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What they don’t tell you about long-term injuries

The mental health implications of rehabbing a serious injury can be as challenging as the physical ones

I have been dreaming about this 12 km route since I moved to Montreal to start my Masters degree last September. When I can’t sleep at night, I imagine what it would be like to finally reach down and stop my watch outside of my building, successfully looping around Parc LaFontaine and Lac aux Castors, seeing Strava award my longest run. 

I’m still in the early stages of rehabilitation for a lower back injury, and this 12 km sits on the things-to-think-about-later shelf in my mind. In university I was a sprinter, racing the 60m hurdles, but I’ve always used a long run to cure a bad day. 

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When I was told I had to stop running, I was crushed. 

After upwards of two years, I was finally diagnosed with a lower back injury, with two bulging discs and a plethora of secondary conditions – likely a combination of genetics and the constant impact of hurdling. I knew I had my work cut out for me to recover safely. But the physical pain associated with returning to running is nothing compared to the mental anguish of a long-term injury. 

Dr. Bruce Pinel, a mental performance consultant and a member of the Canadian Sports Psychology Association told me that when an injury doesn’t have a clear recovery time (like the average six weeks to heal a sprain), it starts to have a greater impact on your lifestyle. And although people’s processes for dealing with the emotional side of injury vary, some athletes experience profound grief. They may even follow something akin to Dr. Elisabeth Kubler-Ross’s five stages of grief: denial, anger, bargaining, depression and finally, acceptance.

“The majority of people with injuries are not elite level athletes,” Pinel says. “The majority do it [their sport] because they love it. When people suffer an injury doing something they choose to do, it’s now interfering with something you have passion for.” 

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In my case, the first stage (denial) meant believing I could just keep running, despite my injury. When it became obvious that I could not, I moved into the second stage – anger. I turned the second stage into my home and myself into a stranger. I couldn’t talk to my teammates, because I was bitter that they were healthy, and I unfollowed a number of track athletes on Instagram. I’d even take the long way home to avoid seeing my former favourite place – the track.  

After that comes bargaining, where you make promises to yourself like “If I can start running, I’ll do an hour of foam rolling every day.” Then comes depression. Pinel says, “You’ll see sociability come down, your desire to hang out with your friends comes down, your self-image comes down, your sense of identity or value structure and who you are as a person, comes down,” he says, correctly guessing that, like me, most of my friends lead active lives. “When you have an injury and have that [social group] threatened, it becomes challenging, because you aren’t able to participate the same way as before,” he says.

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This past winter, several of my friends went on a ski trip to Vermont. When I asked my physiotherapist if she thought I’d be able to ski, she laughed. So I brought my books and stayed behind to study in the chalet while my friends trekked towards the slopes. I tried to be a good sport, but that was easier said than done.

Then, finally, comes acceptance, where you learn to adapt to the situation and move forward. Of course, this isn’t a linear process, and you might bounce back and forth through stages when you encounter new challenges.

The most dangerous point of an injury, according to Pinel, is when you’re 90 per cent healed, because it’s so tempting to think you’re recovered, when you must continue to be patient. “People try to jump that gap and fail to realize that that 90 per cent took you six months,” Pinel says. “You aren’t going to get the next 10 per cent in two days.” Pinel stresses that rehabilitation is 24/7. “If you think your rehabilitation is three times a week for an hour, you’re missing the entire point,” he says. It’s not just being attentive to your physio exercises and your running form (if you’ve returned to running), but how your body moves –  all the time. 

The best way to cope was keeping myself active in new ways. I spent a lot of hours on a spin bike, started doing harder yoga flows, and squeezed in a lot of hiking. Of course, finding a counsellor to talk about your grieving process with – even if you have to shop around for the right one – is always a smart call.

Keep in mind that the stages of grief are temporary, and that even if it feels like the end of the world today, there is always tomorrow.