally and emotionally:
1. The first is to let ourselves feel what we’re feeling for a little while. The devastation, sadness, fear, uncertainty, and grief that comes with a serious injury are very real and powerful and 100% valid emotions that will both eat away at us and detract from our recovery if we bottle them up. So, feel your feelings.
2. Then, at some point, you will have to make a decision about what to do next. I recommend taking in the medical information that you get from the professionals and letting it marinate for a minute. Weigh your options, ask a lot of questions, and don’t be afraid to go see someone else or get a second opinion if you’re not getting objective advice or compassionate support. Trust your intuition.
3. What are your goals? For me, it was “getting back on the court and playing at a high level no matter what” after my ACL and meniscus in 2010 (what I learned about myself and the game of basketball along the way in that process has obviously proven more useful than the physical gains). What are you hoping to accomplish in your recovery? This depends on your age, fitness, level of play pre-injury, and the seriousness of the injury. Your process is unique to you, so really take some time to line these goals out (HINT: A mental performance specialist can help you).
4. Make a plan. Surgery? PT? Counseling? Adjusting your workout regimen to create more balance? What’s it going to take? How committed are you? How much time do you realistically have? For professionals, it is literally their job to recover. Most of the rest of us don’t have that luxury, so what’s real?
5. Collaborate. Despite the loneliness that we feel when injured, we are not alone; there’s always another person – or more likely, a whole bunch of them – who’ve been where you are and can help support you. Also, who’s your inner circle? Who can you absolutely lean on for that support? Who’s on your care team? Who’s your community? Who’s your workout buddy?
6. Participate. Whatever you can do with your team (if that’s your thing), do it. Go to practice, help the younger players, pick the coaches’ brains, study the playbook. Or, if you’re an adventure sport person, go be outside. Even if you can’t fly down that mountain, you can breathe the air, smell the grass and trees, connect with Nature. A note here: If you have a concussion, the protocol is different. This is often called the loneliest injury, because much of the early recovery involves silence, darkness, and being away from all stimuli, including people. If you’re in this boat, try to have patience, reach out when you can, and honor your recovery needs.
7. Evaluate. This is perhaps the most important part. What’s the opportunity here? What can you learn? How can you grow and evolve and adapt through the process of this recovery and comeback? Where are the small victories? How can you become more resilient, mentally fit, emotionally intelligent and flexible? ALSO: Ask self-reflective questions. What else defines me? Who else am I? Or, who am I really? The relative impermanence of sport demands that we eventually expand our self-evaluation. Getting a jump start on this process will help you come back with a more resilient, adaptable, and opportunity-focused mindset.
8. Keep a journal. It’s a great way to track your progress, record your thoughts, and celebrate your milestones and small (and big) victories.
9. Have patience. My sister calls this the “P-word,” and I’m fairly certain that she views it as the worst of all the bad words. It’s hard to find, harder to maintain. But if you want to rehab right, to come back better and healthier and stronger and a more dynamic version of yourself than you were before, you have to give it time. Not the sitting around waiting kind of time, but the methodical, committed, intentional time that it takes to heal.
This list isn’t exhaustive, complete, or even the only one out there. If you’re looking for a few excellent reads about the athletic identity, mindset, and/or recovery, here are four of my favorite books:
The Mindful Athlete by George Mumford
The Subtle Art of Not Giving A Fuck by Mark Manson
Atomic Habits by James Clear
Rebound by Carrie Jackson Cheadle and Cindy Kuzma.
For personalized help with the post-injury comeback, I’d recommend finding and getting together to work with someone in the sport psych field who understands injury, and then have the courage to look inward as you begin the journey forward to your sport. Hang in there.